Pulmonary large cell neuroendocrine carcinoma demonstrates high proliferative activity

被引:41
作者
Iyoda, A
Hiroshima, K
Moriya, Y
Mizobuchi, T
Otsuji, M
Sekine, Y
Shibuya, K
Iizasa, T
Saitoh, Y
Fujisawa, T
机构
[1] Chiba Univ, Grad Sch Med, Dept Thorac Surg, Chuo Ku, Chiba 2608670, Japan
[2] Chiba Univ, Grad Sch Med, Dept Basic Pathol, Chuo Ku, Chiba 2608670, Japan
关键词
D O I
10.1016/j.athoracsur.2003.10.119
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background. In 1999, the World Health Organization classified large cell neuroendocrine carcinoma as a variant of large cell carcinoma and this has been categorized as lying between atypical carcinoid and small cell lung carcinoma in terms of clinical aggressiveness. Methods. We analyzed the proliferative activity of stage 1 large cell neuroendocrine carcinoma derived from patients with primary lung cancer who underwent surgical resection and compared the results with stage I classic large cell carcinoma cases. The mitotic rate was counted in ten high-power fields of light microscope. Immunohistochemical staining using anti-Ki-67 antibody was performed. The Ki-67 labeling index, expressed as a percentage of positive cells, was determined by light microscopy with random counting of at least 1,000 tumor nuclei. The expression of P53 and Bcl-2 was examined and compared. Results. The mitotic rate of large cell neuroendocrine carcinoma cases was significantly higher than that of classic large cell carcinoma cases. The Ki-67 labeling index of stage 1 large cell neuroendocrine carcinoma cases was significantly higher than that of stage 1 classic large cell carcinoma cases. Immunohistochemical expression of P53 in large cell neuroendocrine carcinoma and classic large cell carcinoma was comparable. However, large cell neuroendocrine carcinoma exhibited a significantly higher expression of Bcl-2 than classic large cell carcinoma. The disease specific disease-free survival for patients with stage 1 large cell neuroendocrine carcinoma was significantly lower than that for patients with stage 1 classic large cell carcinoma. Conclusions. Large cell neuroendocrine carcinoma appears to be more clinically aggressive than classic large cell carcinoma with these findings indicating that large cell neuroendocrine carcinoma has a higher level of proliferative activity than classic large cell carcinoma. (C) 2004 by The Society of Thoracic Surgeons.
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页码:1891 / 1895
页数:5
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