Detection of tumor spread through airspaces by airway secretion cytology from resected lung cancer specimens
Detection of tumor spread through airspaces by airway secretion cytology from resected lung cancer specimens
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DOI：
10.1111/pin.12570
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发表时间：
2017-10-01
影响因子：
2.2
通讯作者：
Masuda, Munetaka
中科院分区：
文献类型：
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作者：
Isaka, Tetsuya;Yokose, Tomoyuki;Masuda, Munetaka
目前尚不清楚肿瘤通过空气空间扩散（STAS）是否确实存在于体内还是人为的。我们比较了48例肺腺癌和鳞状细胞癌切除术后肺段性支气管和叶性支气管气道分泌物中STAS和肿瘤细胞簇的形态。在EGFR突变腺癌中，气道分泌物中肿瘤细胞簇的EGFR状态也与主要肿瘤的EGFR状态进行了比较。10例（20.8%）患者气道分泌细胞学检查发现肿瘤细胞聚集，8例为腺癌（20.0%）。STAS的形态与气道分泌细胞学检测到的肿瘤细胞团非常相似。气道分泌物细胞学检查阳性率在乳头状腺癌、微乳头状腺癌和浸润性粘液腺癌中分别为83.3%、100%和50%。在三种EGFR突变腺癌中，FFPE切片中主要肿瘤的EGFR突变亚型和气道分泌物中的肿瘤细胞簇相同。提示STAS可在气道分泌物细胞学中检测到。STAS常见于乳头状或微乳头状腺癌，可在手术时扩散至节段支气管或大叶支气管。
It currently remains unclear whether tumor spread through airspaces (STAS) actually exist in vivo or are an artifact. The morphologies of STAS and tumor cell clusters in airway secretions collected from the segmental or lobar bronchus of resected lung adenocarcinomas and squamous cell carcinomas were compared among 48 patients. The EGFR status of tumor cell clusters in airway secretions was also compared with that of the main tumor in EGFR mutant adenocarcinomas. Tumor cell clusters were observed in the airway secretion cytology of ten patients (20.8%), and eight patients were adenocarcinoma (20.0% of adenocarcinoma). The morphology of STAS closely resembled that of tumor cell clusters detected in airway secretion cytology. The positive rates of airway secretion cytology were 83.3%, 100%, and 50% in papillary adenocarcinoma, micropapillary adenocarcinoma, and invasive mucinous adenocarcinoma, respectively. Among three EGFR mutant adenocarcinomas, the EGFR mutation subtypes of the main tumors in FFPE sections and tumor cell clusters in airway secretions were identical. These indicate that STAS may be detected in the airway secretion cytology. STAS is common in papillary or micropapillary adenocarcinoma and may spread as far as the segmental or lobar bronchus at the time of surgery.