術後経過からみた高悪性度肺神経内分泌腫瘍の病理組織学的検討
肺の高悪性度神経内分泌腫瘍には大細胞神経内分泌癌と小細胞癌とが含まれるが，両者は組織学的に鑑別困難な場合がある．これらを一括して術後経過を検討したところ，病期I期であった17例のうち，7例は術後15ヵ月までに死亡し，10例は25～145ヵ月間再発なく生存していた．そこで，早期死亡例と長期生存例との間における高悪性度神経内分泌腫瘍の病理学的差異について検討した．その結果，組織学的に特定の構造を示すことなく充実性に増殖する腫瘍は早期死亡例に多く，神経内分泌への分化を示す腫瘍や他の癌腫成分が混在する腫瘍は長期生存例に多く存在した．また，早期死亡例では長期生存例に比しMIB-1標識率が有意に高かった．...
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| Published in | 日本呼吸器外科学会雑誌 Vol. 21; no. 4; pp. 531 - 537 |
|---|---|
| Main Authors | , , , , , , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
特定非営利活動法人 日本呼吸器外科学会
2007
|
| Subjects | |
| Online Access | Get full text |
| ISSN | 0919-0945 1881-4158 |
| DOI | 10.2995/jacsurg.21.531 |
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| Abstract | 肺の高悪性度神経内分泌腫瘍には大細胞神経内分泌癌と小細胞癌とが含まれるが，両者は組織学的に鑑別困難な場合がある．これらを一括して術後経過を検討したところ，病期I期であった17例のうち，7例は術後15ヵ月までに死亡し，10例は25～145ヵ月間再発なく生存していた．そこで，早期死亡例と長期生存例との間における高悪性度神経内分泌腫瘍の病理学的差異について検討した．その結果，組織学的に特定の構造を示すことなく充実性に増殖する腫瘍は早期死亡例に多く，神経内分泌への分化を示す腫瘍や他の癌腫成分が混在する腫瘍は長期生存例に多く存在した．また，早期死亡例では長期生存例に比しMIB-1標識率が有意に高かった．病期I期の高悪性度肺神経内分泌腫瘍では，形態学的な癌の分化傾向の程度やMIB-1標識率から予後を推測しうると考えられた． |
|---|---|
| AbstractList | 肺の高悪性度神経内分泌腫瘍には大細胞神経内分泌癌と小細胞癌とが含まれるが，両者は組織学的に鑑別困難な場合がある．これらを一括して術後経過を検討したところ，病期I期であった17例のうち，7例は術後15ヵ月までに死亡し，10例は25～145ヵ月間再発なく生存していた．そこで，早期死亡例と長期生存例との間における高悪性度神経内分泌腫瘍の病理学的差異について検討した．その結果，組織学的に特定の構造を示すことなく充実性に増殖する腫瘍は早期死亡例に多く，神経内分泌への分化を示す腫瘍や他の癌腫成分が混在する腫瘍は長期生存例に多く存在した．また，早期死亡例では長期生存例に比しMIB-1標識率が有意に高かった．病期I期の高悪性度肺神経内分泌腫瘍では，形態学的な癌の分化傾向の程度やMIB-1標識率から予後を推測しうると考えられた． |
| Author | 高木, 啓吾 横内, 幸 岡, 輝明 草地, 信也 若山, 恵 渋谷, 和俊 高橋, 啓 大原関, 利章 辻本, 志朗 |
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| References | 10) 呉 哲彦，小田 誠，太田安彦，他．小細胞肺癌に対する手術適応─長期生存例の検討を通して─．日胸 2001; 60: 201-205. 6) 松野吉宏，淺村尚生，永井完治．肺神経内分泌腫瘍の臨床病理．肺癌 2006; 46: 101-109. 8) Garcia-Yuste M, Matilla JM, Alvarez-Gago T, et al. Prognostic factors in neuroendocrine lung tumors: a Spanish Multicenter Study. Spanish Multicenter Study of Neuroendocrine Tumors of the Lung of the Spanish Society of Pneumonology and Thoracic Surgery (EMETNE-SEPAR). Ann Thorac Surg 2000; 70: 258-263. 3) 石川雄一．肺の神経内分泌腫瘍のスペクトラム─鑑別診断のために─．病理と臨 2003; 21: 507-511. 5) Asamura H, Kameya T, Matsuno Y, et al. Neuroendocrine neoplasms of the lung: a prognostic spectrum. J Clin Oncol 2006; 24: 70-76. 4) 横内 幸．神経内分泌形態を示す原発性肺癌の病理組織学的検討─大細胞神経内分泌癌を中心に─．東邦医会誌 2002; 49: 162-175. 13) Travis WD, Gal AA, Colby TV, et al. Reproducibility of Neuroendocrine lung tumor classification. Hum pathol 1998; 29: 272-279. 18) Mazieres J, Daste G, Molinier L, et al. Large cell neuroendocrine carcinoma of the lung: pathological study and clinical outcome of 18 resected cases. Lung Cancer 2002; 37: 287-292. 21) Mangum MD, Greco FA, Hainsworth JD, et al. Combined small-cell and non-small-cell lung cancer. J Clin Oncol 1989; 7: 607-12. 2) Travis WD, Colby TV, Cirrun B, et al. WHO International Histological Classification of Tumours. Histological typing of lung and pleural tumours. 3rd edition, World Health Organization 1999; 7-12. 20) Hage R, Elbers JR, Brutel de la Riviere A, et al. Surgery for combined type small cell lung carcinoma. Thorax 1998; 53: 450-453. 