肺大细胞未分化癌的光镜、电镜及免疫组化研究

The study of optical microscopy、immunohistochemical and electronic microscopy on pulmonary large cell carcinoma

关键词:  肺大细胞未分化癌  免疫组化  电子显微镜  淋巴结转移

Key words:  pulmonary large cell carcinoma  immunohistochemistry  electronic microscopy  metastasis of lymphonodi

摘要:

探讨肺大细胞未分化癌的各种分化表型以及不同分化表型与淋巴结转移及预后的关系。方法：采用光镜、电镜及免疫组化方法对32例肺大细胞癌手术标本进行观察,所有抗体分别为细胞角蛋白AE3［CK（AE3）］、细胞角蛋白18（CK18）、突触素（Syn）及嗜铬颗粒蛋白A（CgA）。结果：免疫组化为各抗体阳性表达率为CK18 68.75%、CK（AE3）18.75%、Syn40.63%、 CgA31.28%、CK18和Syn（或CgA）阳性率9.36%、CK（AE3）和Syn（或CgA）阳性率6.25%、腺鳞分化阳性率3.13%；电镜结果为具有鳞癌、腺癌及神经内分泌分化特征的分别占25.00%、87.50%、31.28%、其中具有鳞癌和神经内分泌分化的有3例（9.38%），具有腺癌和神经内分泌分化的有5（15.62%）例，具有腺鳞分化的2（6.25%）例。结论：肺大细胞癌在HE染色观察虽然属于未分化癌范围，但电镜和免疫组化仍可确定其有不同程度的分化表

Abstract:

To discuss the different phenotypic differentation of pulmonary large cell carcinoma(PLCC) and the relationship between phenotypic of PLCC and the metastasis of lymphonodi .Methods：The study was performed on 32 cases of PLCC by morphology and immunohistochemistry(IHC) ,the used aitibodies were cyrokeratin(AE3)［CK(AE3)］cytokeratin18(CK18), synaptophsin(Syn), chromogranin(CgA).Results：The expression rates for CK18,CK(AE3), Syn, CgA, CK18 and Syn(or CgA), CK(AE3) and Syn(or CgA) CK18 and CK(AE3) were 68.75%, 18.75%, 40.63%, 31.28%, 9.36%, 6.25% and 3.13% respectively. According to the phenotypic differentiation in EM, the 32 cases of PLCC could be with adenomatous(87.50%), squamous(25.00%), neuroendocrine (31.28%), squamo-neuroendorine (9.38%), adeno-neuroen-docrine(15.62%) and adenosquamouse (6.25%). Conclusions：The results indicated that PLCC has some phenotypic differentiation under EM and IHC although it is undifferentiated carcinoma in HE stain.