子宫卵巢性索样肿瘤免疫组化研究

[目的]探讨子宫卵巢性索样肿瘤的组织发生学。[方法]应用免疫组织化学LSAB法检测18例子宫卵巢性索样肿瘤石蜡切片中Keratin、EMA、CEA、Vimentin、Actin、Desmin、Myoglobin、CD34、S－100和NSE10种标记。[结果]性索上皮样细胞团Vimentin、Actin18例阳性,Desmin16例阳性,NSE4例阳性,CK和EMA各2例阳性。子宫内膜间质样细胞区Vimentin、Actin和desmin18例均为阳性,余则为阴性。[结论]子宫卵巢性索样肿瘤系由子宫多潜能间质细胞起源,向性索上皮样、子宫内膜间质样细胞和平滑肌细胞分化,而又不同于子宫体上皮和间叶成份混合性肿瘤、子宫内膜间质肿瘤和平滑肌肿瘤,建议独立分类。     

An immunohistochemical study of various breast tissues using CA15-3 (MAb 115D8 and MAb DF3)

A CA15-3 RIA KIT, composed with two different monoclonal antibodies (115D 8 and DF 3), has been seen to react with the sera of breast cancer patients. Although the subclass of both antibodies is different, the antigen that reacted with them seems to be same, with a range from 300-450 kd. To reveal the reacting pattern of both antibodies, an immunohistochemical study was performed involving various breast tissues. In general, normal and benign breast tumors exhibited an apical stain by 115D8 and an apical and focal cytosol stain by DF 3. Breast carcinomas displayed not only an apical stain but a strong cytosol stain. However, the staining patterns showed little difference.     

High levels of S-100a0 (alpha alpha) protein in tumor tissues and in sera of patients with renal cell carcinoma

The alpha alpha form of S-100 protein (S-100a0), which is distributed mainly in the heart and striated muscles, and also in the brain and kidney, was determined in tumor tissues and sera of patients with renal cell carcinoma by employing an enzyme immunoassay system for bovine S-100a0 protein. The average content of S-100a0 in the renal cell carcinoma tissue (n = 10) was about 650 ng/mg protein, 4-fold higher than that in the kidney (n = 6, 160 ng/mg protein). Immunohistochemically, S-100a0 antigen was localized in such epithelial cells as proximal tubules, Bowman's capsules and collecting tubules of normal kidney, and in the cytoplasm, nucleus and occasionally plasma membrane of the tumor cells. The contents of S-100a0 protein in various lung carcinoma tissues were low (less than 10 ng/mg protein). Serum S-100a0 concentrations were less than 0.3 ng/ml in healthy subjects, but they were significantly increased in patients with renal cell carcinoma at diagnosis, showing greater than 0.5 ng/ml in 17/32 cases (53%). Serum S-100a0 levels were also enhanced in some patients with lung cancer (10/33, 30%), breast cancer (4/20, 20%) and other non-neoplastic diseases, indicating that S-100a0 protein in the serum is not a specific biomarker for renal cell carcinoma. However, serum S-100a0 concentrations in patients with renal cell carcinoma changed in parallel with the clinical course during treatment. These results suggest that serum S-100a0 may be a useful biomarker at least for monitoring the clinical course of renal cell carcinoma.     

Serological analysis of human renal cell carcinoma

Serological analysis of cDNA expression libraries (SEREX) has proven to be a useful technique in the quest to elucidate the repertoire of immunogenic gene products in human cancer. We have applied the SEREX method to human renal cell carcinoma (RCC) in order to identify associated immunogenic gene products. cDNA expression libraries were prepared from a RCC tumor, a RCC cell line and human testis. The 3 libraries were screened with sera from 35 RCC patients and 15 healthy controls. Approximately 4.5 x 10(6) phage plaques were screened resulting in 234 positive clones, which corresponded to 74 different gene products. The seroreactivity toward 49 of these antigens was assessed. Seroreactivity to 21 (43%) of the antigens was similar in RCC patients and healthy controls, 9 antigens (18%) elicited antibodies more frequently and 19 antigens (39%) solely in RCC patients. In the reverse setting, reactivity of RCC patients' sera was tested against a panel of 44 previously identified "tumor-associated" antigens via the SADA (serum antibody detection array) method; 6 antigens reacted with RCC patients' and healthy donors' sera, 8 were reactive only with RCC patients' sera. From the 27 antigens identified by SEREX and SADA, which did not react with sera from healthy controls, 10 antigens reacted with a significant proportion of RCC patients' sera and 77% of RCC patients' sera reacted at least with one of these antigens. Sera from patients with non-malignant renal diseases or an autoimmune disease did not react with these 10 antigens.     

