Loy T S, Darkow G V, Quesenberry J T
Department of Pathology, University of Missouri Medical Center, Columbia 65212.
Am J Surg Pathol. 1995 Feb;19(2):173-82. doi: 10.1097/00000478-199502000-00006.
To determine the specificity of immunostaining in the diagnosis of pulmonary neuroendocrine carcinomas, we studied 66 ultrastructurally characterized lung cancers with a panel of markers considered to be selective for neuroendocrine tumors (neuron-specific enolase, chromogranin A, Leu 7, synaptophysin) and B72.3, which is reported to be selective for non-small-cell carcinomas. Neuroendocrine tumors studied included 13 small-cell carcinomas, four low-grade neuroendocrine carcinomas, and two large-cell carcinomas with neuroendocrine differentiation. Non-neuroendocrine tumors included 26 adenocarcinomas, 10 squamous cell carcinomas, and 11 large-cell undifferentiated carcinomas. The following percentages of neuroendocrine carcinomas showing immunoreactivity for the various "neuroendocrine markers" were found: synaptophysin, 100%; neuron-specific enolase, 74%; chromogranin A, 37%; and Leu 7, 5%. However, carcinomas without morphologic features of neuroendocrine differentiation showed the following immunoreactivity: synaptophysin, 62%; neuron-specific enolase, 60%; chromogranin A, 17%; and Leu 7, 9%. B72.3 immunostaining was seen in 81% of the carcinomas without neuroendocrine features and in 31% of the small-cell carcinomas. We conclude that many of the commercially available antibodies used as neuroendocrine markers are nonspecific in the diagnosis of pulmonary neuroendocrine carcinomas.
为了确定免疫染色在肺神经内分泌癌诊断中的特异性，我们用一组被认为对神经内分泌肿瘤具有选择性的标志物（神经元特异性烯醇化酶、嗜铬粒蛋白A、Leu 7、突触素）以及据报道对非小细胞癌具有选择性的B72.3，研究了66例经超微结构特征鉴定的肺癌。所研究的神经内分泌肿瘤包括13例小细胞癌、4例低级别神经内分泌癌和2例具有神经内分泌分化的大细胞癌。非神经内分泌肿瘤包括26例腺癌、10例鳞状细胞癌和11例大细胞未分化癌。发现显示对各种“神经内分泌标志物”有免疫反应性的神经内分泌癌的以下百分比：突触素，100%；神经元特异性烯醇化酶，74%；嗜铬粒蛋白A，37%；Leu 7，5%。然而，无神经内分泌分化形态特征的癌显示出以下免疫反应性：突触素，62%；神经元特异性烯醇化酶，60%；嗜铬粒蛋白A，17%；Leu 7，9%。在无神经内分泌特征的癌中81%可见B72.3免疫染色，在小细胞癌中31%可见。我们得出结论，许多用作神经内分泌标志物的市售抗体在肺神经内分泌癌的诊断中是非特异性的。
