Department of Pathology, Istanbul Faculty of Medicine, Istanbul University, ISTANBUL, TURKEY.
Turk Patoloji Derg. 2023;39(1):64-74. doi: 10.5146/tjpath.2022.01593.
Lung adenocarcinomas are divided into acinar, lepidic, papillary, micropapillary, and solid predominant subtypes according to the current World Health Organization (WHO) classification. We designed this retrospective study to demonstrate profiles of MUC expression (MUC1, MUC2, MUC5AC, and MUC6) of different histologic patterns within the same tumor among pulmonary adenocarcinomas and investigate correlations of MUC expression with clinicopathologic features.
We analyzed the expression of mucins (MUC1, MUC2, MUC5AC, and MUC6) in a series of 99 resected lung adenocarcinomas, which included a total of 193 patterns (71 acinar, 30 lepidic, 25 papillary, 20 micropapillary, 34 solid and 13 mucinous) and calculated a final immune reactivity score (FIRS) per tumor.
MUC1 IRS scores were significantly higher in lepidic and solid patterns compared with mucinous patterns (p=0.013). MUC2 expression was seen only in three cases (1 acinar, 2 mucinous). MUC5AC and MUC2 expression was more common in mucinous patterns (p < 0.001 and p=0.028, respectively). MUC6 expression was only detected in seven patterns and the expression was weak. No significant difference was seen among histologic patterns for the staining scores of MUC6. Mucinous adenocarcinoma differed from other histologic subtypes regarding MUC1 and MUC5AC expression. Mucinous adenocarcinoma showed less MUC1 expression with lower IRS scores and higher MUC5AC expression. Tumor size (p=0.006), lymphatic invasion (p=0.018), vascular invasion (p=0.025), perineural invasion (p=0.019), MUC1 IRS scores (p=0.018), and MUC1 IRS scores > 8.5 (p=0.018) were significant predictors for lymph node metastasis.
An alternative scoring for MUC1 can be used as a predictor for lymph node metastasis regardless of the histologic subtype.
根据现行的世界卫生组织（WHO）分类，肺腺癌可分为腺泡型、贴壁型、乳头型、微乳头型和实体为主型亚型。我们设计了这项回顾性研究，旨在展示同一肿瘤内不同组织学模式的 MUC 表达（MUC1、MUC2、MUC5AC 和 MUC6）特征，并探讨 MUC 表达与临床病理特征的相关性。
我们分析了 99 例肺腺癌切除标本中黏蛋白（MUC1、MUC2、MUC5AC 和 MUC6）的表达，包括 71 个腺泡型、30 个贴壁型、25 个乳头型、20 个微乳头型、34 个实体为主型和 13 个黏液型，计算每个肿瘤的最终免疫反应评分（FIRS）。
MUC1 IRS 评分在贴壁型和实体为主型中明显高于黏液型（p=0.013）。MUC2 表达仅见于 3 例（1 例腺泡型，2 例黏液型）。MUC5AC 和 MUC2 表达在黏液型中更为常见（p<0.001 和 p=0.028）。MUC6 表达仅在 7 种模式中检测到，表达较弱。MUC6 的染色评分在组织学模式之间无显著差异。黏液性腺癌在 MUC1 和 MUC5AC 表达方面与其他组织学亚型不同。黏液性腺癌 MUC1 表达较低，IRS 评分较低，MUC5AC 表达较高。肿瘤大小（p=0.006）、淋巴血管侵犯（p=0.018）、脉管侵犯（p=0.025）、神经侵犯（p=0.019）、MUC1 IRS 评分（p=0.018）和 MUC1 IRS 评分>8.5（p=0.018）是淋巴结转移的显著预测因素。
无论组织学亚型如何，MUC1 的替代评分可作为淋巴结转移的预测因子。
