伴微乳头结构的肺腺癌恶性潜能机制研究

Epithelial-mesenchymal Transition Cell Proliferation and Cell Apoptosis in Pulmonary Adenocarcinoma with a Micropapillary Pattern

目的:探讨伴微乳头成分的肺腺癌(pulmonary adenocarcinoma with a micropapillary pattern,MPPAC)上皮间质转化和增殖调亡特征,为临床评价其恶性潜能提供理论依据。方法:根据2011年发表的肺腺癌新分类诊断标准,以是否伴有微小乳头状结构(micropapillary pattern,MPP)将120例肺腺癌病例分为64例MPP阳性组,56例MPP阴性组。免疫组织化学法检测Vimentin、E-cadherin、Capase-3、pEGFR的表达。结果:120例肺腺癌病例中pECFR在女性(P=0.035)、非吸烟(P=0.017)患者中高表达。Vimentin在MPP阳性组的表达(28.1%)高于MPP阴性组(16.1%)并且其多表达于微乳头结构腔内散落的细胞;Caspase-3在MPP阳性组高表达(P=0.001)。结论:微乳头结构的腔内散落细胞表现间质表型有利于癌细胞浸润转移,伴乳头结构的肺腺癌有其独特的分子生物学特征。

Objective： This paper aimed to determine the characteristics of epithelial-mesenchymal transition, cell proliferation, and cell apoptosis in pulmonary adenocarcinoma with a micropapillary pattern （MPPAC）. Methods： Based on the new diagnostic crite- ria for lung adenocarcinoma classification （published in 2011）, 120 cases of lung adenocarcinoma were divided into micropapillary pat- tern （MPP）-positive （n=64） and MPP-negative （n=54） groups. The expression of vimentin, E-cadherin, caspase-3, and pEGFR in pul- monary adenocarcinoma tissue specimens was determined by immunohistochemical assay. Results： pEGFR expression in 120 cases of lung adenocarcinoma was higher in female （P=0.035） and nonsmoking （P=0.017） patients. Vimentin expression was higher in the MPP-positive （28.1%） than MPP-negative （16.1%） groups, and mostly located in scattered cells in the MPP cavity. Caspase-3 expression was significantly higher in the MPP-positive group （P=0.001）. Conclusion： Scattered cells in the MPP cavity have a mesenchymal phenotype, which may favor invasion and metastasis, indicating a unique characteristic of MPPAC.