肺小细胞癌53例临床病理分析

目的探讨肺小细胞癌的临床病理特征、免疫组化特点及组织起源。方法回顾性分析53例肺小细胞癌的临床病理资料和免疫组化标记物的表达情况。结果肺小细胞癌占同期肺癌总数的17%,男女之比为2.8∶1,平均年龄56.7岁,从出现症状至就诊平均59.3天,65.2%有区域淋巴结转移。神经内分泌标记NSE、CgA、Syn的阳性率分别为88.9%、71.4%、60%,总阳性率为75%（21/28）。上皮标记CKpan的阳性率为100%;淋巴细胞标记LCA的阳性率为0。结论肺小细胞癌具有恶性程度高、进展迅速、容易发生转移以及对神经内分泌源性抗体和上皮源性抗体标记阳性等特点。本组病例经免疫组化分析,倾向于肺小细胞癌起源于支气管黏膜干细胞。

Small cell lung carcinoma:a clinicopathologic analysis of 53 cases

Objective To investigate the clinicopathologic characteristics,immunohistochemical features,and histogenesis of the small cell lung carcinoma. Methods The clinical data,pathological findings,and results of immunohistochemical staining were retrospectively studied in 54 cases of small cell lung carcinoma. Results In all the types of lung carcinomas,small cell lung carcinoma accounted for 17.04%;The ratio of man to woman was 2.8 to 1;The average age was 56.7 years old;The average time from the appearance of symptoms to clinical detection was 59.3 days;65.22% of cases had lymph node metastasis.The positive ratie of immunohistochemical staining for neuroendocrine markers was 88.89%,71.43% and 60% for NSE,CgA and Syn,respectively,and the total positive rate of neuroendocrine markers was 75%(21/28);The positive rate of epithelial marker, CKpan,was 100%,but lymphocytoid marker,LCA,was not detected. Conclusion Small cell lung carcinoma is a high malignant tumor,with rapid progression and early metastasis.Both neuroendocrine and epithelial markers are positive to this tumor.The results suggest this tumor may orign from the bronchi mucosa stem cells.