Serum levels of S-100B protein and neuron-specific enolase in glioma patients: a pilot study

BACKGROUND: Serum levels of S-100B protein (S-100B) and neuron-specific enolase (NSE) are elevated after various cerebral injuries and are considered markers of central nervous system damage. In brain tumor patients, literature data on the prognostic value of serum S-100(B) and NSE levels are scarse and conflicting. PATIENTS AND METHODS: We assessed serum S-100B and NSE levels in 20 consecutive cerebral glioma patients, and evaluated serum levels in relation to survival to determine their prognostic value. Kaplan-Meier survival curves were constructed for patients with "high" (> median value) versus "low" (< or = median value) serum S-100B and NSE levels. RESULTS: A statistically significant shorter survival was found in patients with high serum S-100B levels, whereas a similar classification of patients based on serum NSE levels demonstrated no statistically significant difference in survival between the two groups. CONCLUSION: These preliminary data suggest that serum S-100B might be a prognostic variable in cerebral glioma patients. Further study is warranted to evaluate whether serum S-100B is an additional, independent prognostic variable.     

Serum neuron-specific enolase in children with neuroblastoma. Relationship to stage and disease course

Serum neuron-specific enolase (NSE) was measured in 61 children at diagnosis with all stages of neuroblastoma. The median serum values for Stages I, II, III, IV, and IV-S were 13, 23, 40, 214, and 40 ng/ml, respectively. Mean serum levels were different between groups I versus IV, (P = 0.0004) II versus IV (P = 0.0001) and IV-S versus IV (P = 0.004). The prognostic value of serum NSE for disease-free survival was determined in 54 patients at risk for relapse 2 or more years after diagnosis. The disease-free survival rate of all patients with levels of less than 100 ng/ml was 27/34 (79%), whereas it was 2/20 (10%) for those with higher levels. In 28 patients with lower stage disease and a good prognosis (Stages I, II, and IV-S) NSE levels were not predictive of relapse. Only 1 of these 28 patients had a raised level (greater than 100 ng/ml) and survived without relapse, whereas 4 patients who relapsed had serum NSE less than 100 ng/ml at diagnosis. In patients with Stages III and IV disease, a raised serum NSE level was associated with poor outcome: only 1/19 (5%) survived with NSE levels greater than 100 ng/ml, whereas survival was 5/8 (63%) with values below 100 ng/ml. Serial samples were analyzed on 17 patients; all 8 patients with initial NSE levels greater than 100 ng/ml achieved near normal levels during remission (median, 21 ng/ml). However, in only 4/10 patients studied at time of relapse, did the levels rise coincident with relapse. The sera of 47 patients with other forms of cancer and 19 siblings of cancer patients were at or near the normal limits (0-15 ng/ml), with three exceptions: acute lymphoblastic leukemia (286 ng/ml), hepatoblastoma (176 ng/ml), and primitive neuroectodermal tumor (105 ng/ml). Serum NSE is a useful marker for patients with advanced neuroblastoma in whom elevated levels were associated with a poor outcome; the raised NSE levels returned to near normal after therapy. In patients with Stage IV-S disease serum NSE levels were significantly lower than those in Stage IV despite their extensive tumor burden. Serum NSE estimation may confirm Stage IV-S status and suggest a more benign clinical course.     

Immunohistochemical evaluation of uveal melanocytic tumors. Expression of HMB-45, S-100 protein, and neuron-specific enolase

The authors compared the immunohistochemical reactivity of 13 uveal nevi and 20 uveal melanomas for HMB-45, S-100 protein, and neuron-specific enolase (NSE) in formalin-fixed, paraffin-embedded sections. All 33 of the lesions were positive for HMB-45. The false-negative rates for S-100 protein and NSE were 21% and 18%, respectively. If only strongly positive reactions were considered, more than 50% of the tumors would be interpreted as negative for S-100 protein and NSE. Nevi stained with less intensity than melanomas using all three antibodies. The expression of HMB-45 appeared to be greater in active nevi than in inactive nevi. There was a weak association between S-100 protein reactivity and the ability of the uveal melanomas to metastasize (P = 0.1); however, the standard deviation of nucleolar area was a much better predictor (P = 0.02). These results indicate that pathologists will find HMB-45 to be a useful tool in differentiating uveal melanoma from nonmelanocytic tumors.     

