CK7、CK20联合肠道源性标志物检测在肺肠型腺癌和转移性结直肠腺癌鉴别诊断中的价值

目的检测肺肠型腺癌(pulmonary enteric adenocarcinoma, PEAC)和肺转移性结直肠腺癌(pulmonary metastatic colorectal adenocarcinoma, PMCA)中CK7、CK20和肠道源性标志物(CDX2、SATB2、CDH17、β-catenin)的表达,探讨其在两者鉴别诊断中的价值。方法应用免疫组化EnVision法检测11例PEAC和22例PMCA中CK7、CK20、CDX2、SATB2、CDH17和β-catenin的表达,分析其在两者鉴别诊断中的敏感性、特异性、阳性预测值和阴性预测值。结果 CK7在PEAC中的表达高于PMCA,CK20、CDX2、SATB2、CDH17和β-catenin在PMCA中的表达均明显高于PEAC,差异有统计学意义(P<0.05)。SATB2和β-catenin的表达对PEAC与PMCA的鉴别诊断,具有较高的特异性和阳性预测值(100%)。CK7^-/CK20⁺联合肠道源性标志物对PEAC和PMCA的鉴别诊断,均有较高的特异性和阳性预测...

Value of the detection of CK7,CK20 combined with intestinal-derived markers in the differential diagnosis between pulmonary enteric adenocarcinoma and pulmonary metastatic colorectal adenocarcinoma

Purpose To study the expression of CK7,CK20 and intestinal-derived markers(CDX2,SATB2,CDH17,β-catenin)in the pulmonary enteric adenocarcinoma(PEAC)and pulmonary metastatic colorectal adenocarcinoma(PMCA),and to explore the value of their expression in the differential diagnosis of PEAC and PMCA.Methods Expression of CK7,CK20,CDX2,SATB2,CDH17 andβ-catenin in 11 cases of PEAC and 22 cases of PMCA was detected with immunohistochemical of EnVision method.The sensitivity,specificity,positive predictive value(PPV),and negative predictive value(NPV)of these immunohistochemical markers in the differential diagnosis of PEAC and PMCA were also analysed.Results Expression of CK7 in PEAC was higher than that in PMCA,but expression of CK20,CDX2,SATB2,CDH17 andβ-catenin in PMCA was higher than that in PEAC(P<0.05).SATB2 andβ-catenin had very high specificity and PPV(100%)in the differential diagnosis of PEAC and PMCA.CK7^-/CK20^+combined with intestinal-derived markers had high specificity and PPV in the differential diagnosis of PEAC and PMCA.Conclusion SATB2 andβ-catenin is an immunohistochemical marker with high specificity in distinguishing PEAC from PMCA.It can be combined with CK7 and CK20 in improve the accuracy of pathological diagnosis of PEAC.