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Nonsmall cell lung carcinoma with neuroendocrine differentiation - an entity of no clinical or prognostic signficance


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Ionescu, DN, Treaba, D, Gilks, CB, Leung, S, Renouf, D, Laskin, J, Wood-Baker, R and Gown, AM 2007 , 'Nonsmall cell lung carcinoma with neuroendocrine differentiation - an entity of no clinical or prognostic signficance' , American Journal of Surgical Pathology, vol. 31, no. 1 , pp. 26-32 .

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The existence of non-small cell lung carcinoma with
neuroendocrine differentiation as a distinct entity and its
relevance for prognostic and treatment purposes is controversial.
This study assesses the frequency and biologic and
prognostic significance of neuroendocrine (NE) expression of
synaptophysin (SNP), chromogranin (Ch), and neural cell
adhesion molecule (N-CAM) using tissue microarray (TMA)
and immunohistochemistry. Six hundred nine nonsmall cell lung
carcinomas (NSCLCs) were reviewed for subclassification.
TMA blocks were made using duplicate 0.6-mm-diameter tissue
cores and slides stained with SNP, Ch, and N-CAM. Immuno
reactivity was considered if 1% or more of tumor cells were
positive. Hematoxylin and eosin-stained sections were subclassified
as: 243 adenocarcinoma (ACA), 272 squamous
cell carcinoma (SCC), 35 large cell carcinoma, 32 non-small
cell carcinoma NOS, and 6 other (carcinosarcoma, giant cell
carcinoma). Positivity for either marker was identified in 13.6%
of NSCLC (76/558). NSCLC showed reactivity for Ch in 0.4%
of cases (2/524), for SNP in 7.5% of cases (39/521) and for
N-CAM in 8.6% of cases (44/511), whereas only 0.2% of cases
(1/517) showed coexpression of SNP and Ch and none of all 3
markers. The assessment of NE differentiation in NSCLC is
unnecessary and expensive and is of no clinical or prognostic
significance. SNP or N-CAM stains a small minority of NSCLC,
whereas Ch immunoreactivity is less common. Positivity for any
2 NE markers is rare. SNP is more likely to be expressed in
adenocarcinoma (P=0.01) and N-CAM in squamous-cell
carcinoma (P=0.008). Otherwise there was no correlation
between immunoreactivity and tumor morphology. Disease
specific and overall survival is not influenced by NE differentiation
and therefore non-small cell lung carcinoma with neuroendocrine
differentiation should not be a subclass distinct from
the other NSCLC.

Item Type: Article
Authors/Creators:Ionescu, DN and Treaba, D and Gilks, CB and Leung, S and Renouf, D and Laskin, J and Wood-Baker, R and Gown, AM
Journal or Publication Title: American Journal of Surgical Pathology
Publisher: Lippincott Williams & Wilkins
ISSN: 0147-5185
Additional Information:

lung carcinoma, neuroendocrine differentiation,
tissue microarray, immunohistochemistry

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