23) Haga Y, Hiroshima K, Iyoda A, et al. Ki-67 expression and prognosis for smokers with resected stage I non-small cell lung cancer. Ann Thorac Surg 2003; 75: 1727-1732. 12) Dresler CM, Ritter JH, Patterson GA, et al. Clinical-pathologic analysis of 40 patients with large cell neuroendocrine carcinoma of the lung. Ann Thorac Surg 1997; 63: 180-185. 14) 矢満田 健，椎名隆之，牧内明子，他．術後再発および予後からみた病期I期非小細胞肺癌病期分類の問題点．肺癌 2001; 41: 27-31. 1) Travis WD, Linnoila RI, Tsokos MG, et al. Neuroendocrine tumors of the lung with proposed criteria for large-cell neuroendocrine carcinoma. An ultrastructural, immunohistochemical, and flow cytometric study of 35 cases. Am J Surg Pathol 1991; 15: 529-553. 7) Travis WD, Rush W, Flieder DB, et al. Survival analysis of 200 pulmonary neuroendocrine tumors with clarification of criteria for atypical carcinoid and its separation from typical carcinoid. Am J Surg Pathol 1998; 22: 934-944. 19) Hage R, Seldenrijk K, de Bruin P, et al. Pulmonary large-cell neuroendocrine carcinoma (LCNEC). Eur J Cardiothorac Surg 2003; 23: 457-460. 9) Lucchi M, Mussi A, Chella A, et al. Surgery in the management of small cell lung cancer. Eur J Cardiothorac Surg 1997; 12: 689-693. 22) Poleri C, Morero JL, Nieva B, et al. Risk of recurrence in patients with surgically resected stage I non-small cell lung carcinoma: histopathologic and immunohistochemical analysis. Chest 2003; 123: 1858-1867. 15) Jiang SX, Kameya T, Syoji M, et al. Large cell neuroendocrine carcinoma of the lung. A histologic and immunohistochemical study of 22 cases. Am J Surg Pathol 1998; 22: 526-537. 11) Takei H, Asamura H, Maeshima A, et al. Large cell neuroendocrine carcinoma of the lung: a clinicopathologic study of eighty-seven cases. J Thorac Cardiovasc Surg 2002; 124: 285-292. 17) Khalifa M, Hruby G, Ehrlich L, et al. Combined large cell neuroendocrine carcinoma and spindle cell carcinoma of the lung. Ann Diagn Pathol 2001; 5: 240-245. 16) Ruffini E, Rena O, Oliaro A, et al. Lung tumors with mixed histologic pattern. Clinico-pathologic characteristics and prognostic significance. Eur J Cardiothorac Surg 2002; 22: 701-707. |
| References_xml | – reference: 13) Travis WD, Gal AA, Colby TV, et al. Reproducibility of Neuroendocrine lung tumor classification. Hum pathol 1998; 29: 272-279. – reference: 5) Asamura H, Kameya T, Matsuno Y, et al. Neuroendocrine neoplasms of the lung: a prognostic spectrum. J Clin Oncol 2006; 24: 70-76. – reference: 7) Travis WD, Rush W, Flieder DB, et al. Survival analysis of 200 pulmonary neuroendocrine tumors with clarification of criteria for atypical carcinoid and its separation from typical carcinoid. Am J Surg Pathol 1998; 22: 934-944. – reference: 11) Takei H, Asamura H, Maeshima A, et al. Large cell neuroendocrine carcinoma of the lung: a clinicopathologic study of eighty-seven cases. J Thorac Cardiovasc Surg 2002; 124: 285-292. – reference: 6) 松野吉宏，淺村尚生，永井完治．肺神経内分泌腫瘍の臨床病理．肺癌 2006; 46: 101-109. – reference: 15) Jiang SX, Kameya T, Syoji M, et al. Large cell neuroendocrine carcinoma of the lung. A histologic and immunohistochemical study of 22 cases. Am J Surg Pathol 1998; 22: 526-537. – reference: 14) 矢満田 健，椎名隆之，牧内明子，他．術後再発および予後からみた病期I期非小細胞肺癌病期分類の問題点．