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原发性肺癌和肺上皮转移的免疫组织化学特征。

Immunohistochemical profiles in primary lung cancers and epithelial pulmonary metastases.

机构信息

Department of Surgery, Helsingborg Hospital, SE-251 87, Helsingborg, Sweden; Department of Clinical Sciences Lund, Division of Oncology and Pathology, Lund University, SE-221 00 Lund, Sweden.

Department of Genetics and Pathology, Division of Laboratory Medicine, Region Skåne, SE-221 85 Lund, Sweden.

出版信息

Hum Pathol. 2019 Feb;84:221-230. doi: 10.1016/j.humpath.2018.10.009. Epub 2018 Oct 31.

Abstract

Correct diagnosis of pulmonary tumors is essential for treatment decision and often relies on immunohistochemical markers. We stained tissue microarrays from resected primary lung cancer (n = 665) and pulmonary metastases (n = 425) for CK7, CK20, CDX2, CK5, p40, p63, TTF-1, napsin A, GATA3, and PAX8 to systematically assess the diagnostic value of these markers. Primary lung adenocarcinomas expressed TTF-1 in 90% and napsin A in 84% of the cases, whereas 10% were positive for p63, 7% for CDX2, 2% for CK20, and 2% for GATA3. Only 68% of the lung adenocarcinomas were positive for CK7, TTF-1, and napsin A and negative for all other markers. Primary lung squamous cell carcinomas expressed CK5, p40, and p63 in 94%-97% of cases, whereas 44% were positive for CK7, 20% for GATA3, 7% for CDX2, and 3% for TTF-1. Rare cases expressed PAX8, CK20, or napsin A. Pulmonary metastases of colorectal cancer were positive for CK20 in 83% and CDX2 in 99% of the cases. Rare cases expressed CK7, p63, or PAX8, whereas 4% expressed TTF-1. Pulmonary metastases of renal cell carcinomas were positive for PAX8 in 74%, napsin A in 7%, and CK7 in 7% of the cases. Pulmonary metastases of breast cancer were positive for GATA3 in 93% and CK7 in 78% of the cases, whereas 15% expressed CK5. Information on expression and patterns of immunohistochemical markers facilitates histopathological diagnostics. Evidently, unusual immune profiles occur and may lead to incorrect diagnosis.

摘要

准确诊断肺部肿瘤对于治疗决策至关重要,而这通常依赖于免疫组织化学标志物。我们对切除的原发性肺癌(n=665)和肺转移瘤(n=425)的组织微阵列进行了 CK7、CK20、CDX2、CK5、p40、p63、TTF-1、napsin A、GATA3 和 PAX8 的免疫染色,以系统评估这些标志物的诊断价值。原发性肺腺癌病例中,90%的病例表达 TTF-1,84%的病例表达 napsin A,而 10%的病例表达 p63,7%的病例表达 CDX2,2%的病例表达 CK20,2%的病例表达 GATA3。仅有 68%的肺腺癌病例 CK7、TTF-1 和 napsin A 阳性,而其他标志物均阴性。原发性肺鳞癌病例中,94%-97%的病例表达 CK5、p40 和 p63,而 44%的病例表达 CK7,20%的病例表达 GATA3,7%的病例表达 CDX2,3%的病例表达 TTF-1。极少数病例表达 PAX8、CK20 或 napsin A。结直肠癌的肺转移瘤病例中,83%的病例 CK20 阳性,99%的病例 CDX2 阳性。极少数病例 CK7、p63 或 PAX8 阳性,而 4%的病例 TTF-1 阳性。肾细胞癌的肺转移瘤病例中,74%的病例 PAX8 阳性,7%的病例 napsin A 阳性,7%的病例 CK7 阳性。乳腺癌的肺转移瘤病例中,93%的病例 GATA3 阳性,78%的病例 CK7 阳性,而 15%的病例 CK5 阳性。免疫组织化学标志物的表达和模式信息有助于组织病理学诊断。显然,不常见的免疫表型会出现,并可能导致误诊。

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