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目的： 探讨非小细胞肺癌神经内分泌分化的免疫组化诊断。方法： 选择三种神经内分泌共同标记ＣＧＡ、ＳＹＮ、ＮＣＮＭ， 应用免疫组化ＬＳＡＢ 法， 观察它们在ＮＳＣＬＣ 中的表达。结果： 在１６３ 例ＮＳＣＬＣ 中， １８ 例（１１－０４ ％ ） 表达ＣＧＡ，６３ 例（３８－６５ ％ ） 表达ＳＹＮ，４０ 例（２４－５４ ％ ） 表达ＮＣＡＭ 。７７ 例（４７－２４ ％ ） ＮＳＣＬＣ 至少有１ 种ＮＥ 标记表达，其中４０ 例只表达１ 种标记，３０ 例表达２ 种标记，仅７ 例３ 种标记均表达。３ 种标记表达彼此相关（ Ｐ＜０－００５） ，但存在差异（ Ｐ＜ ０－００５） 。与腺癌相比，腺鳞癌、鳞癌、大细胞癌染色阳性率较低。结论：选择３ 种ＮＥ 标记可以检测出ＮＳＣＬＣ 的ＮＥ 分化， 但不能以某一种标记的表达与否作为ＮＳＣＬＣ 的ＮＥ 分化诊断， 应联合检测以至少２ 种标记表达定义为ＮＥ 分化，在不同类型的ＮＳＣＬＣ 中腺癌更易出现ＮＥ 分化。
Objective: To investigate the immunohistochemical diagnosis of neuroendocrine differentiation in non-small cell lung cancer. METHODS: Three neuroendocrine markers, CGA, SYN, and NCNM, were selected and used for immunohistochemical LSAB to observe their expression in NSCLC. RESULTS: Of the 163 NSCLC cases, 18 (11-04%) expressed CGA, 63 (38-65%) expressed SYN, and 40 (24-54%) expressed NCAM. 77 cases (47-24%) of NSCLC had at least one type of NE marker expression, of which 40 cases only expressed 1 marker, 30 cases expressed 2 markers, and only 7 of 3 markers were expressed. The expression of the three markers was related to each other (P<0-005) but there was a difference (P<0-005). Compared with adenocarcinoma, the positive rate of adenosquamous carcinoma, squamous cell carcinoma and large cell carcinoma was low. CONCLUSIONS: The selection of 3 NE markers can detect NE differentiation in NSCLC, but it cannot be used as a marker for the diagnosis of NSCLC for NE differentiation. It should be combined to detect the expression of at least 2 markers defined as NE differentiation in different types. Adenocarcinoma in NSCLC is more prone to NE differentiation.