脑转移癌特异性标志物表达及其意义

Expression of site-specific markers of brain metastatic carcinoma and its significance

目的 :探讨脑转移癌 (BMC)特异性标志物表达 ,鉴别BMC原发来源。方法 :对 31例BMC进行临床病理观察 ;免疫组化EnVision法检测其TTF 1、TG、CK7、CK2 0等标志物表达。结果 :31例中 ,男性 19例 ,女性 12例 ,男∶女比例 1 5 8∶1;年龄 32～ 82岁 (平均 6 1 7岁 ) ;本组含转移性肺癌 2 3例 ,其中TTF 1+ /CK7+ 19例(82 6 % ) ,TTF 1-/CK7+ /CK2 0 + 1例 ,单纯CK7+ 1例 ,TTF 1、CK7、CK2 0均阴性 1例 ;转移性甲状腺癌 2例 ,表达TTF 1+ /TG+ ;转移性胃腺癌和食管腺癌各 1例 ,CD7+ /CD2 0 + ;转移性直肠腺癌 1例 ,CK2 0 + ;转移性乳腺癌 1例 ,CD7+ ;以上标记阴性并失访 2例。术前原发癌未确诊率 4 1 9% ,经免疫标记、进一步检查后 ,未确诊仅为6 7%。结论 :本组BMC以肺源性多见。TTF 1、TG、CK7、CK2 0等单克隆抗体配套免疫组化标记 。

Purpose:To investigate the expression of site specific markers and to identify the primary site of tumor origin in brain metastatic carcinoma (BMC). Methods:31 cases of BMCs were clinicopathologically studied, and TTF 1、TG、CK7、CK20 as markers of BMCs were detected by EnVision immunohistochemical staining. Results:In 31 BMC patients, there were 19 men and 12 women, and the male:female ratio was 1.58∶1. Their age ranged from 32 to 82 years (mean, 61.7 years); 23 cases of them arose from primary lung carcinoma, of which in 19 cases (82.6%) positive staining for both TTF 1 and CK7 metastases were detected, one case negative staining for TTF 1 but positive for both CK7 and CD20, 1 case positive staining only for CK7 and one cases negative staining fully for TTF 1、CK7 and CK20 were also diaplayed;Two cases from thyroid carcinoma expressing TTF 1 and TG were noted in BMCs. One tumor from gastric adenocarcinoma and one tumor from esophageal adenocarcinoma, positive staining for CK7 and CK20, wwere presented. One case from rectal adenocarcinoma expressing only CD20 and one from breast carcnoma staining for CK7 were included in the metastatic carcinomas. Two cases without positive staining for all antibodies above did not responded to the follow up. The primary sites of BMCs were not identified in 41.9% before operation, but only 6.7% of the primary sites of BMCs were not determined after immunnohistochemical staining was used for the differentiation among them,as well as other further examinations. Conclusions:Metastases of primary origin from lung were the most common in the BMCs. Immunohistochemical staining used by a monoclonal antibody panel combining TTF 1、TG、CK7、CK20 could help identify the primary site of tumor origin in BMC.