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題名 | A Retrospective Immunohistochemical and Clinicopathological Study of Small Cell Carcinomas of the Urinary Tract=泌尿道小細胞癌的回溯性免疫組織化學特性和臨床病理分析 |
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作者姓名(中文) | 莊正鏗; 廖順奎; | 書刊名 | 長庚醫學 |
卷期 | 26:1 2003.01[民92.01] |
頁次 | 頁26-33 |
分類號 | 415.82 |
關鍵詞 | 小細胞癌; 腎臟; 膀胱; 移形細胞癌; 神經內分泌標記; Small cell carcinoma; Kidney; Urinary bladder; Transitional cell carcinoma; Neuroendocrine markers; |
語文 | 英文(English) |
中文摘要 | 背景:本研究之目標,在於分析原發性泌尿道小細胞癌的免疫組織化學特性和臨床致病行徑可能關係的回溯性研究。 方法:我們針對10位長庚紀念醫院原發性泌尿道小細胞癌病人(男性7人,女性3人,年齡從35至78歲,平均54歲)收集資料以及追蹤結果做一回溯性研究;其中3例腎腫瘤、2例腎盂、2例輸尿管以及3例起源於膀胱。這些腫瘤組織並且做神經內分泌標的之免疫組織化學染色。 結果:腫瘤最常見的顯著特徵是在細胞組織病理方面,細胞變成小至中等大小、缺少質的圓形或紡錘形細胞、核染色體過多以及核變得不明顯。全部10個腫瘤以免疫染色法都呈現出NSE(neuron-specific enolase)陽性反應,但是CgA(chromograin-A)染色則是性及弱反應的。十個腫瘤組織中共有七個出現vimentin,其中有五個病人在診斷一年內即已過逝。 結論:泌尿道小細胞癌的組織病理特性與神經內分泌標記與小組胞肺癌有相似之處,在這些腫瘤中,NSE的表現比CgA更具有一致性,然而,NSE表的多寡,以及這兩種神經內分泌標記的免染色強度,並不能用來預測臨床結果。在腫瘤組織裡同時出小細胞癌/細胞癌兩?或單獨的小細胞癌病灶與預後結果無關。有趣的是,腫瘤vimentin呈陽性的病人,其預後較差,並且會有癌細胞早期轉移和病人早死的現象。 |
英文摘要 | Backgorund: To investigate the immunohistochemical and clinicopathological behaviors of primary urinary tract small cell carcinomas (SCCs). Methods: A retrospective study of 10 cases of urinary tract SCC (7 men and 3 women, average age, 54; range, 35-78 years) at Chang Gung Memorial Hospital is reported. Among these cases, 3 tumors arose from the kidney, 2 from the renal pelvis, 2 from the ureter, and 3 from the bladder. Clinical and follow-up data were obtained. Histological and immuniohistochemical studies with antibodies to neuroendocrine (NE) markers were conducted. Results: The most prominent common feature of the 10 SCCs was their cell histopathology: small to medium-sized round to spindle-shaped cells with scanty cytoplasm, hyperchromatic nuclei, and inconspicuous nucleoli. Immunostaining revealed positive neuron-specific enolase (NSE) reactivity in 10 of 10 tumors, but there was focal and weak staining for chromogramin-A (CgA) in 4 of 10 tumors. The 7 patients with vimentin-positive SCCs all developed metastastic lesions, and 5 of them expired within 1 year. Conclusions: SCCs of the urinary tract system share similar histopathological features and NE markers with their pulmonary counterpart. NSE was expressed more consistently than CgA in these tumors. However, the preferential expression of NSE and intensity of immunostaining of these 2 NE markers did not predict the clinical outcome of these patients. The presence of both SCC and transitional cell carcinoma or SCC alone did not foretell the clinical outcome either. Patients with the presence of vimentin in the tumor tissues appeared to have poorer prognoses with early metastasis and mortality. |
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