Sinonasal Adenocarcinoma: Update on Classification,Immunophenotype and Molecular Features

Adenocarcinomas of the sinonasal tract may originate from respiratory surface epithelium or the underlying seromucinous glands. These malignancies are divided into salivary-type adenocarcinomas and non-salivary-type adenocarcinomas. The latter are further divided into intestinal-type and nonintestinal-type adenocarcinomas. This review provides an update on tumor classification, differential diagnostic considerations and molecular features, as well as new adenocarcinoma entities in the sinonasal area.     

High Expression of Sonic Hedgehog Signaling Proteins Is Related to the Favorable Outcome,EGFR Mutation,and Lepidic Predominant Subtype in Primary Lung Adenocarcinoma

Background

Dysregulation of the Sonic hedgehog (SHH) signaling pathway has been identified in many human malignancies. However, it remains unclear whether this pathway is activated in human lung adenocarcinoma.

Methods

We investigated the expression of the SHH ligand and its downstream molecules, such as glioma-associated oncogene homologue (GLI)-1, GLI-2, GLI-3, and ATP-binding cassette G2 (ABCG2), in 166 cases of surgically resected lung adenocarcinoma by immunohistochemistry. Correlations between the expression of SHH-related proteins and clinicopathologic parameters, histologic subtypes, and prognostic significance were statistically analyzed.

Results

SHH was highly expressed in the 36.1 % (60/166), GLI-1, GLI-2, and ABCG2 were found in 90/164 (54.9 %), 26/166 (15.7 %), and 139/165 (84.2 %), respectively, and GLI-3 was positive in all cases. SHH was more frequently highly expressed in nonsmokers, patients with no recurrences, lepidic predominant subtype, and with EGFR mutation (p < 0.05, respectively). The high expression of SHH and GLI-1 was related to better overall survival and progression-free survival (p < 0.05).

Conclusions

The SHH signaling pathway is frequently up-regulated in a subset of lung adenocarcinoma and is significantly associated with EGFR mutation and lepidic subtype. Although SHH signaling protein expression is not an independent prognostic marker, the expression of these proteins can predict a better prognostic outcome.

     

盘状大同源物5在肺腺癌中的表达及其临床意义

目的:探讨盘状大同源物5(discs large homolog 5,DLG5)在肺腺癌中的表达及其临床意义。方法:采用免疫组化SP法检测122例Ⅰ期和ⅢA期肺腺癌组织中DLG5的表达情况,并采用Western blotting法检测20对肺腺癌组织癌组织和癌旁组织DLG5的表达情况。统计患者的临床资料,分析DLG5表达与临床特征的相关性,采用Kaplan-Meier曲线对随访数据进行预后分析。结果:Ⅰ期肺腺癌组织中DLG5的阳性表达率明显高于ⅢA期肺腺癌组织(P0.01)。肺腺癌组织中DLG5的阳性表达率明显低于癌旁肺组织。DLG5表达阳性的患者,5年生存率(OS)明显高于表达阴性的患者(51.1%vs 28.1%, P0.01)。肺腺癌组织中DLG5的阳性表达水平与淋巴结转移(P0.01)、TNM分期(P0.01)和肿瘤复发(P0.01)呈负相关。生存分析显示DLG5和TNM分期是肺腺癌的独立预后影响因素。结论:DLG5在肺腺癌中表达下降,DLG5可能对肺腺癌患者的预后有一定的指导意义。     

肺腺癌患者术后血清蛋白质组构型动态随访研究

目的用表面增强激光解析离子化飞行时间质谱(surface-enhanced laser desorption ionization time of flightmass spectrometry,SELDI-TOF-MS)技术建立肺腺癌患者血清蛋白质组构型,并筛选出相对特异标记物,随访分析其手术后的动态变化及意义。方法肺腺癌患者71例,均经手术病理证实;正常志愿者71例,按照性别、年龄、吸烟史与71例肺腺癌患者配对。用弱阳离子交换芯片(WCX2)检测各血清标本,筛选肺腺癌相对特异性蛋白质峰。随访分析71例肺腺癌患者手术后3个月、6个月和9个月血清蛋白质组构型变化。结果与正常志愿者比较发现肺腺癌患者有5个显著高表达的潜在标记物,相对分子量分别为4 047.79,4 203.99,4 959.81,5 329.30和7 760.12 Da;肺腺癌患者手术后血清蛋白质组构型变化的个体差异较大,并与患者病理分期密切相关。结论SELDI-TOF-MS蛋白质质谱技术是一种快速、简便易行且高通量的分析方法,能直接筛选出肺腺癌患者血清中相对特异的潜在标记物,且可能具有较好的临床应用前景。