Inderpal S. Sarkaria, MD, DuyKhanh Pham, MD, Ronald A

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SCCRO Expression Correlates With Invasive Progression in Bronchioloalveolar Carcinoma Inderpal S. Sarkaria, MD, DuyKhanh Pham, MD, Ronald A. Ghossein, MD, Simon G. Talbot, MD, Michael Hezel, BS, Maria E. Dudas, BS, Michael I. Ebright, MD, Shaokun Chuai, MA, Natalie Memoli, MD, Ennapadam S. Venkatraman, PhD, Vincent A. Miller, MD, Mark G. Kris, MD, Maureen F. Zakowski, MD, Valerie W. Rusch, MD, Bhuvanesh Singh, MD The Annals of Thoracic Surgery Volume 78, Issue 5, Pages 1734-1741 (November 2004) DOI: 10.1016/j.athoracsur.2004.05.056

Fig 1 Tissue microarray construction. (A) Paraffin-embedded specimens with confirmed bronchioloalveolar carcinoma were obtained, 0.6-mm biopsy cores taken from representative areas of tissue, and arrayed in triplicate onto a master paraffin block. (B, C) Routine and immunohistochemical stains were performed on 5-μm sections. Representative hematoxylin & eosin staining is shown (B: 5-μm section slide view; C: ×10). (D–F) Areas of tumor-adjacent benign lung (D: ×100) and bronchioloalveolar carcinoma tumor (E: ×100; inset, ×400) were arrayed. For tumors of mixed histologic type, areas of invasive adenocarcinoma were also arrayed (F: ×100; inset, ×400). The Annals of Thoracic Surgery 2004 78, 1734-1741DOI: (10.1016/j.athoracsur.2004.05.056)

Fig 2 Squamous cell carcinoma–related oncogene (SCCRO) immunohistochemical staining in bronchioloalveolar (BAC) and adenocarcinoma (Adeno) cores. Representative sections of negative and positive phenotypes for squamous cell carcinoma–related oncogene expression are shown. Adenocarcinomatous and bronchioloalveolar sections are shown on the top and bottom row, respectively. Low-power (×100) and high-power (×400) views are shown for the positive cores. Note the heavy cytoplasmic staining without nuclear staining (arrows). The Annals of Thoracic Surgery 2004 78, 1734-1741DOI: (10.1016/j.athoracsur.2004.05.056)

Fig 3 Differential squamous cell carcinoma–related oncogene (SCCRO) expression in benign lung versus tumor cores. Moderate and high levels of SCCRO expression were 86.8% sensitive and 100% specific for detecting tumors in this cohort (area under the receiver-operating curve, 0.92). Positive SCCRO phenotype (high-level expression, immunohistochemistry grade 3) was seen in 16.3% of tumors, and was 16.3% sensitive and 100% specific. Of note, a large number of tumor-adjacent benign cores express low levels of SCCRO compared with those with absent expression. The Annals of Thoracic Surgery 2004 78, 1734-1741DOI: (10.1016/j.athoracsur.2004.05.056)

Fig 4 Squamous cell carcinoma–related oncogene (SCCRO) positive phenotype by tumor histologic type. Incidence of high-level SCCRO expression increases in tumors with progressively more invasive histologic type. (AWBF = adenocarcinoma with bronchioloalveolar carcinoma features; BWFI = bronchioloalveolar carcinoma with focal invasion; PBAC = pure bronchioloalveolar carcinoma.) The Annals of Thoracic Surgery 2004 78, 1734-1741DOI: (10.1016/j.athoracsur.2004.05.056)

Fig 5 Survival analysis in benign cores. Low-level squamous cell carcinoma–related oncogene (SCCRO) expression in tumor-adjacent benign cores predicts worse survival in bronchioloalveolar carcinoma compared with absent expression. The Annals of Thoracic Surgery 2004 78, 1734-1741DOI: (10.1016/j.athoracsur.2004.05.056)