Tanaka Ryota, Fujiwara Masachika, Sakamoto Norihiko, Kanno Hitomi, Arai Nobuaki, Tachibana Keisei, Kishimoto Koji, Anraku Masaki, Shibahara Junji, Kondo Haruhiko
Department of Surgery, Kyorin University School of Medicine, Tokyo, Japan.
Department of Pathology, Kyorin University School of Medicine, Tokyo, Japan.
Diagn Cytopathol. 2023 Jun;51(6):356-364. doi: 10.1002/dc.25118. Epub 2023 Feb 28.
Distinguishing the histological types of lung cancer is essential for determining treatment strategies in clinical practice. In this study, cytomorphological characteristics and proliferative activities were compared among histological types of lung cancer by cytomorphometric and flow cytometric analyses using liquid-based cytology (LBC) samples.
Scraped LBC samples from 73 surgically resected specimens were collected between August 2018 and November 2019. Papanicolaou-stained and paired Ki-67-stained slides were used for cytomorphometric analyses. Another sample for each case was analyzed using a flow cytometric system (LC-1000). The cell proliferation index (CPIx) was calculated to evaluate proliferative activity.
In total, 73 cases, including cases of adenocarcinoma (n = 53), squamous cell carcinoma (n = 14), small cell carcinoma (n = 1), large cell neuroendocrine carcinoma (NEC; n = 3), and pleomorphic carcinoma (n = 2) were evaluated. Small cell carcinoma and large cell NEC were categorized into a single group, NEC. The adenocarcinoma group tended to have a larger nuclear area and longer perimeter than other histological types. The NEC group had a considerably higher Ki-67 labeling index and significantly higher CPIx than other histological types (p = .030). A significant positive correlation was observed between the Ki-67 labeling index and CPIx for all cases (r = 0.362, p = .002).
The Ki-67 labeling index and flow cytometric analyses focus on proliferative activity for the distinction of histological types of lung cancer, thereby guiding clinical decision-making.
区分肺癌的组织学类型对于临床实践中确定治疗策略至关重要。在本研究中，使用液基细胞学（LBC）样本，通过细胞形态计量学和流式细胞术分析，比较了肺癌组织学类型之间的细胞形态学特征和增殖活性。
收集了2018年8月至2019年11月期间73例手术切除标本的刮取LBC样本。采用巴氏染色和配对的Ki-67染色玻片进行细胞形态计量学分析。对每个病例的另一个样本使用流式细胞仪系统（LC-1000）进行分析。计算细胞增殖指数（CPIx）以评估增殖活性。
总共评估了73例病例，包括腺癌（n = 53）、鳞状细胞癌（n = 14）、小细胞癌（n = 1）、大细胞神经内分泌癌（NEC；n = 3）和多形性癌（n = 2）。小细胞癌和大细胞NEC被归为一组，即NEC。腺癌组的核面积和周长往往比其他组织学类型更大。NEC组的Ki-67标记指数明显更高，CPIx也显著高于其他组织学类型（p = 0.030）。所有病例的Ki-67标记指数与CPIx之间存在显著正相关（r = 0.362，p = 0.002）。
Ki-67标记指数和流式细胞术分析聚焦于增殖活性以区分肺癌的组织学类型，从而指导临床决策。