Differential expression of the enzyme that esterifies retinol, lecithin:retinol acyltransferase, in subtypes of human renal cancer and normal kidney.

PURPOSE: Retinoids, a group of compounds, including vitamin A (retinol), and related metabolites, have been shown to regulate the growth and differentiation of many types of cells. IFN-alpha and either 13-cis-retinoic acid or liposomal all-trans retinoic acid have been used in the treatment of patients with metastatic renal cell carcinoma. We knew that samples from renal cell carcinomas contained greatly reduced levels of retinol and retinyl esters relative to samples from normal human kidney. This prompted us to examine the levels of LRAT (lecithin:retinol acyltransferase) protein in various subtypes of human kidney cancers relative to normal human kidney by immunohistochemistry. EXPERIMENTAL DESIGN: We examined 31 partial or radical nephrectomy specimens diagnosed with kidney tumors between 1997 and 1998. Representative paraffin-embedded tissue blocks from each tumor, with each containing adjacent nonneoplastic renal parenchyma, were used for immunohistochemical analysis with affinity purified antibodies to human LRAT protein. RESULTS: LRAT protein was detected at high levels in the epithelial cells in the tubules and the lining of Bowman's capsule in the glomeruli of normal, nonneoplastic kidney sections. Among the 31 tumors, there were 13 cases of conventional (clear cell) renal cell carcinoma (RCC; including 2 multilocular cystic RCCs), 7 papillary RCC, 6 chromophobe RCC, 1 RCC, unclassified, and 4 renal oncocytoma. All tumors showed diffuse immunoreactivity for LRAT. In each case, the staining was uniform throughout the tumor, with only minimal variation in the staining intensity between different areas. All 4 renal oncocytomas, 2 of 6 chromophobe RCCs, 1 conventional (clear cell) carcinoma, 1 RCC, unclassified, and 2 conventional RCCs, which were of the multilocular cystic-type stained strongly (3+) for LRAT. In contrast, the remaining conventional RCCs and the papillary RCC samples stained much less intensely for LRAT. Of the 10 tumors that stained 3+ for LRAT in the study, 9 were either benign tumors or tumors with low malignant potential. CONCLUSIONS: These data show that LRAT expression is higher in renal tumors with an indolent biological behavior. Additional studies will ascertain if LRAT possesses any prognostic or therapeutic role in renal cancer.     

35例胃肠道间质瘤的临床病理及免疫组织化学探讨

目的:探讨胃肠道间质瘤(GISTs)的病理组织形态和免疫组织化学特点及其在良性、潜在恶性、恶性临床分布特点方法:选用35例临床资料完整、病理诊断准确的病例(均经免疫组织化学测定CD117、CD34、SMA、S-100、NSE)结果:35例GISTs恶性(包括潜在恶性)达85.0%以上;组织形态以梭形细胞为主23例(65.7%),上皮样细胞7例(20.0%),混合型5例(14.2%);免疫组织化学阳性表达率CD117 74.3%(26/35例)、CD34 68.6%(24/35例)、NSE65.7%(23/35例)、S-100 31.4%(11/35例)、SMA 48.6%、(17/35例);向神经分化13例,向平滑肌分化5例,双向分化12例,未分化5例.结果:GISTs是消化道最常见的间叶性肿瘤,CD117及CD34等免疫标记物配合使用,可起互补作用并对其作出正确诊断.     

