Institute for pathology, forensic medicine and cytology Clinical Hospital Center Split, Split, Croatia.
Diagn Pathol. 2012 Nov 28;7:165. doi: 10.1186/1746-1596-7-165.
Lung cancer most often presents as an inoperable tumour and the diagnosis is usually performed on a small biopsy/cytology specimen. In the group of non small cell lung cancer - not otherwise specified, adenocarcinoma phenotype can be determined immunohistochemically using TTF-1 and Napsin A. Expression of oncofetal protein IMP3 in human cancer is associated with poor differentiation and aggressive behaviour. In the present study expression of IMP3 was correlated with expression of TTF-1 and Napsin A, histological subtype and clinical stage of lung adenocarcinoma. We were interested whether distant metastases are associated with IMP3 overexpression, regardless of the histologic subtype of adenocarcinoma.
In retrospective study, consecutive series of 105 patients with advanced lung adenocarcinoma diagnosed from 2006 to 2009 in Clinical Hospital Center Split, Croatia, were analysed. Clinical data were collected from the Pulmology Department and time of death from the Mortality Registry. Paraffin blocks of bronchoscopic biopsies were collected from the Institute of Pathology and 15 cases excluded from the analysis due to insufficient material. Expression of IMP3, Napsin A and TTF-1 were analysed by indirect enzyme immunohistochemistry. Statistical analysis was performed and P values less than 0.05 considered significant.
Of 90 patients, 71 (78%) were males and 19 (22%) females. Median age for males was 61.5 years (min-max 43-83) and for females 61 years (min-max 44-86). Pleural effusion was found in 15 (16.6%) and distant metastases in 45 (50%) cases. According to histological subtypes, there were 34 acinar, 2 lepidic, 2 papillary and 52 solid subtypes. IMP3 overexpression was found in 63 cases (70%) and was correlated with solid subtype (P = 0.002) and negative/weak Napsin A expression (P = 0.004). Strong Napsin A expression correlated with TTF-1 expression (P = 0.003) and lower histological grades (P = 0.031). Patients with IMP3 overexpression more often had distant metastases than patients with negative IMP3, 55.5% versus 33.3% (P = 0.033). Non solid subtypes with IMP3 overexpression developed distant metastasis more common than non solid subtypes with negative IMP3, 72% versus 35% (P = 0.028).
Expression of IMP3 correlates with solid subtype and with distant metastases regardless of histological subtype of lung adenocarcinoma.
http://www.diagnosticpathology.diagnomx.eu/vs/1966211581795258
肺癌通常表现为不可手术的肿瘤，诊断通常是基于小活检/细胞学标本进行的。在非小细胞肺癌-未特指类型中，可以使用 TTF-1 和 Napsin A 通过免疫组织化学方法确定腺癌表型。在人类癌症中，癌胚蛋白 IMP3 的表达与分化不良和侵袭性行为有关。在本研究中，我们研究了 IMP3 的表达与 TTF-1 和 Napsin A 的表达、组织学亚型和肺腺癌的临床分期之间的关系。我们感兴趣的是，无论腺癌的组织学亚型如何，远处转移是否与 IMP3 过表达有关。
在回顾性研究中，分析了 2006 年至 2009 年在克罗地亚斯普利特临床中心胸肺科连续诊断的 105 例晚期肺腺癌患者的资料。临床数据来自胸肺科，死亡时间来自死亡率登记处。从病理学研究所收集支气管镜活检的石蜡块，由于材料不足，15 例病例被排除在分析之外。通过间接酶免疫组织化学法分析 IMP3、Napsin A 和 TTF-1 的表达。进行了统计学分析，P 值小于 0.05 被认为具有统计学意义。
90 例患者中，71 例（78%）为男性，19 例（22%）为女性。男性的中位年龄为 61.5 岁（最小-最大 43-83 岁），女性为 61 岁（最小-最大 44-86 岁）。15 例（16.6%）患者有胸腔积液，45 例（50%）患者有远处转移。根据组织学亚型，有 34 例腺泡型、2 例贴壁型、2 例乳头型和 52 例实体型。发现 63 例（70%）IMP3 过表达，与实体型（P=0.002）和阴性/弱 Napsin A 表达（P=0.004）相关。强 Napsin A 表达与 TTF-1 表达相关（P=0.003）和较低的组织学分级相关（P=0.031）。IMP3 过表达的患者比 IMP3 阴性的患者更常发生远处转移，分别为 55.5%和 33.3%（P=0.033）。IMP3 过表达的非实体亚型比 IMP3 阴性的非实体亚型更常发生远处转移，分别为 72%和 35%（P=0.028）。
IMP3 的表达与实体型和远处转移相关，无论肺腺癌的组织学亚型如何。
