Synaptophysin、Chromogranin 和 CD56 在缺乏神经内分泌分化形态特征的肺腺癌和肺鳞癌中的作用：一项针对 1170 个组织样本的回顾性大规模研究。
Role of Synaptophysin, Chromogranin and CD56 in adenocarcinoma and squamous cell carcinoma of the lung lacking morphological features of neuroendocrine differentiation: a retrospective large-scale study on 1170 tissue samples.
机构信息
Department of Hematology, Oncology and Rheumatology, University Hospital Heidelberg, Heidelberg, Germany.
Institute of Pathology, University Hospital Heidelberg, Im Neuenheimer Feld 224, Heidelberg, Germany.
出版信息
BMC Cancer. 2021 May 1;21(1):486. doi: 10.1186/s12885-021-08140-9.
BACKGROUND
Synaptophysin, chromogranin and CD56 are recommended markers to identify pulmonary tumors with neuroendocrine differentiation. Whether the expression of these markers in pulmonary adenocarcinoma and pulmonary squamous cell carcinoma is a prognostic factor has been a matter of debate. Therefore, we investigated retrospectively a large cohort to expand the data on the role of synaptophysin, chromogranin and CD56 in non-small cell lung cancer lacking morphological features of neuroendocrine differentiation.
METHODS
A cohort of 627 pulmonary adenocarcinomas (ADC) and 543 squamous cell carcinomas (SqCC) lacking morphological features of neuroendocrine differentiation was assembled and a tissue microarray was constructed. All cases were stained with synaptophysin, chromogranin and CD56. Positivity was defined as > 1% positive tumor cells. Data was correlated with clinico-pathological features including overall and disease free survival.
RESULTS
110 (18%) ADC and 80 (15%) SqCC were positive for either synaptophysin, chromogranin, CD56 or a combination. The most commonly positive single marker was synaptophysin. The least common positive marker was chromogranin. A combination of ≤2 neuroendocrine markers was positive in 2-3% of ADC and 0-1% of SqCC. There was no significant difference in overall survival in tumors with positivity for neuroendocrine markers neither in ADC (univariate: P = 0.4; hazard ratio [HR] = 0.867; multivariate: P = 0.5; HR = 0.876) nor in SqCC (univariate: P = 0.1; HR = 0.694; multivariate: P = 0.1, HR = 0.697). Likewise, there was no significant difference in disease free survival.
CONCLUSIONS
We report on a cohort of 1170 cases that synaptophysin, chromogranin and CD56 are commonly expressed in ADC and SqCC and that their expression has no impact on survival, supporting the current best practice guidelines.
背景
突触素、嗜铬粒蛋白和 CD56 被推荐用于鉴定具有神经内分泌分化的肺肿瘤。这些标志物在肺腺癌和肺鳞状细胞癌中的表达是否是一个预后因素一直存在争议。因此，我们回顾性地研究了一个大样本队列，以扩大缺乏神经内分泌分化形态特征的非小细胞肺癌中突触素、嗜铬粒蛋白和 CD56 作用的数据。
方法
我们组建了一个由 627 例肺腺癌（ADC）和 543 例缺乏神经内分泌分化形态特征的鳞状细胞癌（SqCC）组成的队列，并构建了组织微阵列。所有病例均用突触素、嗜铬粒蛋白和 CD56 染色。阳性定义为>1%的肿瘤细胞阳性。数据与临床病理特征相关，包括总生存和无病生存。
结果
110 例（18%）ADC 和 80 例（15%）SqCC 的突触素、嗜铬粒蛋白、CD56 或其组合阳性。最常见的阳性单标记是突触素。最少见的阳性标记是嗜铬粒蛋白。≤2 种神经内分泌标志物的组合在 2-3%的 ADC 和 0-1%的 SqCC 中阳性。在 ADC 中，神经内分泌标志物阳性的肿瘤在总生存方面无显著差异（单因素：P=0.4；风险比 [HR] = 0.867；多因素：P=0.5；HR = 0.876），在 SqCC 中也无显著差异（单因素：P=0.1；HR = 0.694；多因素：P=0.1；HR = 0.697）。同样，无病生存也无显著差异。
结论
我们报告了一个由 1170 例病例组成的队列，突触素、嗜铬粒蛋白和 CD56 在 ADC 和 SqCC 中常见表达，其表达对生存无影响，支持当前的最佳实践指南。
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