【摘要】 目的 探讨CathepsinK、SMA、CD34在肺腺癌浸润前病变的间质(不典型腺瘤样增生、原位腺癌)及浸润性病变的间质(微浸润性腺癌的微浸润灶及浸润性腺癌)中的表达及其临床意义。方法 按照最新的2015年世界卫生组织肺腺癌新分类方案,对2010年1月至2019年10月病理诊断为不典型腺瘤样增生、原位腺癌、细支气管肺泡癌、微浸润性腺癌和浸润性腺癌的病例,重新诊断、分类。应用免疫组织化学进行CathepsinK、SMA、CD34的检测并比较:(1)在49例肺腺癌浸润前病变的间质及192例浸润性腺癌的间质中的表达差异;(2)在50例微浸润性腺癌的原位腺癌成分的间质中和微浸润灶的间质中的表达差异。结果 (1) CathepsinK、SMA在192例浸润性腺癌的间质中高表达,在49例浸润前病变的间质中低表达;CD34在49例浸润前病变的间质中高表达,在192例浸润性腺癌的间质中低表达;(2)在微浸润性腺癌中,CathepsinK、SMA高表达于微漫润灶的间质中,低表达于周围正常肺泡间隔和原位腺癌成分的间质中;CD34高表达于周围正常肺泡间隔和原位腺癌成分的间质中,低表达于微浸润灶的间质中。结论 CathepsinK、SMA、CD34的表达与肺腺癌的发展和间质浸润密切相关,通过免疫组化检测有助于鉴别诊断肺腺癌的漫润前病变及浸润性病变,同时能指导临床治疗、判断预后。更多还原

【Abstract】 Objective To study the expression and clinical significance of CathepsinK,SMA,CD34 in the stromal cell of preinvasive lesion(atypical adenomatous hyperplasia,adenocarcinoma in situ,the preinvasive ingredient of microinvasive adenocarcinoma) and in the stromal cell of invasive lesion of lung adenocarcinoma(the invasive ingredient of microinvasive adenocarcinoma,invasive adenocarcinoma),Methods According to the 2015 WHO new classification scheme of lung adenocarcinoma,the cases were diagnosed of atypical adenomatous hyperplasia,adenocarcinoma in situ,bronchioloalveolar carcinoma,microinvasive adenocarcinoma and invasive adenocarcinoma in the first people’s Hospital of Xiaoshan-Hangzhou from January 2010 to October 2019,then they were reclassified and rediagnosed.The CathepsinK,SMA,CD34 expression in the stromal cell of different tissues and lesions by immunohistochemistry were detected and compared,then,we found that:(1) The difference of CathepsinK,SMA,CD34 in the stromal cell of the preinvasive lesion in lung adenocarcinoma and invasive lesion of lung adenocarcinoma.(2) The differences of CathepsinK,SMA,CD34 in the stromal cell between the preinvasive ingredient and the invasive ingredient of microinvasive adenocarcinoma.Results(1) The expressions of CathepsinK,SMA were low in the in the stromal cell of preinvasive lesion in lung adenocarcinoma and were high in the stromal cell of lung invasive adenocarcinoma.The expressions of CD34 was high in the stromal cell of the preinvasive lesion of lung adenocarcinoma but was low in the stromal cell of the invasive lesion of lung adenocarcinoma.(2) The expression of CathepsinK,SMA were high in the stromal cell of the invasive ingredient but were low in the stromal cell of the preinvasive ingredient of microinvasive adenocarcinoma.The expression of CD34 was low in the stromal cell of the invasive ingredient but was high in the stromal cell of the preinvasive ingredient of microinvasive adenocarcinoma.Conclusion The expression of CathepsinK,SMA,CD34 is closely related to the occurrence and invasion of lung adenocarcinoma.Early detection can assist in diagnosis atypical adenomatous hyperplasia,adenocarcinoma in situ,microinvasive adenocarcinoma and invasive adenocarcinoma.At the same time,the biological behavior of lung adenocarcinoma can be predicted,prognosis can be evaluated and treatment can be guided.更多还原