Pasala Uma Jyothi Swaroopa, Hui Monalisa, Uppin Shantveer G, Kumar N Narendra, Bhaskar K, Paramjyothi G K
Department of Pathology, Nizam's Institute of Medical Sciences, Hyderabad, Telangana, India.
Department of Pulmonology, Nizam's Institute of Medical Sciences, Hyderabad, Telangana, India.
Lung India. 2021 Mar-Apr;38(2):134-138. doi: 10.4103/lungindia.lungindia_482_19.
Pulmonary neuroendocrine tumors (NETs) comprise a spectrum of tumors ranging from indolent to highly aggressive neoplasm. This study aims to study the clinicopathological and immunohistochemical features of NETs and assess the sensitivity of various IHC markers.
All consecutive cases of pulmonary NETs diagnosed from January 2016 to June 2019 were analyzed retrospectively. The routine hematoxylin- and eosin-stained sections along with immunohistochemistry (IHC) slides were reviewed. IHC was done using a panel of markers which included synaptophysin, chromogranin, CD56, thyroid transcription factor-1 (TTF-1), p-40, napsin-A, and ki67.
Of total number of 53 patients, diagnosis was made on biopsy in 40 patients and resection specimen in 13 patients. Small cell lung carcinoma was the most common (31 cases), followed by 16 cases of typical carcinoid, 5 cases of atypical carcinoid, and 1 case of combined SCLC. Both synaptophysin and chromogranin were positive in all the cases of typical carcinoid. Synaptophysin had better sensitivity than chromogranin in atypical carcinoid and small cell carcinoma. CD56 was positive in 8 out of 9 cases done. TTF-1 was negative in all the cases of typical carcinoid. The sensitivity of TTF-1 in small cell carcinoma was 85.19%. The mean Ki67 labeling index was 1.4%, 6.6%, and 65.6% in typical, atypical carcinoid, and small cell carcinomas, respectively.
Synaptophysin was more sensitive than chromogranin, especially in atypical carcinoid and small cell carcinoma. TTF-1 along with high Ki67 differentiates small cell carcinoma from carcinoid.
肺神经内分泌肿瘤（NETs）包括一系列从惰性到高度侵袭性的肿瘤。本研究旨在探讨NETs的临床病理和免疫组化特征，并评估各种免疫组化标志物的敏感性。
回顾性分析2016年1月至2019年6月诊断的所有连续性肺NETs病例。复习常规苏木精-伊红染色切片及免疫组化（IHC）玻片。免疫组化使用一组标志物，包括突触素、嗜铬粒蛋白、CD56、甲状腺转录因子-1（TTF-1）、p-40、 napsin-A和ki67。
53例患者中，40例通过活检确诊，13例通过切除标本确诊。小细胞肺癌最为常见（31例），其次是16例典型类癌、5例非典型类癌和1例混合性小细胞肺癌。所有典型类癌病例中突触素和嗜铬粒蛋白均为阳性。在非典型类癌和小细胞癌中，突触素的敏感性高于嗜铬粒蛋白。9例检测病例中有8例CD56呈阳性。所有典型类癌病例中TTF-1均为阴性。TTF-1在小细胞癌中的敏感性为85.19%。典型类癌、非典型类癌和小细胞癌的平均Ki67标记指数分别为1.4%、6.6%和65.6%。
突触素比嗜铬粒蛋白更敏感，尤其是在非典型类癌和小细胞癌中。TTF-1与高Ki67有助于将小细胞癌与类癌区分开来。
