Neuroendocrine differentiation in non-small cell lung cancer and its relation to prognosis and therapy.
OBJECTIVE
Histopathologists report the presence of neuroendocrine (NE) differentiation in non-small cell lung carcinoma (NSCLC) in up to a third of cases and are often questioned about its clinical relevance. The conclusions of previous studies have been inconsistent. This paper aims to provide an answer by examining a large series together with a comprehensive critique of the literature.


RESULTS
Four hundred and thirty-nine cases of NSCLC were examined, immunohistochemically, using antibodies to chromogranin A (CGA), synaptophysin (SYN) and CD56/neural cell adhesion molecule (NCAM). Three hundred and forty-one cases had been treated with surgical resection and the remainder with chemotherapy. The results were compared with clinical outcome. Thity-six percent of cases had positive staining for at least one NE marker. CGA was positive in 5.5% of cases, SYN in 16.5% and NCAM in 28%. There was no association between the presence of NE markers and survival in either the surgically treated group or the chemotherapy-treated group. There was also no association between NE markers and response to chemotherapy in the latter group.


CONCLUSIONS
The presence of immunohistochemically detected NE differentiation in NSCLC is not of prognostic significance.
Howe
M C
MC
Department of Histopathology, South Manchester University Hospital, Manchester, UK. miles.howe@smuht.nwest.nhs.uk
Chapman
A
A
Kerr
K
K
Dougal
M
M
Anderson
H
H
Hasleton
P S
PS
D000230:Adenocarcinoma / Q000378:metabolism / Q000473:pathology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018287:Carcinoma, Large Cell / Q000378:metabolism / Q000473:pathology; D018278:Carcinoma, Neuroendocrine / Q000378:metabolism / Q000473:pathology*; D002289:Carcinoma, Non-Small-Cell Lung / Q000378:metabolism / Q000473:pathology* / Q000628:therapy; D002294:Carcinoma, Squamous Cell / Q000378:metabolism / Q000473:pathology; D002454:Cell Differentiation; D053379:Chromogranin A; D002864:Chromogranins / Q000032:analysis; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008175:Lung Neoplasms / Q000378:metabolism / Q000473:pathology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D019006:Neural Cell Adhesion Molecules / Q000032:analysis; D011379:Prognosis; D016019:Survival Analysis; D016708:Synaptophysin / Q000032:analysis
D053379:Chromogranin A; D002864:Chromogranins; D019006:Neural Cell Adhesion Molecules; D016708:Synaptophysin