SMARCA4缺失性非小细胞肺癌6例临床病理特征分析
SMARCA4-deficient non-small cell lung cancer:a clinicopathological features of six cases
张洪兰 1张春芳 1杨聪颖 1聂艳红 1贺艳玲 1张功铭 1陈昊 1刘毅1
作者信息
- 1. 徐州医科大学附属连云港市第一人民医院病理科,江苏连云港 222000
- 折叠
摘要
目的 探讨6例SMARCA4缺失性非小细胞肺癌(SMARCA4-dNSCLC)的临床病理特征.方法 收集6例我院病理科SMARCA4-dNSCLC存档病例,总结常规染色、免疫组织化学及EGFR突变检测资料,并复习相关文献.结果 6例患者均为男性,有吸烟史.肿瘤表现多样,6例均可见实性腺癌区,伴部分或大部分腺泡样、乳头样结构,其中1例细胞内外可见淡蓝色黏液,1例肿瘤细胞呈横纹肌样、合体样、多极核分裂等高级别核形态,所有病例均坏死明显,间质炎细胞浸润.免疫组织化学染色示SMARCA4弥漫阴性,CK7、p53弥漫强阳,TTF-1、Napsin A、p40、p63、CD56、CgA均为阴性,干细胞标志物CD34阴性、SOX-2部分弱阳(4/6),免疫标志物PD-L1弱阳性表达(TPS:0％～3％).ARMS-PCR检测示6例均未检测到表皮生长因子受体EGFR热点区突变.随访,3例死亡(平均生存期17个月),3例远处转移,3例无瘤生存.结论 SMARCA4-dNSCLC是NSCLC的一个小子集,肿瘤直径偏大,好发于吸烟男性,具有特征的免疫和分子表型,预后差,易发生远处转移,对放、化疗不敏感,早期切除可改善预后.
Abstract
Objective To investigate the clinicopathological features of 6 cases of SMARCA4-deficient non-small-cell lung carcinoma(SMARCA4-dNSCLC).Methods 6 archived cases of SMARCA4-dNSCLC in pathology department of our hospital were collected.The data of routine staining,immunohistochemistry and EGFR mutation detection were summarized,and related literature was reviewed.Results All the 6 patients were male with smoking history.The tumors showed various manifestations.Solid adenocarcinoma was seen in all 6 cases,with some or most acinar and papilloid structures.In 1 case,blue mucus was visible inside and outside the cells,and 1 case showed high-grade nuclear morphology.Necrosis was evident in all cases with infiltration of interstitial inflammatory cells.Immunohistochemical staining showed diffuse negative SMARCA4,diffuse positive CK7 and p53,negative TTF-1,Napsin A,p40,p63,CD56 and CgA,negative stem cell marker CD34 and partial weak positive SOX-2(4/6).Immunomarker PD-L1 was weakly positive(TPS:0％-3％).ARMS PCR showed that no EGFR hot spot mutation was detected in 6 cases.At follow-up,there were 3 deaths(mean survival 17 months),3 distant metastases,and 3 tumor-free survival.Conclusion SMARCA4-dNSCLC is a small subset of NSCLC.The tumors are larger in diameter and tend to occur in males who smoke.With characteristic immune and molecular phenotypes,SMARCA4-DNSCLC has a poor prognosis,is prone to distant metastasis,and is insensitive to radiotherapy and chemotherapy.
关键词
SMARCA4缺失/非小细胞肺癌/临床病理特征/预后/治疗Key words
SMARCA4 deletion/Non-small cell lung cancer/Clinicopathologic features/Prognosis/Therapy引用本文复制引用
基金项目
连云港市花果山"科教强医工程"医学创新团队项目()
出版年
2024
NETL
NSTL
万方数据