Expression Of CD34/α-SMA In The Basement Membranes And β-tubulin-Ⅲ In The Tumor Cell Cytoplasm For The Early Invasive Adenocarcinoma

[Objective]1、To study the relationship between the early invasive adenocarcinomaand the appearance and the loss of the basement membranes with CD34andα-SMA-positive in the surrounding of lung adenocarcinoma cells.2、To investigate the clinicopathologic features and expression of β-Tubulin-Ⅲ in the early invasive adenocarcinoma of lung.3、To find a practical immunohistochemical morphological indicators andhelp the pathologists with the differential diagnosis of the early invasiveadenocarcinoma of lung[Methods]A total of72cases of the early primary lung adenocarcinoma and theatypical adenomatous hyperplasia(AHH) were collected at Department ofPathology of Fuzhou General Hospital of Nanjing Military Command fromJanuary2007to December2012. Among the72cases, there were12cases ofAHH,15cases of adenocarcinoma in situ (AIS),18cases of minimally invasiveadenocarcinoma (MIA) and27cases of invasive adenocarcinoma (IA). All ofthe cases were reviewed with HE, PAS and PASM-Masson studies, along withimmunohistochemical studies of CD34, α-SMA and β-tubulin-III, and also withdouble-staining of CK7/CD34and β-tubulin-III/CD34.3cases for each groupwere observed with transmission electron microscopy. Diagnosis wasperformed according to the diagnostic criteria published by InternationalAssociation for the Study of Lung Cancer (IASLC) in February2011.[Results]1、Ultrastructural study showed the presence of the basement membraneon the human pulmonary alveolar epithelial cell, but without the expression of CD34, α-SMA and β-tubulin-III.2、AAH, AIS and the component of the AIS(adherent like growth,embedding type acinar) in MIA, the basement membranes were positive forCD34and α-SMA, and myoblast cells and collagen bundle of the tumorstroma showed strong expression of CD34and α-SMA, with the absence ofβ-tubulin-III in the tumor cells.3、There was lack of the basement membrane in the component of theinvasive adenocarcinoma in MIA and the tumor cells of IA, papillary,micropapillary, solid growth and the infiltrating acinar, with weaken ordisappear for the expression of CD34and α-SMA in tumor stroma, while thetumor cell plasma was positive for β-tubulin–III. Immunohistochemical doublestaining showed that the loss of the basement membranes with CD34andα-SMA-positive in the surrounding of tumor cells was accompanied with thestrong expression of β-tubulin–III.[Conclusions]The loss of the basement membranes with CD34and α-SMA-positive inthe surrounding of lung adenocarcinoma cells and the strong expression of theβ-tubulin-III in the tumor cell cytoplasm marked the early invasive lungadenocarcinoma. These three markers can help to show the lungadenocarcinoma early invasive lesions and help the pathologists to makeaccurate diagnosis to the early invasive adenocarcinoma.