【摘要】 目的探讨在纤维支气管镜活检标本中肺类癌和肺小细胞癌的鉴别诊断。方法分析纤维支气管镜活检标本被误诊为小细胞癌的7例肺类癌的形态特点和免疫组织化学特征,同时以9例小细胞癌活检标本作为对照组。结果肺类癌肿瘤细胞核染色质颗粒状,免疫组织化学染色呈Syn和CgA高表达,Ki-67增殖指数低(典型者<20%)。小细胞癌核染色质细致均匀分布,呈Syn和CgA低表达,Ki-67增殖指数高(典型者>50%)。结论在肺小活检标本中,尤其是对于有组织挤压伤的标本,存在着类癌过诊为小细胞癌的危险性。Ki-67增殖指数的检测对诊断有重要的意义。更多还原

【Abstract】 Objective To explore the differential diagnosis of pulmonary carcinoids and small cell lung cancer(SCLC) in bronchoscopically biopsied specimens.Methods We analyzed 7 cases of pulmonary carcinoids misdiagnosed as SCLC in bronchoscopically biopsied specimens.Bronchial biopsies from 9 cases of SCLC were used as control group for histologic and immunohistochemical studies.Results The pulmonary carcinoids presented as either central or peripheral lesions composed of tumor cells with granular,sometimes coarse chromatin pattern,high levels of chromogranin A/synaptophysin immunoreactivity,and low(<20%) Ki-67 labeling index.SCLC always showed central tumor location,finely dispersed nuclear chromatin,lower levels of chromogranin A/synaptophysin,and high(>50%) Ki-67 labeling index.Conclusion Misdiagnosis of pulmonary carcinoids as SCLC in small crushed bronchial biopsies remains a significantly potential problem in medical practice.The evaluation of tumor cell proliferation by Ki-67 labeling index may be the most useful ancillary technique for the distinction.更多还原