[Use of thyroid transcription factor-1, surfacfant protein-B, cytokeratin 7 and cytokeratin 20 in discrimination between primary and metastatic adenocarcinoma of lung].
[Use of thyroid transcription factor-1, surfacfant protein-B, cytokeratin 7 and cytokeratin 20 in discrimination between primary and metastatic adenocarcinoma of lung].
复制标题
甲状腺转录因子1、表面活性蛋白B、细胞角蛋白7、细胞角蛋白20在鉴别肺原发性和转移性腺癌中的应用
作者：
S. Zou;D. Lin;N. Lü;Xiu;P. Wen;Fu
目的
评估甲状腺转录因子-1（TTF-1）、表面活性蛋白-B（SP-B）细胞角蛋白7（CK 7）和CK 20免疫染色在区分原发性腺癌和转移性腺癌中的实用性。
方法
用TTF-1、SP-B、CK 7和CK 20的单克隆抗体对42例原发性肺腺癌和30例转移癌的福尔马林固定、石蜡包埋的组织块进行免疫组化染色。
结果
TTF-1和SP-B的阳性表达率分别为74%和52%。免疫组化染色阳性率为79%，特异性为94%。免疫表型：所有肺腺癌均为CK 7阳性，24例（57%）CK 7阳性/CK 20阴性，18例CK 7阳性/CK 20阳性。转移部位以结肠和乳腺最多见。免疫表型：转移性结直肠腺癌CK 20均阳性，11例（92%）CK 7阴性/CK 20阳性，1例CK 7阳性/CK 20阳性。转移性乳腺管状癌细胞角蛋白免疫组化结果与原发性肺腺癌相似：CK 7阳性/CK 20阴性4例，CK 7阳性/CK 20阳性4例。33例（79%）原发性肺肿瘤CK 7阳性，TTF-1或SP-B阳性。与原发性肺腺癌或转移性乳腺癌相比，CK 7阴性、CK 20阳性、TTF-1和SP-B阴性的组合与转移性结直肠癌高度显著相关（均P < 0.001）。与原发性肺腺癌或转移性结直肠癌相比，CK 7阳性、CK 20阴性、TTF-1和SP-B阴性的组合与转移性乳腺癌高度显著相关（均P < 0.001）。
结论
使用一组包括TTF-1、SP-B、CK 7和CK 20的抗体有助于区分肺的原发性和转移性腺癌，并提示一些转移性腺癌的原发部位。
OBJECTIVE
To evaluate the utility of thyroid transcription factor-1 (TTF-1), surfactant protein-B, (SP-B) cytokeratin 7 (CK7) and CK20 immunostaining in the discrimination between primary adenocarcinomas and metastatic adenocarcinomas.
METHODS
Formalin fixed, paraffin embedded tissue blocks from 42 primary lung adenocarcinomas and 30 metastatic carcinomas resected during operation were immunostained with monoclonal antibodies to TTF-1, SP-B, CK7, and CK20.
RESULTS
Positive immunostaining with TTF-1 and SP-B was noted in 74% and 52% of primary lung tumor, respectively. The positive immunostaining and specificity of such a combination for discriminating between primary and metastatic adenocarcinoma were 79% and 94%, respectively. All primary lung adenocarcinomas were CK7 positive, 24 (57%) were CK7 positive/CK20 negative and 18 were CK7 positive/CK20 positive in immunophenotype. Colon and breast were the most common sites of metastasis. All metastatic colorectal adenocarcinomas were CK20 positive, 11 (92%) were CK7 negative/CK20 positive and 1 was CK7 positive/CK20 positive in immunophenotype. The results of cytokeratin immunostaining in the metastatic breast tubular carcinomas were similar to those in the primary lung adenocarcinomas: 4 were CK7 positive/CK20 negative and 4 were CK7 positive/CK20 positive. CK7 positive, and TTF-1 or SP-B positive immunophenotype was seen in 33 (79%) primary lung tumors. A combination of CK7 negative, CK20 positive, and TTF-1 and SP-B negative was highly significantly associated with metastatic colorectal carcinomas compared with either primary lung adenocarcinomas or metastatic breast carcinomas (both P < 0.001). A combination of CK7 positive, CK20 negative, and TTF-1 and SP-B negative was highly significantly associated with metastatic breast carcinomas compared with either primary lung adenocarcinomas or metastatic colorectal carcinomas (both P < 0.001).
CONCLUSION
Use of a panel of antibodies including TTF-1, SP-B, CK7 and CK20 is helpful in discriminating between primary and metastatic adenocarcinomas of the lung and suggesting the primary sites of some metastatic adenocarcinomas.