Tan J, Sidhu G, Greco M A, Ballard H, Wieczorek R
Department of Pathology, New York Veterans Affairs Medical Center, New York 10010, USA.
Hum Pathol. 1998 Apr;29(4):390-6. doi: 10.1016/s0046-8177(98)90121-6.
Villin (V) is a glycoprotein of microvilli associated with rootlet formation. Most colonic adenocarcinomas have a V positive (+), cytokeratin (CK) 20 (+), CK7-negative (-) immunophenotype; most lung adenocarcinomas have a CK20(-), CK7(+) immunophenotype. The reports of villin immunoreactivity in lung adenocarcinoma range from 6% to 68% in studies using various fixations and varied anti-villin antibodies. Some lung adenocarcinomas have microvilli with rootlets leading to possible diagnostic confusion with metastatic colonic adenocarcinoma to lung. Nine primary lung adenocarcinomas with rootlets on ultrastructure (including four bronchioloalveolar carcinomas [BAC]), four metastatic lung adenocarcinomas with rootlets, nine metastatic colon adenocarcinomas to lung, and 10 randomly selected lung adenocarcinomas without rootlets (including five BAC), were immunostained with monoclonal antibodies to villin (1D2C3), CK7 (OV-TL12/30), and CK20 (Ks20.8) using a streptavidin peroxidase technique with heat-induced epitope retrieval. All primary lung adenocarcinomas with rootlets were CK7(+) CK20(-), and six of nine (67%) were V(+). Cytoplasmic villin positivity occurred in a diffuse--five of nine (56%), focal--two of nine (22%), or brush border pattern--two of nine (22%). Two of four metastatic lung adenocarcinomas with rootlets were V(+). One metastatic lung adenocarcinoma had a CK7(+), CK20(+), V(-) phenotype. All metastatic colonic adenocarcinomas were V(+), CK20(+), CK7(-), and 1 of 10 (10%) lung adenocarcinomas without rootlets was V(+), and all 10 were CK20(-), and CK7(+). In summary, villin positivity is more common in lung adenocarcinoma with rootlets (67%) than those without rootlets (10%). AU primary lung adenocarcinomas were CK7(+), CK20(-). The combination of villin, CK 7, and CK 20 is helpful in differentiating metastatic colon adenocarcinoma from lung adenocarcinoma with rootlets.
绒毛蛋白（V）是一种与微绒毛相关的糖蛋白，与根丝形成有关。大多数结肠腺癌具有V阳性（+）、细胞角蛋白（CK）20阳性（+）、CK7阴性（-）的免疫表型；大多数肺腺癌具有CK20阴性（-）、CK7阳性（+）的免疫表型。在使用各种固定方法和不同抗绒毛蛋白抗体的研究中，肺腺癌中绒毛蛋白免疫反应性的报告范围为6%至68%。一些肺腺癌具有带有根丝的微绒毛，这可能导致与转移至肺的结肠腺癌产生诊断混淆。对9例超微结构有根丝的原发性肺腺癌（包括4例细支气管肺泡癌[BAC]）、4例有根丝的转移性肺腺癌、9例转移至肺的结肠腺癌以及10例随机选择的无根丝的肺腺癌（包括5例BAC），使用链霉亲和素过氧化物酶技术并进行热诱导抗原修复，用抗绒毛蛋白（1D2C3）、CK7（OV-TL12/30）和CK20（Ks20.8）的单克隆抗体进行免疫染色。所有有根丝的原发性肺腺癌均为CK7阳性（+）、CK20阴性（-），9例中有6例（67%）为V阳性（+）。细胞质绒毛蛋白阳性呈弥漫性——9例中有5例（56%）、局灶性——9例中有2例（22%）或刷状缘模式——9例中有2例（22%）。4例有根丝的转移性肺腺癌中有2例为V阳性（+）。1例转移性肺腺癌具有CK7阳性（+）、CK20阳性（+）、V阴性（-）的表型。所有转移性结肠腺癌均为V阳性（+）、CK20阳性（+）、CK7阴性（-），10例无根丝的肺腺癌中有1例（10%）为V阳性（+），所有10例均为CK20阴性（-）且CK7阳性（+）。总之，绒毛蛋白阳性在有根丝的肺腺癌（67%）中比无根丝的肺腺癌（10%）更常见。所有原发性肺腺癌均为CK7阳性（+）、CK20阴性（-）。绒毛蛋白、CK7和CK20的联合检测有助于鉴别转移性结肠腺癌与有根丝的肺腺癌。
