High-grade neuroendocrine carcinoma of the lung: comparative clinicopathological study of large cell neuroendocrine carcinoma and small cell lung carcinoma.
ABSTRACT Large cell neuroendocrine carcinoma (LCNEC) and small cell lung carcinoma (SCLC) are high-grade neuroendocrine carcinomas. In order to clarify the similarities and differences between these cancers, 22 cases each of LCNEC and SCLC were collected and a comparative pathological study was carried out. First, their clinicopathological characteristics were confirmed, which were very similar to those previously reported. The 5 year survival rate of LCNEC and SCLC patients was 38.3% and 29.7%, respectively. The morphological characteristics of LCNEC and SCLC were then reviewed with regard to the morphology previously used to differentiate these cancers. As a result, many morphological indicators, such as tumor cell size, nuclear/cytoplasmic ratio, nuclear molding, rosette formation, prominent nucleoli and karyolysis were confirmed to be significant indicators for distinguishing LCNEC from SCLC. On comparative immunohistochemistry, LCNEC had significantly high staining scores for the expression of keratin 7 and 18, E- and P-cadherins, beta-catenin, villin 1, retinoblastoma protein (pRB), c-met and alpha-enolase. These results might reflect the differentiation or deviation of LCNEC toward an epithelial nature irrespective of neuroendocrine tumor lineage. In conclusion, the present comparative study of LCNEC and SCLC defined the similarities and differences between these cancers, and showed the biologically and clinicopathologically overlapping spectrum of the tumor lineage.
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ABSTRACT: The overall clinicopathological features or the optimal therapy for large cell neuroendocrine carcinoma (LCNEC) have yet to be defined, because LCNEC has not been studied in the same depth as had small cell lung carcinoma (SCLC) in both clinical and biological standpoints. The aim of this study was to elucidate the clinical features of high-grade neuroendocrine carcinoma (HGNEC)-probable LCNEC diagnosed by biopsy, and compare therapeutic efficacy with patients with SCLC. We retrospectively examined the chart of total of 25 patients who underwent chemotherapy or chemoradiotherapy as initial therapy for a histologic diagnosis of HGNEC-probable LCNEC, using biopsy samples and compared their data with those of 180 patients with SCLC. We analyzed their responses to chemotherapy and/or radiation therapy and survival outcomes. In 25 patients with HGNEC-probable LCNEC, 18 patients initially received chemotherapy (17 (94%) of whom received platinum-based chemotherapy) with an overall response rate (ORR) of 61%. The remaining 7 patients received chemoradiotherapy with an ORR of 86%, and 12 of the 25 patients who received second-line chemotherapy had an ORR of 17%. A total of 101 patients with SCLC who initially received chemotherapy had an ORR of 63%, and 79 patients who initially received chemoradiotherapy had an ORR of 98%, and 102 of the 180 patients who received second-line chemotherapy had an ORR of 45%. The 1-year overall survival rate for patients with stage IV HGNEC-probable LCNEC (n=13) and those with ED-SCLC (n=80) was 34% and 49%, respectively (p=0.84). The overall response rate to initial treatment and the survival outcomes of HGNEC-probable LCNEC were comparable to those of SCLC, but the effectiveness of second-line chemotherapy appeared to differ between the 2 groups.Lung cancer (Amsterdam, Netherlands) 09/2011; 75(3):368-73. DOI:10.1016/j.lungcan.2011.08.012 · 3.74 Impact Factor
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ABSTRACT: The ectopic endometrial tissues lining the lumen of the fallopian tubes are currently defined as either "endometrial colonization" or "endometriosis" on the basis of their location within or beyond the isthmic portion of the fallopian tubes. The underlying etiology is unclear. The goal of this study was to define the fallopian endometrial lesions pathogenetically rather than anatomically. We investigated 39 cases of the ectopic endometrial tissues within the fallopian tubes, most of which exceeded the isthmus. Immunohistochemical analysis was performed to evaluate the expression of Cox-2, NF-κB, and VEGF, which are specifically expressed by classic endometriosis. Other clinicopathologic parameters were also recorded. The results indicated that the lesions that were confined to the mucosa might differ from those observed in the muscular or serosal layers, which showed significantly less surrounding inflammatory reaction and less concurrent salpingitis and other endometriotic lesions. The expression of Cox-2, NF-κB, and VEGF of the ectopic endometrial stromal cells tended to increase in the progression from the inner to the outer part of the tubes with significance. The expression of NF-κB and VEGF correlates with the microscopic findings of inflammation. Sterilization by tubal ligation exhibited a unique pattern of distribution. Except in those patients with tubal ligation, considering the different expression patterns observed in the tubal ectopic endometrial lesions, the mucosal type should be diagnosed as "endometrial colonization" wherever the lesion occurs. The others should be diagnosed as "endometriosis" to reveal the etiology identical to typical endometriotic lesions.International Journal of Gynecological Pathology 06/2014; 33(4). DOI:10.1097/PGP.0000000000000080 · 1.63 Impact Factor
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ABSTRACT: PurposeA new approach has been developed to quantify cell sizes and intracellular volume fractions using temporal diffusion spectroscopy with diffusion-weighted acquisitions.Methods Temporal diffusion spectra may be used to characterize tissue microstructure by measuring the effects of restrictions over a range of diffusion times. Oscillating gradients have been used previously to probe variations on cellular and subcellular scales, but their ability to accurately measure cell sizes larger than 10 μm is limited. By combining measurements made using oscillating gradient spin echo (OGSE) and a conventional pulsed gradient spin echo (PGSE) acquisition with a single, relatively long diffusion time, we can accurately quantify cell sizes and intracellular volume fractions.ResultsBased on a two compartment model (incorporating intra- and extracellular spaces), accurate estimates of cell sizes and intracellular volume fractions were obtained in vitro for (i) different cell types with sizes ranging from 10 to 20 μm, (ii) different cell densities, and (iii) before and after anticancer treatment.Conclusion Hybrid OGSE-PGSE acquisitions sample a larger region of temporal diffusion spectra and can accurately quantify cell sizes over a wide range. Moreover, the maximum gradient strength used was lower than 15 G/cm, suggesting that this approach is translatable to practical MR imaging. Magn Reson Med, 2015. © 2015 Wiley Periodicals, Inc.Magnetic Resonance in Medicine 04/2015; DOI:10.1002/mrm.25684 · 3.40 Impact Factor