Napsin A在卵巢透明细胞癌中的表达及意义

目的 探讨Napsin A在卵巢透明细胞癌（CCC）中的免疫组化表达及其临床意义，试图寻找一组与卵巢其他上皮性肿瘤诊断与鉴别诊断有用的抗体。方法 收集18例卵巢原发性CCC、32例高级别浆液性癌（HGSCs）、16例交界性浆液性肿瘤（SBTs）、27例子宫内膜的子宫内膜样腺癌（ECs）及13例卵黄囊瘤，利用免疫组化染色标记Napsin A、PAX-8、WT-1和ER。结果 卵巢CCC中100%（18/18）一致性弥漫表达Napsin A和PAX-8；HGSCs中100%（32/32）一致性表达PAX-8和 ER，91%（29/32）一致性表达WT-1；SBTs中100%（16/16）一致性表达PAX-8、WT-1和ER；ECs中，96%（26/27）一致性表达PAX-8，85%（23/27）一致性表达ER；HGSCs、SBTs、ECs和卵黄囊瘤均不表达Napsin A。结论 Napsin A是诊断卵巢CCC极其敏感和特异的标志物，联合应用Napsin A、PAX-8、WT-1和ER在CCC、HGSCs、SBTs、ECs及卵黄囊瘤的鉴别诊断中具有重要的意义。

Expression and Significance of Napsin A in Clear Cell Carcinomas of the Ovary

Objective To detect the expression and significance of Napsin A in Clear Cell Carcinomas of the Ovary, try to find a useful panel of antibodies in the differential diagnosis of other epithelial ovarian tumor. Methods We identified an archival series of ovarian clear cell carcinomas (n=18), high-grade serous carcinomas (n=32), serous borderline tumors (n=16), endometrial endometrioid adenocarcinomas (n=27), and yolk sac tumor (n=13), using standard immunohistochemical techniques to mark Napsin A, TTF-1, PAX-8, WT-1 and ER. Results Of the ovarian CCC, 100% (18/18) showed Napsin A and PAX-8 expression, with the vast majority showing uniform immunostaining. Of the HGSCs, 100% (32/32) showed uniform expression of ER and PAX-8, and 91% (29/32) of WT-1.Of the SBTs, 100% (16/16) showed uniform expression of PAX-8, WT-1 and ER. Of the ECs, 96% (26/27) showed expression of PAX-8 and 85% (23/27) showed expression of ER. None of the cases of HGSCs, SBTs, ECs and yolk sac tumor exhibited expression of Napsin A. Conclusion Our study showed that Napsin A is an extremely sensitive and specific marker of ovarian CCC. Napsin A, PAX-8, WT-1 and ER expressions have important significance in the differential diagnosis among CCC, HGSCs, SBTs, ECs and yolk sac tumor.