Division of Thoracic Surgery, Shizuoka Cancer Center, Japan.
Division of Diagnostic Pathology, Shizuoka Cancer Center, Japan.
Lung Cancer. 2014 Apr;84(1):45-50. doi: 10.1016/j.lungcan.2014.01.010. Epub 2014 Jan 23.
Our previous study found unique adenosquamous carcinomas (ADSQs) containing a mucoepidermoid carcinoma (MEC)-like component and a characteristic p63 staining pattern. This study focused on these unique ADSQs.
Thirty ADSQ cases were studied histologically and by immunohistochemistry for TTF-1 and p63. Of these 30 ADSQs, eight were selected as unique ADSQs. The clinicopathological characteristics of these ADSQs were further studied, and the gene rearrangement of mammalian mastermind-like 2 (MAML2) was investigated by fluorescence in situ hybridization (FISH) for differentiation from pulmonary MEC.
The clinicopathological characteristics between the eight ADSQs and the other ADSQ cases showed no statistically significant differences, except for serum CEA level. Histologically, the eight ADSQs contained varying degrees of the MEC-like component, which consisted of solid nests with mucin-filled cysts or a cribriform-like structure. Immunohistochemically, p63-positive nuclei characteristically encircled the tumor nests, although TTF-1 was completely negative. All unique ADSQs not only had a variable degree of squamous cell carcinoma component in addition to the MEC-like component, but also contained a small tubular adenocarcinoma component in three tumors. FISH analysis revealed no MAML2 gene rearrangement in the eight ADSQs.
Of the 30 ADSQs investigated in this study, eight contained a MEC-like component with a characteristic p63 basilar staining pattern similar to that of bronchial basal cells. These unique ADSQs shared clinical characteristics with ordinary ADSQs, but clinicopathologically differed from pulmonary ordinary MEC. Therefore, these unique ADSQs may be either a novel ADSQ subtype originating from bronchial epithelium or variant-type MEC.
我们之前的研究发现了一种独特的腺鳞癌（ADSQ），其包含黏液表皮样癌（MEC）样成分和特征性的 p63 染色模式。本研究专注于这些独特的 ADSQ。
对 30 例 ADSQ 病例进行组织学和免疫组织化学研究，检测 TTF-1 和 p63。在这 30 例 ADSQ 中，选择了 8 例作为独特的 ADSQ。进一步研究这些 ADSQ 的临床病理特征，并通过荧光原位杂交（FISH）研究哺乳动物类脑基因 2（MAML2）的基因重排，以与肺 MEC 相区分。
8 例 ADSQ 与其他 ADSQ 病例的临床病理特征除了血清 CEA 水平外，无统计学显著差异。组织学上，8 例 ADSQ 包含不同程度的 MEC 样成分，其由充满黏液的囊泡或筛状结构的实性巢组成。免疫组织化学上，p63 阳性核特征性地环绕肿瘤巢，而 TTF-1 完全阴性。所有独特的 ADSQ 不仅除了 MEC 样成分外，还具有不同程度的鳞状细胞癌成分，并且在三个肿瘤中还包含小管腺癌成分。FISH 分析显示，8 例 ADSQ 中均未发现 MAML2 基因重排。
在本研究中调查的 30 例 ADSQ 中，有 8 例包含具有特征性 p63 基底染色模式的 MEC 样成分，类似于支气管基底细胞。这些独特的 ADSQ 与普通的 ADSQ 具有相似的临床特征，但在临床病理上与肺普通 MEC 不同。因此，这些独特的 ADSQ 可能是源自支气管上皮的新型 ADSQ 亚型或变异型 MEC。
