| Objective:(1) To grasp the pathological classification, the morphological features, thepathological diagnosis methods of lung cancer and try to study theclinical significance of various immunohistochemical markers in lungcancer.(2) To discuss the significance of expression of collapsin response mediatorprotein-2(CRMP-2) and the expression of insulinlike growth factor ⅡmRNA binding protein-3(IMP-3) in lung cancer.Methods:(1) Lung adenocarcinoma, lung squamous cell carcinoma, lung sarcomatoidcarcinoma and lung tumors with neuroendocrine morphology, includingtypical carcinoid, atypical carcinoid, large cell neuroendocrinecarcinoma，a total of97cases were selected from the files of Institute ofPathology, Tongji Hospital， Huazhong University of Science andTechnology.(2) Immunohistochemical staining for CRMP-2and IMP-3was performed inall cases (in total97).Results:(1) In above97cases of lung cancer and10cases of tumors adjacent lungtissue, immunohistochemistry results showed that CRMP-2expressionwas negative in adjacent lung tissue, squamous cell carcinoma,adenocarcinoma, and sarcomatoid lung cancer; however, in lung tumors with neuroendocrine morphology, CRMP-2was expressed in differentlevels, the overall expression rate of CRMP-2was approximately33.0%.CRMP-2has some significance for diagnosis of lung cancer(Χ~2=4.707,P=0.030). CRMP-2expression rate reached53.3%in lung tumors withneuroendocrine morphology, but it was not expressed in squamous cellcarcinoma, adenocarcinoma, and sarcomatoid carcinoma, the differencewas statistically significant (Χ~2=29.452, P <0.001), therefore, CRMP-2was important for the identification of lung tumors with neuroendocrinemorphologyand other types of lung cancer. High grade of lung tumorswith neuroendocrine morphology, including small cell lung cancer andlarge cell neuroendocrine carcinoma, the expression rate of CRMP-2was only about20%; while in the moderate and low grade ones,including typical carcinoid and atypical carcinoid, the CRMP-2expression rate was extremely high, reaching100%, so that CRMP-2was an important indicator to identify the grade of lung tumors withneuroendocrine morphologytumors (Χ~2=37.502, P <0.001).(2) CRMP-2expression was associated with smoking, tumors size, clinicalstage and lymph node metastasis. The CRMP-2of expression smokingpatients was significantly higher than that of non-smoking patients (Χ~2=12.293, P <0.001); CRMP-2expression in patient whose tumorsdiameter was longer than5cm was significantly increased (Χ~2=4.402, P=0.036); CRMP-2expression was much higher in the patients whoseclinical stage is higher (Χ~2=23.049, P=0.002); CRMP-2expression inthe cases with lymph node metastasis was also increased, the differencewas statistically significant (Χ~2=8.787, P=0.003). CRMP-2expressionwas not related to age, gender, and tumors location.(3) IMP-3expression in tumors adjacent lung tissue was negative, butobviously expressed in lung cancer, the difference was statistically significant (χ2=10.827, P=0.001), so that IMP-3expression wasimportant for pathological diagnosis of lung tumors. Besides, IMP-3expression rate in pulmonary sarcomatoid cancer and squamous cellcarcinoma respectively reached64.7%and87.5%, while it was lower inlung adenocarcinoma, was approximately33.3%; in lung tumors withneuroendocrine morphology, IMP-3expression rate was about51.7%, thedifference was not statistically significant (χ2=0.561, P=0.454). Inaddition, IMP-3expression was obviously different in high grade lungtumors with neuroendocrine morphology and in moderate and low gradeones. In large cell neuroendocrine carcinoma and small cell carcinoma,IMP-3expression rates were as high as77.8%and88.5%; while inmoderate and low grade ones, IMP-3expression rate was extremely low,the difference was statistically significant (χ2=38.991, P <0.001). In thiscase, IMP-3expression had great reference value in identifying the gradeof lung tumors with neuroendocrine morphology.(4) IMP-3expression was associated with smoking, tumors size, clinicalstage and lymph node metastasis. The IMP-3of expression smokingpatients was significantly higher than that of non-smoking patients (Χ~2=6.781, P=0.009); IMP-3expression in patient whose tumors diameterwas longer than5cm was significantly increased (Χ~2=6.877, P=0.009);IMP-3expression was much higher in the patients whose clinical stage ishigher (Χ~2=16.607, P=0.020); IMP-3expression in the cases withlymph node metastasis was also increased, the difference was statisticallysignificant (Χ~2=9.189, P=0.002). IMP-3expression was not related toage, gender, and tumors location.Conclusion:(1) CRMP-2is not expressed in tumors adjacent lung tissue, squamouscell carcinoma, adenocarcinoma, and sarcomatoid carcinoma，while isobviously expressed in lung tumors with neuroendocrine morphology, which suggests that CRMP-2is specific and sensitive in diagnosis oflung tumors with neuroendocrine morphology.(2) CRMP-2expression rate in high grade lung tumors withneuroendocrine morphology is low, while it expressed in all the casesof moderate and low grade neuroendocrine tumors, which suggeststhat CRMP-2has some value in the judgment of the malignancy ofpulmonary neuroendocrine tumors.(3) CRMP-2expression is associated with smoking, tumor size, clinicalstage and lymph node metastasis, which suggests that CRMP-2isrelated to the malignant biological behavior of lung cancer.(4) IMP-3is not expressed in tumors adjacent lung tissue, while isexpressed in malignant lung tumors, including squamous cellcarcinoma, adenocarcinoma, sarcomatoid carcinoma and lung tumorswith neuroendocrine morphology in different levels, which suggeststhat IMP-3has reference value in diagnosis of lung cancer.(5) IMP-3expression is significantly higher in high grade lung tumorswith neuroendocrine morphology than that in moderate and low gradeof neuroendocrine tumors, which suggests that IMP-3has somevalue in the judgment of the malignancy of lung tumors withneuroendocrine morphology.(6) IMP-3expression is associated with smoking, tumor size, clinicalstage and lymph node metastasis, which suggests that IMP-3isrelated to the malignant biological behavior of lung cancer. |
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