【摘要】 目的 探讨共表达甲状腺转录因子1(TTF-1)和p40的非小细胞肺癌(NSCLC)患者的临床病理特征。方法 收集7例共表达TTF-1和p40的NSCLC患者的资料，回顾性分析其临床特征、病理形态、免疫表型及分子特征，并复习相关文献。结果 患者中位年龄58岁，多为男性且吸烟者；影像显示为外周型肿块。肿瘤细胞呈实性巢状排列，瘤细胞呈圆形、卵圆形或多角形，胞质透明或嗜酸性，核分裂象>10个/10HPF;3例可见脉管内癌栓。同一群肿瘤细胞同时表达TTF-1和p40,CK7、p63、CK5/6和napsinA呈灶性或弥漫表达，增殖指数Ki-67阳性10%～90%。2例采用ARMS-PCR法分别检测到表皮生长因子受体(EGFR) 18号外显子G719A/S/C突变和21号外显子L858R突变，1例采用二代测序法检测到TPM3-ROS1融合突变和ROS1(G2032R)突变。随访1～46个月，2例患者分别于22、46个月死亡，3例患者出现颈部淋巴结或脑转移。结论 共表达TTF-1和p40的NSCLC具有独特的临床病理特征，临床进展快，预后差，可能是一种新的肿瘤实体。更多还原

【Abstract】 Objective To explore the clinical and pathological characteristics of non-small cell lung carcinoma(NSCLC) patients with co-expressing thyroid transcription factor-1(TTF-1) and p40.Methods Seven cases of NSCLC co-expressing TTF-1 and p40 were collected. A retrospective analysis of their clinical features, pathological morphology, immunophenotype, and molecular characteristics was conducted, along with a review of relevant literature.Results The patients with a median age of 58 years old, common in males or people who had a history of smoking. Imaging showed peripheral masses in all cases. Tumor cells exhibited a solid nest-like arrangement, round, oval, or polygonal, with transparent or acidophilic cytoplasm; the mitotic figures were >10/10 high-power fields(HPF). Vascular tumor emboli were observed in 3 cases. The same group of tumor cells expressed TTF-1 and p40 simultaneously; CK7, p63, CK5/6 and napsinA showed focal or diffuse expression, and the Ki-67 proliferative index was positive in 10% to 90%. According to g ARMS-PCR, two cases were found to have epidermal growth factor receptor(EGFR) exon 18 G719A/S/C mutations and exon 21 L858R mutations, while using next-generation sequencing, one case showed TPM3-ROS1 fusion mutation and ROS1(G2032R) mutation. After 1 to 46 months of followed-up, two patients died after 22 and 38 months, respectively. Three patients developed cervical lymph node or brain metastasis.Conclusion NSCLC co-expressing TTF-1 and p40 exhibits unique clinical and pathological features, characterized by rapid clinical progression and poor prognosis, suggesting it may represent a novel tumor entity.更多还原