The Relationship between the Biological Characteristics of Squamous Cell Lung Cancer of Neuroendocrine-like Differentiation and Its Prognosis

Objective: To investigate the relationship between the biological characteristics of squamous cell lung cancer of neuroendocrine-like differentiation (ND) and its prognosis. Methods: We used immunohistochemistry to detect the expression of neuron-specific enolase (NSE), synaptophysin (SYN) and chromogranin A (CGA) in paraffin-embedded specimens of 120 cases of surgically and pathologically confirmed squamous cell lung carcinoma. The Kaplan-meier survival curve model and the COX proportional hazards model were employed for univariate and multivariate survival analysis. Results: The positive rates of CGA, NSE, and SYN expression were 46.7%, 60.8%, and 36.7%, respectively. According to the criterion that the positive expression of at least two of the above markers indicates squamous cell lung cancer with ND, the incidence rate was 40.8%. No significant correlation was found among the three markers. Squamous cell lung cancer with ND was correlated with tumor cell differentiation and T stage. The expression of SYN was correlated with age, gender and tumor cell differentiation. Survival analysis by Log-Rank test showed that SYN expression (X~2=3.961, P=0.047) and postoperative chemotherapy (X~2=4.447, P=0.035)were related to the postoperative survival rate. There was no correlation between squamous cell lung cancer with ND and survival (X~2=0.524, P=0.469). Cox survival analysis indicated that patient age (OR=0.459, P=0.029), postoperative chemotherapy (OR=1.866, P=0.091) and the positive expression of SYN (OR=2.114, P=0.036) and CGA (OR=0.558, P=0.066) were correlated with survival rate. Cenclusion: Squamous cell lung cancer with ND is related to the degree of tumor differentiation and stage. Expression of SYN and postoperative chemotherapy are two parameters affecting prognosis in patients with squamous cell lung cancer with ND.