肺原发性印戒细胞癌临床病理学观察

Clinical Pathology Review of Primary Signet-Ring Cell Carcinoma of Lung

目的:探讨肺原发性印戒细胞癌的临床病理特点及生物学特征。方法:对8例肺原发性印戒细胞癌患者的肿瘤组织病理学进行分析,并对细胞角蛋白广谱(Ckpan)、细胞角蛋白(CK)7、CK20、血管内皮生长因子(VEGF)、甲状腺转录因子(TTF)-1等指标进行免疫组织化学染色和阿辛蓝(AB)、过碘酸雪夫(PAS)特殊染色。结果:光镜下见肿瘤细胞中等大小、圆形、胞质内含大量黏液,形成圆形黏液滴,推挤细胞核至一侧,呈印戒样外观。特殊染色AB及PAS全部阳性;免疫组化结果Ckpan及癌胚抗原(CEA)8例全部阳性,CK7、TTF-1及VEGF阳性7例,CK20阳性1例。结论:肺原发性印戒细胞癌确诊主要依靠病理及免疫组化检查,其中TTF-1、CK7及CK20有助于鉴别肺原发与转移性印戒细胞癌。

Objective： To investigate the clinical-pathology features and biologic characters of lung primary signet-ring cell carcinoma. Methods： The histopathological features of 8 patients with primary signet-ring cell carcinoma of the lung were anylazed, and values of cytokeratin pan （Ckpan）, cytokeratin 7 （CK7）, cytokeratin 20 （CK20）, vascular endothelial growth factor （VEGF） and thyroid transcription factor-1 （TTF-1） were detected by immunohistochemistry staining and special stain- ing （AB and PAS）. ResultS： Tumor ceils were medium-sized, round with considerable mucin, which pushed against the cell nucleus creating a signet ring cell appearance under light microscope. There were positive results by special stains with AB and PAS. The immunohistochemical stains showed that 8 patients were CKpan and carcinoembryonic antigen （CEA） positive, 7 patients were CKT, TFF-1 and VEGF positive and 1 patient was CK20 positive. Conclusion： The final diagnosis of the pri- mary signet-ring cell carcinoma of the lung depends on the pathology and immunohistochemistry stain. The values of TFF-1, CK7 and CK20 may help differentiate primary and metastatic signet-ring cell carcinoma.