Gould V E, Memoli V A, Dardi L E, Sobel H J, Somers S C, Johannessen J V
Ultrastruct Pathol. 1981 Jul-Sep;2(3):199-217. doi: 10.3109/01913128109048304.
Two primary neuroendocrine skin carcinomas, one bronchial carcinoma, and one typical medullary thyroid carcinoma have been shown by immunohistochemical and electron microscopy to contain two or more immunoreactive peptides as well as melanosomes and premelanosomes. Of the battery of antisera tested, somatostatin was the only material present in all four tumors; calcitonin and ACTH were present in three of the four neoplasms. Neurosecretory granules on the one hand and melanosomes on the other were more readily identifiable in separate cells. However, in at least 2 cases, individual cells were thought to contain both types of structures. Of the various explanations possible, we choose to interpret these tumors as complex neuroendocrine carcinomas comprising cellular populations capable of synchronous production of immunoreactive peptides and melanin. since melanocytes are members of the dispersed neuroendocrine (APUD) system, these observations may not appear entirely surprising. Note-worthy, however, is that melanin synthesis seemingly remains a synchronously available option to neoplastic neuroendocrine cell populations of possibly diverse histogenesis that are actively engaged in the production of multiple hormonal peptides. We consider that these phenomena represent yet another facet of neoplastic multidirectional differentiation. It is possible that the determination of immunoreactive peptides as "markers" may play a future role in the diagnosis, therapy, and prognosis of these and similar tumors and in the study of the dysplasias that may precede them.
通过免疫组织化学和电子显微镜检查发现，两例原发性神经内分泌皮肤癌、一例支气管癌和一例典型的甲状腺髓样癌含有两种或更多种免疫反应性肽，以及黑素小体和前黑素小体。在所测试的一系列抗血清中，生长抑素是所有四种肿瘤中唯一存在的物质；降钙素和促肾上腺皮质激素存在于四种肿瘤中的三种。一方面神经分泌颗粒，另一方面黑素小体，在不同的细胞中更容易识别。然而，至少在2例中，单个细胞被认为含有这两种类型的结构。在各种可能的解释中，我们选择将这些肿瘤解释为复杂的神经内分泌癌，其包含能够同步产生免疫反应性肽和黑色素的细胞群。由于黑素细胞是弥散神经内分泌（APUD）系统的成员，这些观察结果可能并不完全令人惊讶。然而，值得注意的是，黑色素合成似乎仍然是可能具有不同组织发生的肿瘤性神经内分泌细胞群同步可用的选择，这些细胞群积极参与多种激素肽的产生。我们认为这些现象代表了肿瘤多向分化的另一个方面。确定免疫反应性肽作为“标志物”可能在这些及类似肿瘤的诊断、治疗和预后以及对可能先于它们的发育异常的研究中发挥未来作用。
