Unit of Surgical Pathology, Laboratory of Molecular Pathology, S. Chiara Hospital, Largo Medaglie Oro 9, Trento, Italy.
Am J Clin Pathol. 2011 Nov;136(5):773-82. doi: 10.1309/AJCPYY79XAGRAYCJ.
Large cell carcinomas (LCCs) of the lung are heterogeneous and may be of different cell lineages. We analyzed 56 surgically resected lung tumors classified as LCC on the basis of pure morphologic grounds, using a panel of immunophenotypic markers (adenocarcinoma [ADC]-specific, thyroid transcription factor-1, cytokeratin 7, and napsin A; squamous cell carcinoma [SQCC]-specific, p63, cytokeratin 5, desmocollin 3, and Δnp63) and the quantitative analysis of microRNA-205 (microRNA sample score [mRSS]). Based on immunoprofiles 19 (34%) of the cases were reclassified as ADC and 14 (25%) as SQCC; 23 (41%) of the cases were unclassifiable. Of these 23 cases, 18 were classified as ADC and 5 as SQCC according to the mRSS. Our data show that an extended panel of immunohistochemical markers can reclassify around 60% of LCCs as ADC or SQCC. However, a relevant percentage of LCCs may escape convincing immunohistochemical classification, and mRSS could be used for further typing, but its clinical relevance needs further confirmation.
肺大细胞癌（LCC）具有异质性，可能来源于不同的细胞谱系。我们分析了 56 例基于纯形态学基础诊断为 LCC 的手术切除肺肿瘤，使用一组免疫表型标志物（腺癌 [ADC]-特异性标志物、甲状腺转录因子-1、细胞角蛋白 7 和 napsin A；鳞状细胞癌 [SQCC]-特异性标志物、p63、细胞角蛋白 5、桥粒蛋白 3 和 Δnp63）和 microRNA-205（microRNA 样本评分 [mRSS]）的定量分析。根据免疫表型，19 例（34%）病例被重新分类为 ADC，14 例（25%）为 SQCC；23 例（41%）病例无法分类。在这 23 例病例中，根据 mRSS，18 例被分类为 ADC，5 例被分类为 SQCC。我们的数据表明，扩展的免疫组化标志物面板可以将大约 60%的 LCC 重新分类为 ADC 或 SQCC。然而，仍有相当一部分 LCC 可能无法通过免疫组织化学分类来明确诊断，而 mRSS 可用于进一步分型，但它的临床相关性仍需进一步证实。