肺癌 2001; 41: 27-31. – reference: 18) Mazieres J, Daste G, Molinier L, et al. Large cell neuroendocrine carcinoma of the lung: pathological study and clinical outcome of 18 resected cases. Lung Cancer 2002; 37: 287-292. – reference: 19) Hage R, Seldenrijk K, de Bruin P, et al. Pulmonary large-cell neuroendocrine carcinoma (LCNEC). Eur J Cardiothorac Surg 2003; 23: 457-460. – reference: 1) Travis WD, Linnoila RI, Tsokos MG, et al. Neuroendocrine tumors of the lung with proposed criteria for large-cell neuroendocrine carcinoma. An ultrastructural, immunohistochemical, and flow cytometric study of 35 cases. Am J Surg Pathol 1991; 15: 529-553. – reference: 2) Travis WD, Colby TV, Cirrun B, et al. WHO International Histological Classification of Tumours. Histological typing of lung and pleural tumours. 3rd edition, World Health Organization 1999; 7-12. – reference: 17) Khalifa M, Hruby G, Ehrlich L, et al. Combined large cell neuroendocrine carcinoma and spindle cell carcinoma of the lung. Ann Diagn Pathol 2001; 5: 240-245. – reference: 22) Poleri C, Morero JL, Nieva B, et al. Risk of recurrence in patients with surgically resected stage I non-small cell lung carcinoma: histopathologic and immunohistochemical analysis. Chest 2003; 123: 1858-1867. – reference: 23) Haga Y, Hiroshima K, Iyoda A, et al. Ki-67 expression and prognosis for smokers with resected stage I non-small cell lung cancer. Ann Thorac Surg 2003; 75: 1727-1732. – reference: 12) Dresler CM, Ritter JH, Patterson GA, et al. Clinical-pathologic analysis of 40 patients with large cell neuroendocrine carcinoma of the lung. Ann Thorac Surg 1997; 63: 180-185. – reference: 16) Ruffini E, Rena O, Oliaro A, et al. Lung tumors with mixed histologic pattern. Clinico-pathologic characteristics and prognostic significance. Eur J Cardiothorac Surg 2002; 22: 701-707. – reference: 20) Hage R, Elbers JR, Brutel de la Riviere A, et al. Surgery for combined type small cell lung carcinoma. Thorax 1998; 53: 450-453. – reference: 10) 呉 哲彦，小田 誠，太田安彦，他．小細胞肺癌に対する手術適応─長期生存例の検討を通して─．日胸 2001; 60: 201-205. – reference: 21) Mangum MD, Greco FA, Hainsworth JD, et al. Combined small-cell and non-small-cell lung cancer. J Clin Oncol 1989; 7: 607-12. – reference: 4) 横内 幸．神経内分泌形態を示す原発性肺癌の病理組織学的検討─大細胞神経内分泌癌を中心に─．東邦医会誌 2002; 49: 162-175. – reference: 8) Garcia-Yuste M, Matilla JM, Alvarez-Gago T, et al. Prognostic factors in neuroendocrine lung tumors: a Spanish Multicenter Study. Spanish Multicenter Study of Neuroendocrine Tumors of the Lung of the Spanish Society of Pneumonology and Thoracic Surgery (EMETNE-SEPAR). Ann Thorac Surg 2000; 70: 258-263. – reference: 9) Lucchi M, Mussi A, Chella A, et al. Surgery in the management of small cell lung cancer. Eur J Cardiothorac Surg 1997; 12: 689-693. – reference: 3) 石川雄一．肺の神経内分泌腫瘍のスペクトラム─鑑別診断のために─．病理と臨 2003; 21: 507-511. |
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| Snippet | 肺の高悪性度神経内分泌腫瘍には大細胞神経内分泌癌と小細胞癌とが含まれるが，両者は組織学的に鑑別困難な場合がある．これらを一括して術後経過を検討したところ，病期I... |
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| SubjectTerms | 予後 大細胞神経内分泌癌 小細胞癌 手術 肺神経内分泌腫瘍 |
| Title | 術後経過からみた高悪性度肺神経内分泌腫瘍の病理組織学的検討 |
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