成束蛋白和细胞角蛋白14在多种肿瘤组织中的表达及其鉴别诊断意义

目的 揭示成束蛋白(fascin)和细胞角蛋白14(CK14)在不同器官的相同或不同组织学类型癌组织中的表达规律,探讨其鉴别诊断的应用价值.方法 构建450例不同器官的相同或不同组织学类型癌组织芯片,用免疫组化方法检测fascin和CK14的表达情况.结果 fascin在食管、肺、喉、宫颈和外生殖器的鳞癌中弥漫高表达,阳性率分别为90.0%、90.0%、96.7%、78.6%和89.7%,在肺腺癌、胃腺癌、结直肠腺癌、肝细胞癌、胰腺导管腺癌、乳腺浸润性导管癌、甲状腺乳头状癌、子宫宫内膜样腺癌、卵巢浆液性囊腺癌和肾透明细胞癌中表达阳性率分别为38.0%、23.3%、14.3%、10.3%、73.3%、13.3%、6.7%、60.0%、66.7%和10.0%;在鳞癌和其他组织学类型肿瘤中的表达差异有统计学意义(P＜0.001).CK14在食管、肺、喉、宫颈和外生殖器鳞癌中表达阳性率分别为76.7%、36.7%、83.3%、60.7%和96.3%,而在肺腺癌、胃腺癌、结直肠腺癌、肝细胞癌、胰腺导管腺癌、乳腺浸润性导管癌、甲状腺乳头状癌、子宫宫内膜样腺癌、卵巢浆液性囊腺癌和肾透明细胞癌中表达阳性率分别为13.3%、13.3%、20.7%、41.4%、46.7%、6.7%、40.0%、13.3%、20.0%和6.7%;在鳞癌和其他组织学类型肿瘤中的表达差异有统计学意义(P＜0.001).fascin与CK14联合,在鳞癌中任一蛋白阳性率,与在其他组织学类型肿瘤中的表达差异均有统计学意义(P＜0.001).结论 fascin和CK14在多器官鳞癌呈高表达,在其他组织学类型肿瘤呈较低表达.联合检测fascin和CK14的表达,可用于鳞癌的诊断和鉴别诊断.

Expression of fascin and CK14 in different histological types of cancer and its differential diagnostic significance

Objective To investigate and analyze the expression of fascin and CK14 in multiple histological types of cancer and to explore the potential value of the two proteins as markers in diagnosis and differential diagnosis of various cancer types. Methods Tissue microarray containing esophageal squamous cell carcinoma (SCC), lung SCC, larynx SCC, uterine cervical SCC, SCC of external genital organs, lung adenocarcinoma, gastric adenocarcinoma, colorectal adenocarcinoma, heptocellular carcinoma, pancreatic ductal adenocarcinoma, breast infiltrating ductal carcinoma, thyroid papillary carcinoma, uterine endometrioid adenocarcinoma, ovarian serous adenocarcinoma and renal clear cell carcinoma, 30 cases each, as well as corresponding normal controls was constructed. The expression of fascin and CK14 among different types of carcinoma and corresponding normal controls was detected by immunohistochemistry.Results In normal esophagus, bronchus, larynx, uterine cervix and skin, fascin was mainly expressed in the basal cells or reserve cells, but the expression was diffuse in esophageal SCC, lung SCC, larynx SCC,uterine cervical SCC and SCC of external genital organs, with a positive rate of 90.0%, 90.0%, 96.7%,78.6% and 89.7%, respectively. In the normal tissue of other organs, except breast and uterine endometrium, fascin was negative. In lung adenocarcinoma, gastric adenocarcinoma, colorectal adenocarcinoma, hepatocellular carcinoma, pancreatic ductal adenocarcinoma, breast infiltrating dutal adenocarcinoma, thyroid papillary carcinoma, uterine endometrioid adenocarcinoma, ovarian serous adenocarcinoma and renal clear cell carcinoma, the positive rates were 38.0%, 23.3%, 14.3%, 10.3%,73.3%, 13.3%, 6.7%, 60.0%, 66.7% and 10.0%, respectively. The difference between fascin expression in SCC and in other histological types was statistically significant (P ＜0.001 ). CK14 was mainly expressed in the basal cells, reserve cells or myoepithelia of normal tissues. The positive rates of CK14 were 76.7%, 36.7%, 83.3%, 60.7% and 96.3% in esophageal SCC, lung SCC, larynx SCC, uterine cervical SCC and SCC of external genital organs, respectively. It was weak and focal in lung adenocarcinoma, gastric adenocarcinoma, colorectal adenocarcinoma, hepatocellular carcinoma, pancreatic ductal adenocarcinoma,breast infiltrating dutal adenocarcinoma, thyroid papillary carcinoma, uterine endometrioid adenocarcinoma,ovarian serous adenocarcinoma, and renal clear cell carcinoma, with a positive rate of 13. 3%, 13. 3%,20.7%,41.4%, 46.7%, 6.7%, 40.0%, 13.3%, 20.0% and 6.7%, respectively. The difference between CK14 expression in SCC and in other histological types was statistically significant (P＜0.001).The difference between co-expression of fascin/CKl4 in SCC and in other histological types was also statistically significant (P＜0.001). Conclusion Fascin and CK14 are highly expressed in SCC,compared with other histological types of carcinoma. Combination of fascin and CK14 should be a valuable marker in diagnosis and differential diagnosis of carcinoma.