Inamura Kentaro, Satoh Yukitoshi, Okumura Sakae, Nakagawa Ken, Tsuchiya Eiju, Fukayama Masashi, Ishikawa Yuichi
Department of Pathology, Cancer Institute, Japanese Foundation for Cancer Research, Tokyo, Japan.
Am J Surg Pathol. 2005 May;29(5):660-5. doi: 10.1097/01.pas.0000160438.00652.8b.
Primary pulmonary adenocarcinomas with enteric differentiation (PAED) are mainly composed of tall-columnar cells that show similarity to intestinal epithelia and colorectal carcinomas. In this study, we analyzed the immunostaining profiles of 7 PAEDs in comparison with 14 metastatic colorectal carcinomas (MCRs) and 30 usual pulmonary adenocarcinomas (PACs), using antibodies against CDX-2, cytokeratin 7 (CK7), cytokeratin 20 (CK20), TTF-1, surfactant apoprotein-A (SP-A), Napsin A, and MUC2. The positive rates for CDX-2, CK7, CK20, TTF-1, SP-A, Napsin A, and MUC2 were 71%, 100%, 43%, 43%, 14%, 0%, and 43%, respectively, in the PAEDs; 100%, 0%, 86%, 0%, 0%, 0%, and 57% in the MCRs; 3%, 100%, 0%, 93%, 73%, 90%, and 0% in PACs. As expected, immunoreactivity of CDX-2, CK20, and MUC2 was detected in PAEDs. The observed decrease or loss of immunoreactivity for TTF-1, SP-A, and Napsin A indicates that these lesions demonstrate a shift away from their pulmonary phenotype, although CK7 expression was retained. The results indicate that CK7 and CK20 may be useful markers for distinction of PAEDs from MCRs.
具有肠化生的原发性肺腺癌（PAED）主要由高柱状细胞组成，这些细胞与肠上皮和结直肠癌具有相似性。在本研究中，我们使用针对CDX-2、细胞角蛋白7（CK7）、细胞角蛋白20（CK20）、甲状腺转录因子-1（TTF-1）、表面活性蛋白A（SP-A）、Napsin A和MUC2的抗体，分析了7例PAED与14例转移性结直肠癌（MCR）和30例普通肺腺癌（PAC）的免疫染色谱。在PAED中，CDX-2、CK7、CK20、TTF-1、SP-A、Napsin A和MUC2的阳性率分别为71%、100%、43%、43%、14%、0%和43%；在MCR中分别为100%、0%、86%、0%、0%、0%和57%；在PAC中分别为3%、100%、0%、93%、73%、90%和0%。正如预期的那样，在PAED中检测到了CDX-2、CK20和MUC2的免疫反应性。观察到TTF-1、SP-A和Napsin A免疫反应性的降低或丧失，表明这些病变虽然保留了CK7表达，但显示出从肺表型的转变。结果表明，CK7和CK20可能是区分PAED与MCR的有用标志物。
