46例肺癌组织光镜及电镜的对比观察

对46例肺癌组织进行光镜及电镜的对比观察,结果发现电镜下腺鳞癌的发生率远远高于光镜.光镜下诊断腺鳞癌仅1例(2.2%),而电镜诊断12例(26.1%).光镜下无1例非小细胞型神经内分泌癌,电镜下2例小细胞癌、1例腺癌和2例大细胞癌胞浆中发现神经内分泌颗粒.表明在此2型肺癌的诊断中电镜观察起着很重要的作用.结果证明肺癌细胞有很高的异质性,表现为同一肿瘤中出现腺癌和鳞癌结构以及腺癌和(或)鳞癌与神经内分泌结构.同一肿瘤中出现不同组织类型的成份,支持肺癌细胞起源于支气管粘膜中干细胞的学说.

The Comparative Observation of 46 Cases of Lung Carcinoma on Light and Electron Microscopy

The cellular heterogeneity of lung carcinoma and ultrastructural diagnosis of neuroendocrine carcinoma of the non-small-cell type were studied. Methods: 46 cases of lung carcinoma were examined comparatively on light and electron microscopy. Results: 1 case(2.2%)of adenosquamous carcinoma was observed on light microscopy and 12(26.1%)cases of adenosquamous carcinoma on electron microscopy. N. S. G(neurosecretory granules)were identified ultrastructurally in 1 cases of adenocarcinoma and 2 cases of large cell carcinoma. Squamous, glandular and endocrine features were found together in one case diagnosed as adenocarcinoma on light microscopy. No case of neuroendocrine carcinoma of non-small-cell type was diagnosed on light microscopy, but 3 cases were diagnosed on electron microscopy. Conclusions:Our results indicated that lung carcinoma cell had high hetergeneity which appeared that some adenocarcinomas had cells with squamous characteristics, some squamous carcinomas had cells with glandular features, and both had cells with endocrine structures. The ultrastructural findings showed that some lung carcinomas were derived from stem cells of bronchial epithelium which possesed the ability of multipotential differentiation. Electron microscpy plays an important role in diagnosis of neuroendocrine carcinoma of non-small-cell type.