Institute of Pathology, University Hospital Heidelberg, Heidelberg, Germany.
Translational Lung Research Centre Heidelberg, Member of the German Centre for Lung Research, Heidelberg, Germany.
Histopathology. 2018 May;72(6):997-1006. doi: 10.1111/his.13455. Epub 2018 Feb 20.
Pulmonary (ADC) and colorectal (CRC) adenocarcinomas are frequent entities in pathological routine diagnostics. Whereas the differential diagnosis is usually straightforward based on histomorphology, it can be challenging in small biopsies. In general, CDX-2, CK20, Napsin-A and TTF-1 are recommended immunohistological markers in this scenario. Hepatocyte nuclear factor 4 alpha (HNF4-α) and special AT-rich sequence-binding protein 2 (SATB2) were described recently as promising additional markers, but comprehensive large-scale data are lacking so far. Therefore, we analysed the expression of these six markers in 1021 non-small-cell lung cancers (NSCLC), including 472 ADC as well as in 80 pulmonary metastases of CRC.
Tissue microarrays of NSCLC and pulmonary metastases of CRC were stained for CDX-2, CK20, HNF4-α, Napsin-A, SATB2 and TTF-1 and staining results were correlated with clinicopathological variables. ADC exhibited expression of CDX-2, CK20, HNF4-α, Napsin-A, SATB2 and TTF-1 in nine (2%), 21 (4%), 17 (4%), 345 (73%), 35 (7%) and 408 (86%) samples, while 80 CRC were positive in 79 (99%), 74 (93%), 77 (96%), no (0%), 78 (98%) and five (6%) cases, respectively.
In addition to conventional immunomarkers, HNF4-α and particularly SATB2 may be helpful in the differential diagnosis of pulmonary ADC and metastases of CRC.
肺（ADC）和结直肠（CRC）腺癌是病理常规诊断中的常见实体。虽然基于组织形态学的鉴别诊断通常很直接，但在小活检中可能具有挑战性。一般来说，在这种情况下推荐使用 CDX-2、CK20、Napsin-A 和 TTF-1 作为免疫组织化学标志物。最近，肝细胞核因子 4α（HNF4-α）和特殊富含 AT 的序列结合蛋白 2（SATB2）被描述为有前途的附加标志物，但目前还缺乏全面的大规模数据。因此，我们分析了这六种标志物在 1021 例非小细胞肺癌（NSCLC）中的表达，包括 472 例 ADC 以及 80 例 CRC 的肺转移。
对 NSCLC 和 CRC 的肺转移组织微阵列进行 CDX-2、CK20、HNF4-α、Napsin-A、SATB2 和 TTF-1 的染色，并将染色结果与临床病理变量相关联。ADC 在 9%（2/21）、4%（9/211）、4%（7/171）、73%（345/472）、7%（3/41）和 86%（408/472）的样本中表达 CDX-2、CK20、HNF4-α、Napsin-A、SATB2 和 TTF-1，而 80 例 CRC 分别在 99%（79/80）、93%（74/80）、96%（77/80）、0%（0/80）、98%（78/80）和 6%（5/80）的样本中表达。
除了常规免疫标志物外，HNF4-α和特别是 SATB2 可能有助于肺 ADC 和 CRC 转移的鉴别诊断。
