Value of P63 and CK5/6 in Distinguishing Squamous Cell Carcinoma From Adenocarcinoma in Lung Fine-Needle Aspiration Specimens
Value of P63 and CK5/6 in Distinguishing Squamous Cell Carcinoma From Adenocarcinoma in Lung Fine-Needle Aspiration Specimens
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DOI：
10.1002/dc.20975
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发表时间：
2009-03-01
影响因子：
1.3
通讯作者：
Baloch, Zubair
中科院分区：
文献类型：
--
作者：
Khayyata, Said;Yun, Shine;Baloch, Zubair
目前FDA批准的非小细胞肺癌标准治疗是Carboplastin/TaxollAvastin，其基于令人印象深刻的生存获益：但是，在此情况下，鳞状细胞癌（SQCC）患者不能接受Avastin治疗，因为30%的死亡率是由于致命的咯血引起的。在这项研究中，我们评估了细胞形态学和免疫组织化学在区分SQCC和腺癌（ADC）中的作用。病例队列包括53例经手术病理随访的非小细胞肺癌FNA病例。由一组细胞病理学家独立审查所有FNA标本，以区分SQCC和ADC。23例（11例ADC和12例SQCC）可用细胞块材料进行TTF-1、CK 7、CK 20、P63和CK 516免疫组化染色。手术切除时，ADC和SQCC分别为35/53（66%和53%）（联合准确率为60%）。免疫组织化学染色显示，14/23例（61%）表达TTF-1。9例TTF-1阴性，8例（89%）为SQCC，23例（87%）CK 7阳性，1例（4%）ADC灶性CK 20阳性。9112例（75%）SQCC同时表达P63和CK 5/6，ADC中无一例同时表达P63和CK 5/6。TTF-1、CK 7、CK 20、P63和CK 5/6的免疫组化可用于鉴别SQCC和ADC。Diagn，cytopathol，2009;37：178-183（C）2009 Wiley-Liss，Inc.
The current FDA-approved standard of care for nonsmall cell lung cancer is Carboplastin/TaxollAvastin based upon an impressive survival benefit: however, patients with squamous carcinoma (SQCC) cannot receive Avastin because of a 30% morality rate due to fatal hemoptysis.In this study we evaluated the role of cytomorphology and immunohistochemistry in differentiating SQCC from adenocarcinoma (ADC) in lung FNA specimens.The case cohort included 53 FNA cases of nonsmall cell lung carcinoma with surgical pathology folow-up. All FNA specimens were reviewed independently by a panel of cytopathologists to differentiate between SQCC and ADC. The cell block material was available in 23 cases (11 ADC and 12 SQCC) to perform immunohistochemical stains for TTF-1 CK7, CK20, P63, and CK516.On surgical resection, 35/53 (66%) for ADC and 53% for SQCC (combined accuracy 60%). By immunohistochemical staining, 14/23 (61%) cases expressed TTF-1. Nine cases were TTF-1 negative; eight of the TTF-1 negative cases (89%) were SQCC.Twenty-three cases expressed CK7 (87%); one ADC case (4%) showed focal CK20 positivity. Both P63 and CK5/6 expression was seen in 9112 (75%) SQCC cases; none of the ADC cases showed this dual expression.Cytomorphology alone may not be able to stratify all cases of nonsmall cell lung carcinoma into ADC and SQCC in FNA specimens. The immune-panel of TTF-1, CK7, CK20, P63, and CK5/6 is useful in differentiating SQCC from ADC. Diagn, cytopathol, 2009;37:178-183 (C) 2009 Wiley-Liss, Inc.