可切除性肺大细胞神经内分泌癌的CDX2表达及预后因素

CDX2 Expression and Prognostic Factors of Resectable Pulmonary Large Cell Neuroendocrine Carcinoma.

作者信息

Mori Ryo, Yamashita Shin-Ichi, Midorikawa Kensuke, Abe Sosei, Inada Kazuo, Yoneda Satoshi, Okabayashi Kan, Nabeshima Kazuki

机构信息

Department of General Thoracic, Breast and Pediatric Surgery, Faculty of Medicine, Fukuoka University, Fukuoka, Japan.

General Thoracic and Breast Surgery Center, Fukuoka University Chikushi Hospital, Chikushino, Japan.

出版信息

Clin Med Insights Oncol. 2020 Nov 26;14:1179554920967319. doi: 10.1177/1179554920967319. eCollection 2020.

DOI:10.1177/1179554920967319

PMID:33293882

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7705386/

Abstract

BACKGROUND AND AIM

Pulmonary large cell neuroendocrine carcinoma (LCNEC) is a rare neoplasm, and its clinical features and management are still limited. We evaluated the clinicopathological factors, including CDX2 immunohistochemical expression, to predict survival in patients with LCNEC.

PATIENTS AND METHODS

In all, 50 patients with LCNEC who underwent surgery at 4 institutes between 2001 and 2017 were included. Clinicopathological characteristics were evaluated for prognostic factors and statistically analyzed by Kaplan-Meier curve with a log-rank test or Cox regression models. We used immunohistochemical (IHC) analysis to determine the expressions of CDX2 and compared them with clinicopathological factors and survival.

RESULTS

Sixteen of the 50 cases (32%) were CDX2 positive. No correlation was found between the CDX2 expression by IHC and clinicopathological factors. Multivariate analysis identified adjuvant chemotherapy (hazard ratio [HR] =2.86, 95% confidence interval [CI] = 1.04-8.16, = .04) and vascular invasion (HR = 4.35, 95% CI = 1.21-15.63, = .03) as being associated with a significantly worse rate of recurrence-free survival.

CONCLUSION

CDX2 was expressed in 1/3 of LCNEC but not associated with prognostic factor. Adjuvant chemotherapy and vascular invasion were associated with a negative prognostic factor of LCNEC.

摘要

背景与目的

肺大细胞神经内分泌癌（LCNEC）是一种罕见肿瘤，其临床特征及治疗方法仍有限。我们评估了包括CDX2免疫组化表达在内的临床病理因素，以预测LCNEC患者的生存率。

患者与方法

纳入2001年至2017年间在4家机构接受手术的50例LCNEC患者。评估临床病理特征以寻找预后因素，并通过Kaplan-Meier曲线及对数秩检验或Cox回归模型进行统计学分析。我们采用免疫组化（IHC）分析来确定CDX2的表达，并将其与临床病理因素及生存率进行比较。

结果

50例病例中有16例（32%）CDX2呈阳性。IHC检测的CDX2表达与临床病理因素之间未发现相关性。多因素分析确定辅助化疗（风险比[HR]=2.86，95%置信区间[CI]=1.04-8.16，P=.04）和血管侵犯（HR= 4.35，95%CI=1.21-15.63，P= .03）与无复发生存率显著降低相关。