脑转移瘤及相应原发性肺癌的免疫组化特征

Immunohistochemical characteristics of brain metastases and corresponding primary lung cancer.

作者信息

Marinova Marinova Dora, Vitkov Mekov Evgeni, Gosheva Dimitrova Denitsa, Todorov Titorenkov Plamen, Martinov Mihailov Miroslav, Slavov Nachev Sevdalin, Milosheva Youroukova Vania, Temelkov Kostadinov Dimitar, Georgieva Slavova Yanina

机构信息

1Clinical Center for Lung Diseases, Medical University, Sofia, Bulgaria.

出版信息

J BUON. 2019 Jul-Aug;24(4):1626-1637.

PMID:31646818

Abstract

PURPOSE

to study brain metastases (BM) and their corresponding primary lung cancers (LCs).

METHODS

Surgically resected BMs and their corresponding primary LCs from 30 patients (25 men, 83%; age 55±9 years) were studied: 21 adenocarcinomas (ACs), 5 squamous cell carcinomas (SCCs), 4 small cell lung carcinomas (SCLCs). The histological subtype, immunohistochemical expression of TTF1, p63, Ki67 (proliferative activity), CD31, number of intratumoral microvessels, (NIM) and survival were evaluated.

RESULTS

There was a different histological structure in 47% of the cases of ACs of the lung in comparison with the corresponding metastasis, but none in SCC and SCLC. TTF-1 was expressed in a greater number of ACs (n=20; 95%), with lower mean expression levels, while the corresponding BM expressed the marker less frequently (n=16;76%) with higher mean expression values (p=0.011). P63 was expressed in all SCCs (p=0.68). Cytokeratin 7 was expressed equally in all ACs. Ki-67 proliferative index (PI) was higher in SCLC than in AC (p=0.008), in SCLC BM than in AC BM (p<0.001), and in SCLC BM than in SCC BM (p=0.008). The Ki-67 PI in BM was higher than in AC (p=0.003), SCC (p=0.048), but without difference in SCLC (p=0.141). CD31 NIM was higher in AC than in SCLC (p=0.003), in SCC than in SCLC (p=0.009), while no difference between AC and SCC was found (p=0.467). There were no differences between LC/BM in the NIM. Survival after surgery for LC was significantly longer in AC than in SCLC (p=0.017). SCLC histology and Ki67>18% were established as negative prognostic factors after surgery for LC. Such factors were not found after surgery for BM.

CONCLUSION

There are differences between primary LC and corresponding BM - in histology, immunohistochemical expression and proliferative activity, but there are no significant differences in vascularization. SCLC histology and Ki67>8% may represent negative prognostic factors after surgery for LC with BM.

摘要

目的

研究脑转移瘤（BM）及其相应的原发性肺癌（LC）。

方法

对30例患者（25例男性，占83%；年龄55±9岁）手术切除的脑转移瘤及其相应的原发性肺癌进行研究：21例腺癌（AC）、5例鳞状细胞癌（SCC）、4例小细胞肺癌（SCLC）。评估组织学亚型、TTF1、p63、Ki67（增殖活性）、CD31的免疫组化表达、瘤内微血管数量（NIM）及生存期。

结果

47%的肺腺癌病例与其相应转移瘤的组织学结构不同，而鳞状细胞癌和小细胞肺癌病例中则无此情况。更多的腺癌（n = 20；95%）表达TTF-1，平均表达水平较低，而相应的脑转移瘤表达该标志物的频率较低（n = 16；76%），平均表达值较高（p = 0.011）。所有鳞状细胞癌均表达p63（p = 0.68）。细胞角蛋白7在所有腺癌中的表达相同。小细胞肺癌的Ki-6�增殖指数（PI）高于腺癌（p = 0.008），小细胞肺癌脑转移瘤的Ki-67 PI高于腺癌脑转移瘤（p < 0.001），且高于鳞状细胞癌脑转移瘤（p = 0.008）。脑转移瘤中的Ki-67 PI高于腺癌（p = 0.003）、鳞状细胞癌（p = 0.048），但在小细胞肺癌中无差异（p = 0.141）。腺癌的CD31 NIM高于小细胞肺癌（p = 0.003），鳞状细胞癌的高于小细胞肺癌（p = 0.009），而腺癌和鳞状细胞癌之间无差异（p = 0.467）。肺癌/脑转移瘤在NIM方面无差异。腺癌患者肺癌手术后的生存期明显长于小细胞肺癌患者（p = 0.017）。小细胞肺癌组织学类型和Ki67>18%被确定为肺癌手术后的阴性预后因素。脑转移瘤手术后未发现此类因素。