Demirag F, Cakir E, Bayiz H, Eren Yazici U
Department of Pathology, Atatürk Chest Diseases and Chest Surgery Education and Research Hospital, Ankara, Turkey.
Acta Chir Belg. 2013 Jan-Feb;113(1):19-24. doi: 10.1080/00015458.2013.11680879.
Adenosquamous carcinoma of the lung involves both adenocarcinoma and squamous cell carcinoma, each comprising at least 10% of the tumor. Atypical adenomatous hyperplasia (ADH), bronchiolar columnar cell dysplasia (BCCD), basal cell dysplasia (BCD), columnar cell dysplasia (CCD), bronchial epithelial dysplasia with transitional differentiation (BEDT) and squamous dysplasia (SD) are preinvasive lesions. The aim of this study is to define the preinvasive lesions and evaluate the role of MUC1, bcl-2, and the preinvasive and invasive components of adenosquamous carcinoma.
A group of 31 patients with adenosquamous carcinoma of the lung were selected. The ratio of squamous to glandular differentiation, the associated preinvasive lesions, the features of peritumoral tissue, the stroma of the tumor, necrosis, perineural and vascular invasion were analyzed. For the immunohistochemical study, blocks containing squamous cell carcinoma, adenocarcinoma and preinvasive lesions were selected. MUC1 and bcl-2 analyses were performed by the immunoperoxidase method using the avidin-biotin complex.
Associated preinvasive lesions amd SD, BCCD, BEDT, AAH and CCD were observed in 24, 6, 3, 1 and 6 cases, respectively. Expression for MUC1 was positive in the squamous component of 30 cases, the adenocarcinoma component of 27 cases and in 34 preinvasive lesions. A strong correlation was found between MUC-1 expression in the squamous component and tumor localization (p = 0,01). The positive expression of Bcl-2 in the adenocarcinomatous component was correlated with the presence of preinvasive lesions (p = 0,01).
Squamous dysplasia was the most frequent preinvasive lesion of adenosquamous carcinomas. MUC1 and bcl-2 expression levels were strongly associated with preinvasive lesions in adenosquamous carcinomas.
肺腺鳞癌同时包含腺癌和鳞癌成分，每种成分至少占肿瘤的10%。非典型腺瘤样增生（ADH）、细支气管柱状细胞发育异常（BCCD）、基底细胞发育异常（BCD）、柱状细胞发育异常（CCD）、具有移行分化的支气管上皮发育异常（BEDT）和鳞状发育异常（SD）均为浸润前病变。本研究的目的是明确浸润前病变，并评估MUC1、bcl-2以及腺鳞癌浸润前和浸润成分的作用。
选取31例肺腺鳞癌患者。分析鳞癌与腺癌分化比例、相关浸润前病变、瘤周组织特征、肿瘤间质、坏死、神经和血管侵犯情况。对于免疫组化研究，选取包含鳞癌、腺癌和浸润前病变的组织块。采用抗生物素蛋白-生物素复合物免疫过氧化物酶法进行MUC1和bcl-2分析。
分别在24例、6例、3例、1例和6例中观察到相关浸润前病变以及SD、BCCD、BEDT、AAH和CCD。MUC1在30例鳞癌成分、27例腺癌成分以及34例浸润前病变中呈阳性表达。发现鳞癌成分中MUC-1表达与肿瘤定位之间存在强相关性（p = 0.01）。腺癌成分中Bcl-2的阳性表达与浸润前病变的存在相关（p = 0.01）。
鳞状发育异常是腺鳞癌最常见的浸润前病变。MUC1和bcl-2表达水平与腺鳞癌的浸润前病变密切相关。
