Raso Maria Gabriela, Bota-Rabassedas Neus, Wistuba Ignacio I
Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.
Cancers (Basel). 2021 Feb 16;13(4):820. doi: 10.3390/cancers13040820.
Lung cancer is consistently the leading cause of cancer-related death worldwide, and it ranks as the second most frequent type of new cancer cases diagnosed in the United States, both in males and females. One subtype of lung cancer, small cell lung carcinoma (SCLC), is an aggressive, poorly differentiated, and high-grade neuroendocrine carcinoma that accounts for 13% of all lung carcinomas. SCLC is the most frequent neuroendocrine lung tumor, and it is commonly presented as an advanced stage disease in heavy smokers. Due to its clinical presentation, it is typically diagnosed in small biopsies or cytology specimens, with routine immunostaining only. However, immunohistochemistry markers are extremely valuable in demonstrating neuroendocrine features of SCLC and supporting its differential diagnosis. The 2015 WHO classification grouped all pulmonary neuroendocrine carcinomas in one category and maintained the SCLC combined variant that was previously recognized. In this review, we explore multiple aspects of the pathologic features of this entity, as well as clinically relevant immunohistochemistry markers expression and its molecular characteristics. In addition, we will focus on characteristics of the tumor microenvironment, and the latest pathogenesis findings to better understand the new therapeutic options in the current era of personalized therapy.
肺癌一直是全球癌症相关死亡的首要原因，在美国，无论男性还是女性，肺癌都是新诊断癌症病例中第二常见的类型。肺癌的一种亚型，小细胞肺癌（SCLC），是一种侵袭性、低分化的高级别神经内分泌癌，占所有肺癌的13%。SCLC是最常见的神经内分泌性肺肿瘤，在重度吸烟者中通常表现为晚期疾病。由于其临床表现，它通常在小活检或细胞学标本中通过常规免疫染色来诊断。然而，免疫组化标志物在显示SCLC的神经内分泌特征和支持其鉴别诊断方面极具价值。2015年世界卫生组织分类将所有肺神经内分泌癌归为一类，并保留了先前认可的SCLC混合亚型。在本综述中，我们探讨了该实体病理特征的多个方面，以及临床相关免疫组化标志物的表达及其分子特征。此外，我们将关注肿瘤微环境的特征以及最新的发病机制研究结果，以便在当前个性化治疗时代更好地理解新的治疗选择。
