SMARCB1缺失型肺癌的临床病理特征分析  

Clinicopathologic Features of SMARCB1-deficient Lung Cancer

作　　者：李玉玉 陈文 王凤华 刘君君 刘月姣 LI Yu-yu;CHEN Wen;WANG Feng-hua;LIU Jun-jun;LIU Yue-jiao(Department of Pathology,The 8th Medical Center,Chinese PLA General Hospital,Beijing,100091,China)

机构地区：[1]中国人民解放军总医院第八医学中心病理科,北京100091

出　　处：《现代生物医学进展》2025年第3期401-410,共10页Progress in Modern Biomedicine

基　　金：国家自然科学基金面上项目(32271411)。

摘　　要：目的:探讨SMARCB1缺失型肺癌的临床病理学特征。方法:收集6例SMARCB1缺失型肺癌病例作为实验组,随机收集同时期6例确诊为肺癌病例作为对照组,采用免疫组化两步法进行染色,对比分析其临床资料、影像学形态、病理学特征及病程治疗。结果:SMARCB1缺失型肺癌病例6例,均为男性,平均年龄61.16岁,临床表现为咳嗽、咳少量白色痰,间断痰中带血,偶伴胸闷气促等症状。SMARCB1缺失型肺癌CT检查肺叶团块影,边缘模糊,肺叶类圆形透光区;进一步PET-CT检查,肺叶团块FDG摄取增高,考虑肺癌。SMARCB1缺失型肺癌实验组和对照组肺癌各亚型均表达相应的特异性标志,肺腺癌表达TTF-1和NapsinA,鳞状细胞癌则表达P40和P63。SMARCB1缺失型肺癌Ki-67增殖指数和PHH3+细胞数量均显著高于对照组肺癌,差异具有统计学意义。CD34、Vimentin和CD56表达在两组间没有统计学差异。PD-1、ALK(D5F3)、NTRK(EPR17341)在两组实验中免疫组化表达均为阴性。EGFR、HER-2抗体在SMARCB1缺失型肺癌实验组阳性表达率分别为16.67%、16.67%,对照组中阳性表达率为50.00%、83.33%,差异均没有统计学意义。SMARCB1缺失型肺癌实验组目前化疗方案为每化疗周期进行洛铂50 mg+注射用紫杉醇(白蛋白结合型)0.4 g+注射用卡瑞利珠单抗200 mg。结论:SMARCB1缺失型肺癌的诊断目前仍依赖影像学形态、组织病理学特征及免疫组化标记的表达情况等手段进行综合分析,SMARCB1免疫组化标记阴性表达可作为确诊的手段。Objective:To explore the clinicopathological features of SMARCB1-deficient lung cancer.Methods:6 cases of SMARCB1-deficient lung cancer were collected as the experimental group,and 6 cases of confirmed lung cancer in the same period were collected as the control group.The immunohistochemical two-step method was used for staining,and the clinical data,imaging morphology,pathological features,and course of treatment were compared and analyzed.Results:There were 6 cases of SMARCB1-deficient lung cancer,all male,with an average age of 61.16 years;the clinical manifestations were cough,a small amount of white sputum,intermittent sputum with blood,occasional chest tightness,and shortness of breath.SMARCB1-deficient lung cancer CT examination of lung lobe mass shadow,blurred edges,lobe-like circular light area;Further PET-CT examination revealed increased uptake of FDG in the lobular mass,suggesting lung cancer.Each subtype of SMARCB1-deficient lung cancer experimental group and the control group expressed corresponding specific markers.TTF-1 and NapsinA were expressed in lung adenocarcinoma,while P40 and P63 were expressed in squamous cell carcinoma.The Ki-67 proliferation index and the number of PHH3+cells in SMARCB1-deficient lung cancer were significantly higher than those in the control group,and the difference was statistically significant.There were no significant differences in the expression of CD34,Vimentin and CD56 between the two groups.The immunohistochemical expression of PD-1,ALK(D5F3)and NTRK(EPR17341)were negative in both groups.The positive expression rates of EGFR and HER-2 antibodies in the SMARCB1-deficient lung cancer experimental group were 16.67%and 16.67%,and the positive expression rates in the control group were 50.00%and 83.33%,with no statistical significance.The current chemotherapy regimen for the SMARCB1-deficient lung cancer group was loplatin 50 mg+paclitaxel for injection(albumin-binding type)and 0.4 g+carrilizumab for injection 200 mg per chemotherapy cycle.Conclusion:The diagnosis of

关 键 词：SMARCB1 非小细胞肺癌 免疫组化 病理 

分 类 号：R3[医药卫生—基础医学] R365