Cagle P T, el-Naggar A K, Xu H J, Hu S X, Benedict W F
Department of Pathology, Baylor College of Medicine, Houston, Texas, USA.
Am J Pathol. 1997 Feb;150(2):393-400.
Neuroendocrine lung tumors have been considered by some to be a continuum ranging from relatively benign typical carcinoids to highly malignant small-cell carcinomas. Histopathological diagnosis may sometimes be difficult because of their overlapping features. Correct classification, however, carries important prognostic and therapeutic significance. To determine the clinicopathological implications of retinoblastoma (RB) protein expression in these neoplasms, we examined the RB status in a series of neuroendocrine tumors by immunohistochemical analysis of paraffin-embedded tissue sections. A total of 105 tumors were studied. All 44 typical and 15 atypical carcinoids, one of which was initially misdiagnosed as a small-cell carcinoma, manifested a heterogeneous RB-positive staining pattern. Atypical carcinoids in general showed an increase in the number of tumor cells with strong nuclear staining compared to typical carcinoids. In contrast, all 40 small-cell and 6 large-cell neuroendocrine carcinomas failed to show RB staining in any tumor nuclei, indicating loss of RB function. Our results suggest that RB status as measured by immunohistochemical staining can be used as a marker to distinguish typical and atypical carcinoids from small-cell and large-cell neuroendocrine carcinomas.
一些人认为神经内分泌性肺肿瘤是一个连续谱，范围从相对良性的典型类癌到高度恶性的小细胞癌。由于它们具有重叠的特征，组织病理学诊断有时可能会很困难。然而，正确的分类具有重要的预后和治疗意义。为了确定视网膜母细胞瘤（RB）蛋白表达在这些肿瘤中的临床病理意义，我们通过对石蜡包埋组织切片进行免疫组化分析，检测了一系列神经内分泌肿瘤中的RB状态。共研究了105个肿瘤。所有44个典型类癌和15个非典型类癌，其中1个最初被误诊为小细胞癌，均表现出异质性的RB阳性染色模式。与典型类癌相比，非典型类癌总体上显示强核染色的肿瘤细胞数量增加。相比之下，所有40个小细胞和6个大细胞神经内分泌癌在任何肿瘤细胞核中均未显示RB染色，表明RB功能丧失。我们的结果表明，通过免疫组化染色检测的RB状态可作为区分典型和非典型类癌与小细胞和大细胞神经内分泌癌的标志物。
