Division of Pathology, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, Sendai, Miyagi, Japan.
Department of Pathology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan.
Pathol Int. 2021 Oct;71(10):682-691. doi: 10.1111/pin.13149. Epub 2021 Jul 28.
Prostatic and colon carcinomas with neuroendocrine differentiation are reported to behave more aggressively than those without such differentiation. In hepatocellular carcinomas (HCCs), however, only a few studies have reported the expression status of neuroendocrine markers and somatostatin receptor 2, the main target of a somatostatin analog. Furthermore, the prognostic significance of the markers in HCCs has not been fully explored. We evaluated the expression of the neuroendocrine makers (chromogranin A, synaptophysin, and CD56) and somatostatin receptor 2 (SSTR2) in 95 HCCs, and investigated the correlation between the expression of these markers and clinicopathological findings. Chromogranin A was immunolocalized in 2 cases, synaptophysin in 15 cases, CD56 in 11 cases, and SSTR2 in 19 cases. Immunoreactivity of synaptophysin and CD56 were the significant unfavorable prognostic factors in terms of 2-year disease-free survival (DFS) and the overall survival (OS) along with a high nuclear mitosis level (>10/10 high-power field), a larger tumor size (>5 cm), the presence of vascular and/or biliary invasion, and high TNM stage (III/IV). Multivariate Cox proportional hazards analysis identified synaptophysin as an independent prognostic factor for 2-year DFS and OS. Synaptophysin expression can be used to predict an unfavorable prognosis in patients with HCC.
具有神经内分泌分化的前列腺癌和结肠癌比没有这种分化的肿瘤更具侵袭性。然而，在肝细胞癌（HCC）中，只有少数研究报道了神经内分泌标志物和生长抑素受体 2 的表达状态，生长抑素类似物的主要靶点。此外，这些标志物在 HCC 中的预后意义尚未得到充分探讨。我们评估了 95 例 HCC 中神经内分泌标志物（嗜铬粒蛋白 A、突触素和 CD56）和生长抑素受体 2（SSTR2）的表达，并研究了这些标志物的表达与临床病理发现之间的相关性。嗜铬粒蛋白 A 在 2 例中免疫定位，突触素在 15 例中，CD56 在 11 例中，SSTR2 在 19 例中。突触素和 CD56 的免疫反应性是 2 年无病生存（DFS）和总生存（OS）的显著不利预后因素，同时还存在高核有丝分裂水平（>10/10 高倍视野）、较大的肿瘤大小（>5cm）、存在血管和/或胆管侵犯以及较高的 TNM 分期（III/IV）。多变量 Cox 比例风险分析确定突触素是 2 年 DFS 和 OS 的独立预后因素。突触素表达可用于预测 HCC 患者的不良预后。
