P63,CK5/6,TTF1和napins A联合检测在肺鳞癌和肺腺癌鉴别诊断中的价值

目的:探讨p63,CK5/6,TTF1和napinsA在肺鳞癌和腺癌鉴别诊断中的价值.方法:应用免疫组织化学EnVision法分别检测42例肺鳞癌和42例肺腺癌中p63,细胞角蛋白5/6(cytokeratin 5/6,CK5/6),甲状腺转录因子1 (thyroid transcription factor-1,TTF1)和napins A的表达,同时分析它们对肺鳞癌和腺癌诊断的敏感性和特异性.结果:p63和CK5/6在肺鳞癌中的阳性表达率分别为100％和97.6％,明显高于TF1和napsin A(P＜0.01).而TTF1和napsinA在肺腺癌中的阳性表达率分别为97.6％和100％,明显高于p63和CK5/6(P＜0.01).p63或CK5/6检测对肺鳞状细胞癌诊断的敏感性和特异性分别为100％和92.9％,TTF1和napsinA联合检测对肺腺癌诊断的敏感性和特异性分别为97.6％和100％.结论:p63,CK5/6,TTF1和napinsA联合检测有助于肺鳞癌和腺癌的鉴别.

Value of combined assay of p63, CK5/6, TTF 1, and napsin A in differential diagnosis of lung squamous cell carcinoma and lung adenocarcinoma

Objective: To explore the value of p63,cytokeratin 5/6(CK5/6),thyroid transcription factor-1(TTF1),and napsin A in the differential diagnosis of lung squamous cell carcinoma and lung adenocarcinoma.Methods: The immunohistochemical EnVision technique was used to assay the expression of p63,CK5/6,TTF1 and napsin A in 42 patients with lung squamous cell carcinoma and 42 patients with lung adenocarcinoma.The sensitivity and specificity of measurement of p63,CK5/6,TTF1 and napsin A in the diagnosis of lung squamous cell carcinoma and lung adenocarcinoma were also analysed.Results: p63 and CK5/6 were expressed 100% and 97.6%,respectively,of lung squamous cell carcinomas examined,both of which were higher than those in lung adenocarcinoma(P<0.01).The incidence of positive expression of TTF1 and napsin A in lung adenocarcinoma were 97.6% and 100%,higher than those in lung squamous cell carcinoma(P<0.01).The sensitivity and specificity of p63 and CK5/6 for the diagnosis of lung squamous cell carcinoma were 100% and 92.9%,respectively.The sensitivity and specificity of TTF1 and napsin A for the diagnosis of lung adenocarcinoma were 97.6% and 100%,respectively.Conclusion: The combined assay for p63,CK5/6,TTF1,and napsin A may be helpful for the differential diagnosis of lung squamous cell carcinoma and lung adenocarcinoma.