SMARCA4-deficient non-small cell lung cancer:a clinicopathological features of six cases
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.
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