Expression of KIT (CD117) in renal cell carcinoma and renal oncocytoma

OBJECTIVE: Overexpression of KIT (CD117), a tyrosine kinase receptor, has been reported in a variety of tumors, some of which are susceptible to therapy with imatinib mesylate. Our aim was to analyze KIT expression immunohistochemically in renal cell carcinomas (RCCs) and in oncocytomas. METHODS: Routinely processed, paraffin-embedded specimens from 61 RCCs and 13 renal oncocytomas were investigated immunohistochemically. Cytoplasmic and membrane-bound KIT staining of tumor cells was determined semiquantitatively. A subset of cases was additionally analyzed for point mutations of c-kit exon 17 by peptide nucleic acid-mediated nested polymerase chain reaction-clamping. RESULTS: All cases of oncocytomas and chromophobe RCCs showed membrane-bound KIT positivity, while about three-quarters of cases showed cytoplasmic reactivity. All other types of RCC were found KIT negative. Within the group of chromophobe RCCs, negative cytoplasmatic KIT reactivity was significantly correlated with advanced tumor stage (pT > or = 2; p = 0.036). Analysis of c-kit exon 17 revealed no 'gain-of-function' mutation like the codon 816 Asp-->Val mutation (D816V). Conclusions: KIT expression is a hallmark of oncocytoma and chromophobe RCC. Since all other types of RCC were found to be KIT negative, immunohistochemical KIT reactivity may be used as an additional diagnostic criterion to distinguish chromophobe RCC from other RCC types. KIT reactivity and the absence of c-kit mutation D816V in chromophobe RCC justify speculations that imatinib mesylate therapy could be effective in patients with advanced disease.     

Positron emission tomography utilizing C-11 5-hydroxytryptophan, plasma biochemistry and neuroendocrine immunohistochemistry of metastatic renal-cell carcinoma

The aim of this study was to characterise metastatic renal cell carcinoma in 18 patients with positron emission tomography (PET) utilising C-11-5-hydroxytryptophan, plasma biochemistry and neuroendocrine immunochemistry. Of these 18 patients, ten underwent the PET investigations. The standardised uptake values (SUVs) in hepatic deposits were higher than those in pulmonary lesions, with mean values of 3.15 and 2.35, respectively. The immunohistochemical study included staining of 10/18 surgical tumour specimens with antibodies reactive with chromogranin (Cg), neurone-specific enolase (NSE), and synaptophysin (Sy). In 17/18 patients, plasma measurements of the neuroendocrine peptides, CgA, CgB, pancreastatin, and serotonin, were performed. The results obtained in this study show that PET with C-11-5-hydroxytryptophan, a precursor in serotonin synthesis in neuroendocrine cells, can be utilised to visualise primary renal cell cancer and its secondaries in vivo. The results obtained also suggest that neuroendocrine differentiation may occur in human RCC.     

Prediction of prognosis in primary breast cancer by detection of a high molecular weight mucin-like antigen using monoclonal antibodies DF3, F36/22, and CU18: a Cancer and Leukemia Group B study

Three monoclonal antibodies (MAbs) (DF3, F36/22, CU18) were used to monitor expression of distinct epitopes present within a family of mucin-like, breast carcinoma-associated molecules. Primary tumor specimens from more than 190 stage II breast cancer patients were evaluated for expression of the high molecular weight antigens. With a median follow-up of 6 years, patients whose tumors exhibited high immunoperoxidase staining scores (greater than 50% positive cells) with MAb DF3 had a superior disease-free survival ([DFS] 56% +/- 6% v 37% +/- 5% at 6 years; P = .0088) and overall survival ([OS] 72% +/- 5% v 59% +/- 5% at 6 years; P = .025). Staining scores with the other two antibodies did not correlate with improved prognosis. For MAbs DF3 and CU18, patients whose tumors exhibited predominantly apical cellular reactivity patterns had improved DFS, although differences reached conventional levels of statistical significance only with MAb CU18. In multivariate analyses, the prognostic value of MAb DF3 staining was independent of other identified prognostic factors. Furthermore, the concordance between primary and axillary lymph node metastases staining with each MAb was 73%, 80%, and 85% for MAbs DF3, F36/22, and CU18, respectively. These results suggest that staining with MAb DF3 identifies a group of node-positive women with a relatively favorable prognosis. Expression of the DF3 mucin-like glycoprotein is related to better differentiation, and staining with MAb DF3 provides an accurate and objective estimate of clinical outcome independent of histopathologic evaluation.     

