60例肺大细胞癌的免疫组织化学观察

采用5种与分化表型有关的抗体：CK－HMW、CK－LMW、SC、CgA、Syn对60例肺大细胞癌进行免疫组织化学观察。结果显示，5种抗体表达率分别为CK－HMW16．7％，CK－LMW56．7％，SC35．0％，CgA35．0％，Syn43．4％。在免疫组化分化表型上，60例肺大细胞癌可分为向腺分化者27例（45％）、鳞分化者5例（8．3％）、NE分化者22例（36．7％）、腺鳞分化者3例（5％）、腺鳞神经内分泌分化者2例（3．3％）、无分化表型者1例（1．7％）。结果表明，CK－LMW及CK－HMW可分别作为腺及鳞分化的标记。Syn对鉴别肺大细胞癌的NE分化更有意义。多种抗体联合检测才能更全面地反映肺大细胞癌的分化表型。不同分化表型肺大细胞癌的临床病理意义有待于进一步研究和探讨。

An immunohistochemical observation on 60 cases of pulmonary large cell carcinoma

An observation was performed immunohistochemically on 60 cases of pulmonary large cell carcinoma (PLCC) using a panel of following antibodies: cytokeratin-HMW (CK-HMW), cytokeratin-LMW (CK-LMW),secretory component (SC), chromogranin A (CgA) and synaptophysin (Syn). The expression rates for CKHMW, CK-LMW, SC, CgA and Syn were 16. 7%, 56. 7 %, 35. 0%, 35. 0% and 43. 4%, respectively. According to the phenotypic differentiation, the 60 cases of PLCC could be divided into adenomatous (27 cases, 45% ), squamous (5 cases, 8. 3% ), neuroendocrine (NE, 22 cases, 36. 7 % ), adenosquamous (3 cases, 5% ), adeno-squamoneuroendocrine (2 cases, 3. 3%) types, and 1 case (1. 7% ) without any feature. The results indicated that the CK-HMW and CK-LMW may be used as markers for squamous and adenomatous types respectively. Synaptophysin showed an important significance in identification of NE differentiation of PLCC. The phenotypic differentiation of PLCC would be reflected more comprehensively, if multiple antibodies could be used in the test. Further investigation is necessary to reveal the clinicopathologic significance of the phenotypic differentiation in PLCC.