부산대학교 도서관

Simple Summary: Small cell lung cancer (SCLC) and large cell neuroendocrine carcinoma (LCNEC) of the lung are now classified as lung neuroendocrine carcinomas (NECs) and have different treatment strategies compared with non-SCLC. Although these NECs are less frequently resected by surgery, the diagnosis of LCNEC is particularly difficult in some cases because staining for neuroendocrine markers is necessary in addition to morphological features. In our retrospective study of pathology specimens from 42 surgically resected SCLCs and 44 LCNECs, we demonstrated that immunohistochemical staining with Musashi-1, a marker of neural stem cells, more diffusely and intensely stained SCLC and LCNEC tissues. The findings of this study may improve and simplify the diagnosis of NECs in surgical and biopsy specimens and increase the opportunity to provide more appropriate treatment for patients. Small cell lung cancer (SCLC) and large cell neuroendocrine carcinoma (LCNEC) have recently been grouped as lung neuroendocrine carcinomas (NECs). Because these lung NECs are clinically malignant and their treatment strategies differ from those of non-SCLC, the quality of diagnosis has a significant prognostic impact. The diagnosis of LCNEC requires positive immunohistochemical staining with chromogranin A, synaptophysin, and CD56, along with a morphological diagnosis, and insulinoma-associated protein 1 (INSM1) has been proposed as an additional marker but is still not an ideal or better marker. We investigated Musashi-1 as a novel immunohistochemical marker in 42 patients with SCLCs and 44 with LCNECs who underwent lung resection between 1998 and 2020 at our institution. We found Musashi-1 expression in 98% (41/42) SCLC and in 90% (40/44) LCNEC. These findings were similar to CD56 expression and superior to synaptophysin, chromogranin A, and INSM1. Musashi-1 also tended to show more diffuse and intense staining, especially in LCNEC, with more cases staining > 10% than any other existing markers (Musashi-1, 77%; INSM1, 45%; chromogranin A, 34%; synaptophysin, 41%; and CD56, 66%). In conclusion, we identified Musashi-1 as a novel immunohistochemical staining marker to aid in the diagnosis of lung NEC. [ABSTRACT FROM AUTHOR]