Immunohistochemical detection of tumor cells in the bone marrow of breast cancer patients

BACKGROUND: Contamination of bone marrow and peripheral blood stem cells with tumor cells is a problem that may be encountered when autologous hematopoietic stem cell transplantation is conducted concurrently with high-dose chemotherapy. METHODS: Using monoclonal antibodies to a variety of tumors, the detection of tumor cells in the bone marrow of breast cancer patients was studied by immunohistochemistry. RESULTS: KL-1 and CAM5.2 were strongly reactive with breast cancer cells, but not with normal bone marrow cells. The reactivity of the tumor cells with EMA was not strong, and DF-3 and 115D8 yielded only slightly positive reactions. These latter antibodies also exhibited some reactivity to normal bone marrow cells. When tumor cells were admixed with normal cells, the sensitivity of CAM5.2 and EMA permitted the detection of one cell in 10(4), but with KL-1, the detection of one in 10(5) cells was possible. When immunohistochemical staining was used in testing 40 patients with advanced or recurrent breast cancer, positive reactions were obtained in four of 27 patients (14.8%) with KL-1, four of 26 (15.4%) with CAM5.2, and nine of 37 (23.7%) with KL-1 + CAM5.2, figures similar to those reported by others who studied stage IV patients. CONCLUSIONS: Immunohistochemical staining with KL-1 and CAM5.2 is therefore considered to be a useful technique for detecting contamination by tumor cells.      

Papillary cystadenocarcinoma of salivary-glands - an immunohistochemical study

The immunohistochemical features of 16 cases of papillary cystadenocarcinoma of salivary glands using a panel of monoclonal and polyclonal antibodies were evaluated. The specimens were from patients postoperatively diagnosed as papillary cystadenocarcinoma of salivary glands where the age of the patients ranged from 20-70 years, males were more commonly affected than the females and parotid gland was the most commonly affected site. The cytokeratins detected by MoAb KL1 and K8.12 were positive in all cases showing a heterogeneity in intensity of reaction. A coexpression of vimentin with cytokeratin was found in 10 cases. The tumor cells had a coexpression of S-100 protein and neuron specific enolase (NSE). Glial fibrillary acidic protein (GFAP) was positive in one case with multiple expression of cytokeratins, vimentin NSE, S-100 protein. The polymorphic mucin MAM-6 was positive in all cases and MAM-3 in 8 cases showing different intensity of reaction. The tumor cells were positive for lysozyme (8 cases), lactoferrin (10 cases) and alpha-1-antichymotrypsin (10 cases). The immunoreactive c-erbB-2 oncoprotein on the cell surface membrane was detected in 2 cases. The labeling index of proliferating cell nuclear antigen in the tumor cells ranged from 3.8 to 43.2% (mean 14.2 +/- standard deviation 9.8). Histopathological feature and a heterogeneity of multiple expression of tissue markers may suggest that a population of cells in papillary cystadenocarcinoma may be counterparts of modified myoepithelial cells of pleomorphic adenoma that express epithelial, mesenchymal and neuronal differentiation although the role of myoepithelial cells in the genesis of this tumor is not clear. However, disorganized stratification and malignant transformation of ductal cells may be the most likely possibility in the histogenesis of this tumor.     

An immunohistochemical analysis of extramammary Paget's disease compared with mammary Paget's disease

Fourteen cases of extramammary Paget's disease and five cases of mammary Paget's disease have been studied using stereomorphometric, histochemical, and immunohistochemical methods. The antibodies were anti-CEA, anti-EMA, 115D8 and DF3. Intracytoplasmic mucin was positive in Paget's cells, and both 115D8 and DF3 were detected intensely in all of Paget's cells. 115D8 and DF3 were also positive in the normal apocrine sweat gland, the intercellular canaliculi of the eccrine sweat gland, and the intraductal carcinoma of the breast. Therefore, we have concluded that extramammary Paget's disease is an intraepidermal adenocarcinoma originating in the apocrine sweat gland.     

A case of undifferentiated glioma in a 70-year-old woman

The present case involved a 70-year-old woman who was diagnosed with a right cerebral hemorrhage. Excisional surgery of the hematoma was performed. Grossly, a whitish, solid tumor (1×1×0.8cm in size) was recognized in large, polygonal cells and small undifferentiated cells in a jumbled architectural arrangement with a cartilage component. The large, polygonal cell component was conspicuous and somewhat rhabdoid in appearance and appeared to be an astrocytic tumor showing glial differentiation. The small, undifferentiated cell component resembled tumor cells of a primitive neuroectodermal tumor (PNET). Clinical follow-up of the patient for 2 months after the first operation revealed recurrence with rapid growth. A second operation was performed, but the patient died 8 months after the first operation (2 months after the second). Immunohistochemically, the tumor cells suggesting glial differentiation were positive for glial fibrillary acidic protein (GFAP), S-100, neuron-specific enolase (NSE), and vimentin. PNET-like components in the primary tumor were positive for NSE, GFAP, and S-100, and weakly positive for vimentin and synaptophysin. Each tumor cell was negative for epithelial membrane antigen (EMA), keratin, desmin, actin, myoglobin, neurofilament (NF), and MIC2 protein. The recurrent tumor revealed predominantly PNET-like components; however, only a few tumor cells were positive for GFAP. This appearance suggested that this brain tumor might originate from a common multipotential stem cell. Considering its histopathological and immunohistochemical characteristics, the primary tumor was finally regarded as an undifferentiated glioma with dedifferentiation of the glial component in the recurrent tumor.     

