共表达甲状腺转录因子1与p40的非小细胞肺癌患者临床病理特征分析  

Clinicopathological Features of Non-small Cell Lung Carcinoma withCoexpression of Thyroid Transcription Factor-1 and p40

作　　者：陈慧萍[1] 张瑞珍 章纳 任景丽[2] 冯怡锟[2] 胡桂明[2] CHEN Huiping;ZHANG Ruizhen;ZHANG Na;REN Jingli;FENG Yikun;HU Guiming(Pathology Department,Women and Infants Hospital of Zhengzhou,Zhengzhou 453000,China;Pathology Department,the Second Affiliated Hospital of Zhengzhou University,Zhengzhou 450014,China)

机构地区：[1]郑州市妇幼保健院病理科,河南郑州453000 [2]郑州大学第二附属医院病理科,河南郑州450014

出　　处：《河南医学研究》2024年第19期3457-3460,共4页Henan Medical Research

基　　金：河南省医学科技攻关计划联合共建项目(LHGJ20230364)。

摘　　要：目的探讨共表达甲状腺转录因子1(TTF-1)和p40的非小细胞肺癌(NSCLC)患者的临床病理特征。方法收集7例共表达TTF-1和p40的NSCLC患者的资料,回顾性分析其临床特征、病理形态、免疫表型及分子特征,并复习相关文献。结果患者中位年龄58岁,多为男性且吸烟者;影像显示为外周型肿块。肿瘤细胞呈实性巢状排列,瘤细胞呈圆形、卵圆形或多角形,胞质透明或嗜酸性,核分裂象>10个/10HPF;3例可见脉管内癌栓。同一群肿瘤细胞同时表达TTF-1和p40,CK7、p63、CK5/6和napsinA呈灶性或弥漫表达,增殖指数Ki-67阳性10%~90%。2例采用ARMS-PCR法分别检测到表皮生长因子受体(EGFR)18号外显子G719A/S/C突变和21号外显子L858R突变,1例采用二代测序法检测到TPM3-ROS1融合突变和ROS1(G2032R)突变。随访1~46个月,2例患者分别于22、46个月死亡,3例患者出现颈部淋巴结或脑转移。结论共表达TTF-1和p40的NSCLC具有独特的临床病理特征,临床进展快,预后差,可能是一种新的肿瘤实体。Objective To explore the clinical and pathological characteristics of non-small cell lung carcinoma(NSCLC)patients with co-expressing thyroid transcription factor-1(TTF-1)and p40.Methods Seven cases of NSCLC co-expressing TTF-1 and p40 were collected.A retrospective analysis of their clinical features,pathological morphology,immunophenotype,and molecular characteristics was conducted,along with a review of relevant literature.Results The patients with a median age of 58 years old,common in males or people who had a history of smoking.Imaging showed peripheral masses in all cases.Tumor cells exhibited a solid nest-like arrangement,round,oval,or polygonal,with transparent or acidophilic cytoplasm;the mitotic figures were>10/10 high-power fields(HPF).Vascular tumor emboli were observed in 3 cases.The same group of tumor cells expressed TTF-1 and p40 simultaneously;CK7,p63,CK5/6 and napsinA showed focal or diffuse expression,and the Ki-67 proliferative index was positive in 10%to 90%.According to g ARMS-PCR,two cases were found to have epidermal growth factor receptor(EGFR)exon 18 G719A/S/C mutations and exon 21 L858R mutations,while using next-generation sequencing,one case showed TPM3-ROS1 fusion mutation and ROS1(G2032R)mutation.After 1 to 46 months of followed-up,two patients died after 22 and 38 months,respectively.Three patients developed cervical lymph node or brain metastasis.Conclusion NSCLC co-expressing TTF-1 and p40 exhibits unique clinical and pathological features,characterized by rapid clinical progression and poor prognosis,suggesting it may represent a novel tumor entity.

关 键 词：非小细胞肺癌 甲状腺转录因子-1 P40 共表达 

分 类 号：R734.2[医药卫生—肿瘤]