首页|伴SMARCA4缺失的非小细胞肺癌5例临床病理学特征

伴SMARCA4缺失的非小细胞肺癌5例临床病理学特征

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目的 探讨伴 SMARCA4 缺失的非小细胞肺癌(SMARCA4-deficient non-small lung cancer,SMARCA4-dNSCLC)的临床病理学特征.方法 回顾性分析5例SMARCA4-dNSCLC临床资料,肿瘤组织均进行HE、免疫组化染色及分子检测,分析其临床病理特征并复习相关文献.结果 5例均为男性,平均发病年龄66岁.5例均有吸烟病史,3例以咳嗽咳痰、痰中带血为首发症状就诊,1例因肺结核病史伴肢体活动障碍就诊,1例为体检发现肺结节.镜下观察肿瘤细胞分化较差,呈实性巢片状分布,部分呈腺样结构,肿瘤细胞胞质丰富,呈嗜酸性或透明样,核染色质空泡状,核仁可见,核分裂象常见.间质可见炎细胞浸润及片状坏死.免疫组化染色示5/5弥漫表达CK(AE1/AE3)和CK7,5/5 BRG1表达缺失,1/5弥漫表达p40和CK5/6,Ki67增殖指数20%~90%,4例行FISH检测均检出SMARCA4基因缺失.5例患者随访2~15个月,3例死亡,2例存活.结论 SMARCA4-dNSCLC具有广泛的形态学特征,恶性程度高,治疗复杂,分子检测BRG1缺失有助于诊断,加深对其的认识能帮助临床正确选择治疗策略并准确评估患者预后.
Clinicopathological features of 5 cases of non-small cell lung cancer with SMARCA4 deficient
Purpose To investigate the clinical pathologic features of five SMARCA4-deficient non-small lung cancers(SMARCA4-dNSCLCs).Methods Five cases of SMARCA4-dNSCLC was underwent by HE,immunohistochemical staining,and molecular detection,analyzed their clinicopathological char-acteristics and reviewed relevant literatures.Results All 5 ca-ses were male,and mean age was 66 years.Five patients had a history of smoking,three patients were treated with cough and blood in sputum as the first symptom,one was treated with a history of pulmonary tuberculosis combined with limb mobility disorder,and one was diagnosed with pulmonary nodules by physical examination.Under microscopic observation,tumor cells were poorly differentiated,with solid nest sheet distribu-tion,some with glandular structure,tumor cells had abundant e-osinophilic or transparent cytoplasm,vacuolar nuclear chroma-tin,nucleoli was visible,and nuclear mitosis was common.In-flammatory cell infiltration and sheet of necrosis were seen in the stroma.Immunohistochemical staining showed 5/5 diffuse ex-pression of CK(AE1/AE3)and CK7,5/5 loss expression of BRG1,1/5 diffuse expression of p40 and CK5/6,and Ki67 proliferating index ranged from 20%to 90%.FISH tests showed that 4/4 SMARCA4 genes missed.Five patients were followed up for 2-15 months,3 patients died and 2 patients survived.Conclusions SMARCA4-dNSCLC can have extensive morphologi-cal features,high degree of malignancy,and complicated treat-ment.BRG1 deficiency is helpful for diagnosis.Deepening the understanding of SMARCA4-dNSCLC can help the clinical cor-rect choice of treatment strategies and accurately evaluate patient prognosis.

non-small cell lung cancerSMARCA4BRG1SWI/SNF

赵静、陆一凡、江涛、熊丹婷、俞士杰、杨留芳、张继伟、干文娟

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苏州大学附属第四医院病理科,苏州 215123

非小细胞肺癌 SMARCA4 BRG1 SWI/SNF

苏州市科技计划苏州市重点扶持学科项目

SZM2022014SZFCXK202141

2024

临床与实验病理学杂志
安徽医科大学,中华医学会安徽分会

临床与实验病理学杂志

CSTPCD北大核心
影响因子:0.776
ISSN:1001-7399
年,卷(期):2024.40(5)
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