促结缔组织增生性小圆细胞瘤的临床病理特征

目的 分析促结缔组织增生性小圆细胞瘤的临床表现，病理形态学及免疫表型特征：方法：分析4例促结缔组织增生性小圆细胞瘤患者的临床资料，对其标本进行大体和镜下观察，对石蜡切片行CK，EMA，Desmin，Vim．NSE，Actin。等免疫组织化学EnVision^(TM)法染色：结果：4例患者均为男性，平均年龄22岁：3例发生于腹腔，1例发生于睾丸：组织学上由大小不一的细胞巢组成，巢周围结缔组织显著增生，瘤细胞表达CK，EMA，Desmin，Vim及NSE。2例未行化疗，分别存活10月和15月，2例行全身化疗两周期后病灶稳定无进展：结论：促结缔组织增生性小圆细胞瘤是一种好发于男性青少年的高度恶性小圆细胞性肉瘤。Desmin核旁点状染色具有诊断价值：手术切除肿瘤联合化放疗是治疗的主要方法?     

Initial clinical evaluation of two murine IgG2a monoclonal antibodies for immunotherapy of gastrointestinal carcinoma

Eleven patients with advanced gastrointestinal (GI) carcinoma were entered in Phase I initial clinical trials with IgG2a antiGI carcinoma monoclonal antibodies (MAbs) GA733 (five patients) or CO19-9 (six patients). Infusion of MAb GA733 in doses greater than 30 mg was accompanied by mild and short-lasting GI toxicity. Infused MAb GA733 was bound to each patient's tumor tissue in vivo. MAb circulated in the blood for 10-25 days. All patients developed anti-mouse antibodies between 15 and 60 days post infusion. Furthermore, all but one patient raised anti-idiotypic antibodies against MAb GA733. Following administration of 10-600 mg of MAb CO19-9, no immediate or delayed toxicity symptoms were noted. Binding of infused MAb CO19-9 to tumor cells in vivo could not be detected in any of the six patients studied. The MAb circulated in the bloodstream between 5 and 12 days. Human anti-mouse antibody was detected in sera of three patients. None of the eleven patients treated with either MAb had anti-tumor responses in this Phase I clinical trial. The strong binding reactivity of MAb GA733 to tumors in vivo suggests the use of this MAb in cancer patients with less tumor burden to determine the tumoricidal efficacy of this antibody.     

Serum neuron-specific enolase as a marker of lung cancers

Neuron-specific enolase (NSE) in sera of lung cancer patients was studied in order to evaluate its clinical significance as a tumor marker. The subjects included 15 normal volunteers, 13 cases without malignant neoplasms or neuronal diseases and 42 lung cancer cases. NSE was quantified by a double antibody radioimmunoassay. As one of the sera from normal volunteers and control patients showed an NSE content 10 ng/ml or more, values of 10 ng/ml or over were considered to be positive. Seventeen of 42 sera from lung cancer patients showed positive NSE levels. Histological evaluation revealed that the degrees of NSE positiveness for small cell carcinoma, large cell carcinoma, squamous cell carcinoma and adenocarcinoma were 73%, 50%, 33%, and 21%, respectively, and that all the positive cases except for one were confined to disease stages III or IV. The level of NSE in patients with 10 ng/ml or more before surgery decreased to within normal limits 1-2 weeks after surgery Localization of NSE could be confirmed immunohistologically in small cell carcinoma cells. In conclusion, NSE was considered to be very useful as a tumor marker of the lung, especially in small cell carcinoma for diagnosis and determination of disease extent and response to therapy, and also in non-small cell carcinoma for the evaluation of treatment effectiveness.