Abstract：
Background. Lung carcinoma with p40/TTF1 coexpression (LC-PTC) is a very rare tumor with poor prognosis, and few cases have been reported to date. Objectives. To better understand biological behavior and prognosis of LC-PTC. Methods. We collected 9 examples of LC-PTC and compared them with 36 lung adenosquamous carcinomas during the same period in clinicopathologic characteristics, biologic behaviour, and prognosis. Results. Lung carcinoma with p40/TTF1 coexpression mainly occurred in middle-aged and elderly men; 8 tumors belonged to the peripheral type, and 1 belonged to the central type. The rates of lymph node and distant metastasis were 88% (7/8) and 50% (4/8), respectively; 2 patients died during follow-up. Histologically, the LC-PTC showed nest-like growth pattern without glandular growth pattern; the surface of 2 tumors was covered with ciliated columnar epithelium and tumor cells grew under the columnar epithelium. In all patients, tumor cells diffusely coexpressed p40 and TTF1. Although there was no significant difference in the maximum diameter of tumor with lymph node metastasis or with distant metastasis between LC-PTC and lung adenosquamous carcinoma, LC-PTC had a higher rate of lymph node metastasis and distant metastasis. There was no significant difference in overall survival of patients between LC-PTC and lung adenosquamous carcinoma. Additional histologic evaluation of normal pulmonary structures revealed that p40/TTF1 coexpression cells existed in bronchial mucosa and the number of cells coexpressing p40/TTF1 increased gradually from proximal bronchus to distal bronchus. Conclusions. Lung carcinoma with p40/TTF1 coexpression is a rare tumor with high metastatic potential and may originate from p40/TTF1 coexpression cells in distal bronchial mucosa.
摘要：
背景。p40/TTF1共表达的肺癌(LC-PTC)是一种非常罕见的肿瘤，预后差，迄今为止，很少有病例报告。Objectives.为了更好地了解LC-PTC的生物学行为和预后。方法。我们收集了9例LC-PTC，并与同期36例肺腺鳞癌的临床病理特征进行了比较。生物学行为，和预后。结果。p40/TTF1共表达的肺癌主要发生在中老年男性；8个肿瘤属于外周型，1属于中央型。淋巴结转移和远处转移率分别为88%(7/8)和50%(4/8),2例患者在随访期间死亡。组织学上,LC-PTC呈巢状生长模式，无腺状生长模式；2例肿瘤表面覆盖有纤毛柱状上皮，肿瘤细胞在柱状上皮下生长。在所有患者中，肿瘤细胞弥漫性表达p40和TTF1。虽然有淋巴结转移或远处转移的肿瘤最大直径在LC-PTC与肺腺鳞癌之间无显著差异,LC-PTC的淋巴结转移率和远处转移率较高。LC-PTC与肺腺鳞癌患者的总生存期差异无统计学意义。对正常肺结构的其他组织学评估显示，支气管粘膜中存在p40/TTF1共表达细胞，并且从近端支气管到远端支气管，共表达p40/TTF1的细胞数量逐渐增加。Conclusions.p40/TTF1共表达的肺癌是一种罕见的肿瘤，具有高转移潜力，可能起源于远端支气管粘膜中的p40/TTF1共表达细胞。
