Clinicopathological and genetic analyses of pulmonary enteric adenocarcinoma
Clinicopathological and genetic analyses of pulmonary enteric adenocarcinoma
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DOI：
10.1136/jcp-2022-208583
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发表时间：
2022-12-01
影响因子：
3.4
通讯作者：
Ohbayashi, Chiho
中科院分区：
文献类型：
--
作者：
Okada, Fumi;Takeda, Maiko;Ohbayashi, Chiho
目的肺肠腺癌(PEAC)是一种罕见的肺腺癌。由于其罕见，对PEAC的病理学和分子生物学研究很少。在此，我们进行了PEAC的临床病理、免疫组织化学和分子分析，重点分析了它与侵袭性粘液腺癌(IMA)的区别。方法对16例PEAC患者的临床病理特征进行分析，并应用下一代测序技术(NGS)进行基因分析。并与IMA的结果进行了比较。结果PEAC患者平均年龄72.9岁，男7例，女9例。PEAC和IMA的临床数据比较显示，年龄、性别或吸烟史没有显著差异。15例PEAC有脏性坏死。免疫组织化学结果：CK7，88%(14/16)，CK20，81%(13/16)，CDX2，88%(14/16)，P53，69%(11/16)，MUC1,100%(16/16)，MUC2，19%(3/16)，MUC5AC，69%(11/16)，MUC6，19%(3/16)。IMA中上述抗体的阳性率分别为100%、87%、0%、7%、93%、0%、100%和80%。PEAC和IMA均未检测到EGFR突变、MET外显子14跳跃突变、BRAF突变、ALK融合基因和Ros-1融合基因突变。在PEAC病例中，NGS发现7例(44%，7/16)存在KRAS突变，9例(56%，9/16)发现TP53突变。在IMA病例中，最常见的突变基因是KRAS(90%)。结论PEAC患者脏性坏死率、CDX2和TP53基因突变的免疫阳性率明显高于IMA患者，而KRAS基因突变的发生率明显低于IMA患者。
AimsPulmonary enteric adenocarcinoma (PEAC) is a rare variant of pulmonary adenocarcinoma. Due to its rarity, few pathological and molecular studies have been performed on PEAC. We herein conducted clinicopathological, immunohistochemical and molecular analyses of PEAC with a focus on its differentiation from invasive mucinous adenocarcinoma (IMA). MethodsWe examined the clinicopathological features of 16 cases of PEAC and performed a genetic analysis using next-generation sequencing (NGS). The results obtained were compared with those for IMA. ResultsThe average age of patients with PEAC (seven men and nine women) was 72.9 years. A comparison of clinical data on PEAC and IMA revealed no significant differences in age, sex or smoking history. Fifteen PEAC cases had dirty necrosis. Immunohistochemically, the positive rates for each antibody in PEAC were as follows: CK7, 88% (14/16); CK20, 81% (13/16); CDX2, 88% (14/16); p53, 69% (11/16); MUC1, 100% (16/16); MUC2, 19% (3/16); MUC5AC, 69% (11/16); MUC6, 19% (3/16). The positive rates for these antibodies in IMA were 100%, 87%, 0%, 7%, 93%, 0%, 100% and 80%, respectively. EGFR mutations, the MET exon 14 skipping mutation, BRAF mutations, the ALK fusion gene and ROS-1 fusion gene were not detected in any cases of PEAC or IMA. Among PEAC cases, NGS identified KRAS mutations in seven (44%, 7/16) and TP53 mutations in nine (56%, 9/16). Among IMA cases, the most commonly mutated gene was KRAS (90%). ConclusionsThe rates of dirty necrosis, immunopositivity for CDX2 and TP53 mutations were significantly higher, while that of KRAS mutations was significantly lower in PEAC cases than in IMA cases.