Simsir Aylin, Wei Xiao-Jun, Yee Herman, Moreira Andre, Cangiarella Joan
Department of Pathology, New York University School of Medicine--Bellevue Hospital Center, New York 10016, USA.
Am J Clin Pathol. 2004 Mar;121(3):350-7. doi: 10.1309/CM20-WA20-RW3T-600L.
We studied the staining patterns of bronchioloalveolar carcinoma (BAC) with antibodies to cytokeratin (CK) 7, CK20, and thyroid transcription factor-1 (TTF-1) to determine the diagnostic usefulness of this panel in differentiating BAC from metastatic adenocarcinoma in material obtained by fine-needle aspiration biopsy (FNAB) of the lung. We identified 16 cases of BAC. Of these, 6 were mucinous, 4 were nonmucinous, and 6 were mixed with focal mucinous differentiation. Immunohistochemical analysis with antibodies to CK7, CK20, and TTF-1 was performed on cell-block sections. Of the 6 mucinous BACs, 4 (67%) were CK7+, CK20+, and TTF-1-. All 4 nonmucinous BACs were CK7+ and CK20-, and 2 (50%) were TTF-1+. All 6 mixed BACs were diffusely positive for CK7 and focally positive for CK20; 5 (83%) were TTF-1+. Nonmucinous BACs display CK7, CK20, and TTF-1 immunoreactivity similar to conventional pulmonary adenocarcinoma. Mucinous and mixed BACs have an immunohistochemical phenotype that is different from that of conventional pulmonary adenocarcinoma. Knowledge of these staining patterns is crucial for distinguishing mucinous and mixed BACs from metastatic adenocarcinoma involving the lungs.
我们使用细胞角蛋白（CK）7、CK20和甲状腺转录因子-1（TTF-1）抗体研究细支气管肺泡癌（BAC）的染色模式，以确定该抗体组合在通过肺细针穿刺活检（FNAB）获取的材料中区分BAC与转移性腺癌的诊断价值。我们鉴定出16例BAC。其中，6例为黏液性，4例为非黏液性，6例为伴有局灶性黏液分化。对细胞块切片进行了CK7、CK20和TTF-1抗体的免疫组织化学分析。6例黏液性BAC中，4例（67%）为CK7阳性、CK20阳性、TTF-1阴性。所有4例非黏液性BAC均为CK7阳性、CK20阴性，2例（50%）为TTF-1阳性。所有6例混合性BAC均为CK7弥漫性阳性、CK20局灶性阳性；5例（83%）为TTF-1阳性。非黏液性BAC显示出与传统肺腺癌相似的CK7、CK20和TTF-1免疫反应性。黏液性和混合性BAC具有与传统肺腺癌不同的免疫组织化学表型。了解这些染色模式对于区分黏液性和混合性BAC与累及肺的转移性腺癌至关重要。
