Sturm N, Lantuéjoul S, Laverrière M H, Papotti M, Brichon P Y, Brambilla C, Brambilla E
Laboratoire de Pathologie Cellulaire, Service de Chirurgie Thoracique, and Lung Cancer Research Group, INSERM 9924, Centre Hospitalo-Universitaire Albert Michallon, Grenoble, France.
Hum Pathol. 2001 Sep;32(9):918-25. doi: 10.1053/hupa.2001.27110.
Basaloid carcinoma (BC) and large-cell neuroendocrine carcinoma (LCNEC) are 2 recently recognized variants of large-cell lung carcinomas that may overlap in their morphology, and are discriminated by expression of neuroendocrine markers in LCNEC. Because thyroid transcription factor 1 (TTF-1) is expressed in lung adenocarcinomas but not in squamous cell carcinomas (SCC), and 34betaE12 recognizes a set of high-molecular-weight cytokeratins characteristic of basal stem cells, we hypothesized that these 2 markers could help in distinguishing BC from LCNEC. Immunostaining for TTF-1 was detected in 40.9% of pure LCNEC but in no BC or basaloid variant of SCC. In contrast, immunoreactivity for 34betaE12 was shown in all BC and basaloid variant of SCC but in only 1 LCNEC. Bouin fixation was less efficient than formalin in the immunodetection of both markers for its well-known deleterious effect on antigen preservation. Specificity of TTF-1 for LCNEC (100%) and that of 34betaE12 for BC (98.3%) exceeded that of NE markers for distinction of these 2 entities. These data show that TTF-1 and 34betaE12, in association with specific neuroendocrine markers, represent a useful panel of antibodies in differentiating carcinomas presenting with a solid pattern, palisading, or pseudorosettes, the expression of TTF-1 excluding the diagnosis of BC, and staining with 34betaE12 excluding pure LCNEC.
基底样癌（BC）和大细胞神经内分泌癌（LCNEC）是最近才被认识的大细胞肺癌的两种变体，它们在形态上可能重叠，可通过LCNEC中神经内分泌标志物的表达来区分。由于甲状腺转录因子1（TTF-1）在肺腺癌中表达而在鳞状细胞癌（SCC）中不表达，且34βE12识别一组基底干细胞特有的高分子量细胞角蛋白，我们推测这两种标志物有助于区分BC和LCNEC。在40.9%的纯LCNEC中检测到TTF-1免疫染色，但在BC或SCC的基底样变体中均未检测到。相反，在所有BC和SCC的基底样变体中均显示34βE12免疫反应性，但仅在1例LCNEC中显示。由于Bouin固定对抗原保存有众所周知的有害作用，在两种标志物的免疫检测中其效率低于福尔马林固定。TTF-1对LCNEC的特异性（100%）和34βE12对BC的特异性（98.3%）超过了用于区分这两种实体的神经内分泌标志物的特异性。这些数据表明，TTF-1和34βE12与特定的神经内分泌标志物联合，在鉴别呈现实性模式、栅栏状或假菊形团的癌中是一组有用的抗体，TTF-1的表达可排除BC的诊断，而34βE12染色可排除纯LCNEC。
