β-tubulinⅢ和CD34在非黏液型肺腺癌早期浸润病理诊断中的应用  

Application ofβ-tubulin III and CD34 in the pathological diagnosis of early invasion in non-mucinous lung adenocarcinoma

作　　者：崔艳梅[1] 王晓江[2] 朱蕙芳 宋可依 俞林颢 雷曦 胡丹[3] 刘伟[3] CUI Yan-mei;WANG Xiao-jiang;ZHU Hui-fang;SONG Ke-yi;YU Lin-hao;LEI Xi;HU Dan;LIU Wei(Department of Pathology,the Affiliated Hospital to Fujian University of Traditional Chinese Medicine,Fuzhou 350004,China;Department of Molecular Pathology Laboratory,Clinical Oncology School of Fujian Medical University/Fujian Cancer Hospital,Fuzhou 350014,China;Department of Pathology,Clinical Oncology School of Fujian Medical University/Fujian Cancer Hospital,Fuzhou 350014,China)

机构地区：[1]福建中医药大学附属人民医院病理科,福州350004 [2]福建医科大学肿瘤临床医学院/福建省肿瘤医院分子病理研究室,福州350014 [3]福建医科大学肿瘤临床医学院/福建省肿瘤医院病理科,福州350014

出　　处：《诊断病理学杂志》2025年第3期281-286,共6页Chinese Journal of Diagnostic Pathology

基　　金：福建省自然科学基金项目(编号:2022J01432)。

摘　　要：目的探讨β-tubulinⅢ和CD34在非黏液型肺腺癌早期浸润病理诊断中的应用价值。方法应用免疫组化EnVision法检测非典型腺瘤样增生(AAH)51例,原位腺癌(AIS)134例,微小浸润性腺癌(MIA)403例以及浸润性腺癌(IA)540例组织中β-tubulinⅢ和CD34表达差异。结果β-tubulinⅢ在正常肺组织及肺腺癌前体病变(AAH、AIS)中均为阴性表达,在MIA和IA中阳性表达率分别为47.1%和77.4%,β-tubulinⅢ在各组间的表达差异具有统计学意义(P<0.001)。在AAH、AIS与MIA的鉴别诊断中,β-tubulinⅢ阳性表达诊断MIA的特异性为100%,灵敏度为47.1%。CD34在正常肺组织、AAH和AIS中,肺泡壁毛细血管及基膜呈阳性,勾勒出肺泡壁的基本结构,肺泡结构完整;在MIA的浸润灶及IA中,肺泡壁破坏,CD34染色呈“迷宫”样结构,浸润性腺体周围CD34染色不连续或消失。结论在非黏液型肺腺癌与前体病变中,β-tubulinⅢ表达具有显著差异,且CD34染色模式不同,两者联合检测有助于肺腺癌早期浸润的判断。Objective To explore the application value ofβ-tubulin III and CD34 in the early invasive pathological diagnosis of non-mucinous lung adenocarcinoma.Methods Immunohistochemistry using the EnVision method was employed to detect the expression differences ofβ-tubulin III and CD34 in 51 cases of atypical adenomatous hyperplasia(AAH),134 cases of adenocarcinoma in situ(AIS),403 cases of microinvasive adenocarcinoma(MIA),and 540 cases of invasive adenocarcinoma(IA).Resultsβ-tubulin III was negative in normal lung tissue and precursor lesions of lung adenocarcinoma(AAH,AIS).The positive expression rates in MIA and IA were 47.1%and 77.4%,respectively.The expression difference ofβ-tubulin III among the groups was statistically significant(P<0.001).In the differential diagnosis of AAH,AIS,and MIA,the specificity ofβ-tubulin III positivity for diagnosing MIA was 100%,while the sensitivity was 47.1%.CD34 showed positive staining in the capillaries and basement membrane of alveolar walls in normal lung tissue,AAH,and AIS,outlining the basic structure of the alveolar walls with intact alveolar structure.In MIA and IA,CD34 staining presented a"labyrinth"pattern in the invasive foci,and the staining around invasive glands was either discontinuous or absent.Conclusion The expression ofβ-tubulin III differs significantly between non-mucinous lung adenocarcinoma and precursor lesions,and CD34 staining patterns are distinct.Combined detection of both markers can aid in the early assessment of lung adenocarcinoma invasion.

关 键 词：肺腺癌 β-tubulinⅢ CD34 免疫组化 预后 

分 类 号：R734.2[医药卫生—肿瘤]