Clinical characterization of non-small-cell lung cancer tumors showing neuroendocrine differentiation features.

Abstract

In most cases of small-cell lung carcinomas (SCLC) phenotypic features compatible with a neuroendocrine differentiation status can be identified by monoclonal (MOC) antibody-based immunohistological procedures. Similar features can be recognized only in a minority of non-SCLC tumors. During a period of 30 months, all diagnostic non-SCLC biopsies (141 cases) were prospectively analysed for the presence of markers indicative for neuroendocrine differentiation. In 31% of all cases, such a presence could be noticed. Neuroendocrine differentiation (50% to 100% positive-staining tumor cells) was recognized more frequently in adenocarcinoma when compared to large-cell and squamous-cell carcinoma (chi 2 = 9.31, 2 degrees of freedom, P less than 0.01). To investigate whether the clinical behavior of these "neuroendocrine" non-SCLC cases mimics SCLC, a multivariate analysis for prognostic factors was performed. Among other prognostic factors, biopsies containing more than 50% positive-staining tumor cells with the MOC antibody-1 (MOC-1) were recognized as negative prognostic factors.

Neuroendocrine differentiation and clinical behaviour in non-small cell lung tumours

“…Using this criterion, 30% of NSCLC tumours in both the retrospective and prospective group were found to be neuroendocrine. These results compare well with those reported previously (Linnoila et al, 1988b;Graziano et al, 1989;Berendsen et al, 1989). Importantly, tumours positive for two or more markers in our consecutive surgical series were associated with nodal involvement, particularly N2 disease.…”

“…In vitro drug sensitivity testing of SCLC, NSCLC and NE-NSCLC cell lines has shown that SCLC and NE-NSCLC cell lines are more responsive to cytotoxic drug treatment than non-NE-NSCLC (Gazdar, 1986). Similarly, several studies have shown that patients with NE-NSCLC show increased response to chemotherapy compared to patients with non-NE-NSCLC tumours (Mulshine et al, 1987;Gazdar et al, 1988b;Linnoila et al, 1988a;Berendsen et al, 1989;Graziano et al, 1989).…”

“…Although elevated levels of neuroendocrine (NE) markers have been detected in NSCLC tumours, the expression of more than one NE marker, though common in small cell lung cancer (SCLC) occurs much less frequently in NSCLC (Berger et al, 1981). Recent immunohistochemical studies have shown the presence of multiple NE markers in 10-20% of NSCLC (Gazdar, 1986;Linnoila et al, 1988b;Berendsen et al, 1989). The occurrence of NE differentiation in NSCLC tumours is significant not only because it suggests that the major forms of lung cancer represent a continuum of differentiation within a common cell lineage, but also because the response of neuroendocrine NSCLC (NE-NSCLC) to chemotherapy has been shown to be similar to that of SCLC.…”

Calcitonin driven v-Ha-ras induces multilineage pulmonary epithelial hyperplasias and neoplasms

“…In the WHO classi®cation, only SCLC and carcinoids are considered to be NE (de Bruine and Bosman, 1990;Paladugu et al, 1985), but many NSCLCs can express NE markers. Although this observation suggests an inherent plasticity of airway epithelium (Basbaum and Jany, 1990), it is also consistent with a common lineage for the major forms of lung cancer (Berendsen et al, 1989;Warren et al, 1984;Hammond and Sause, 1985).…”

Carcinoma neuroendocrino de células grandes de pulmón: análisis de una serie de once casos en un hospital universitario

“…Los Carcinoides Típicos (CT) representan TNP de bajo grado; los Carcinoides Atípicos (CA) TNP de grado intermedio; por úl-timo, los Carcinomas Neuroendocrinos de Células Grandes (CNCG) y los CPCP son TNP de alto grado. Esta heterogenicidad de los TNP implica diferencias clínicas, pronósticas, de tratamiento y de supervivencia de los pacientes [7][8][9][10][11] . Los CNCG son poco frecuentes (menos del 5% de los CPNCP), por lo que no existe suficiente información específica de esta entidad clínica.…”