研究鉴别原发性肺腺癌与转移性肺肿瘤的一组免疫组化标志物

The Expressions of Immunohistochemical Markers in Discriminating between Primary Adenocarcinomas and Lung Metastatic Tumors

目的:探讨原发性肺腺癌和转移性肺肿瘤中天门冬氨酸蛋白酶(Napsin A)、肺表面活性物质相关蛋白A(SP-A)、甲状腺转移因子-1(TTF-1)临床病理学意义。方法:用免疫组化技术Super PicTureTM Polymer二步法检测Napsin A、SP-A、TTF-1在76例原发性非小细胞肺癌和40例转移性肺肿瘤中的表达水平。结果:Napsin A与原发性肺腺癌的分化程度呈正相关(P<0.05)。Napsin A、SP-A和TTF-1在原发性非小细胞肺癌中的阳性表达与其分型密切相关(均P<0.05)。Napsin A比SP-A、TTF-1具有较高的敏感性和特异性。结论:Napsin A是原发性肺腺癌发生发展过程中较早出现的一种较为敏感的肿瘤标志物,其表达强度与肿瘤的恶性程度密切相关,而且联合使用SP-A、TTF-1有助于鉴别原发性肺腺癌与转移性肺肿瘤。

Objective： To evaluate the utility of novel aspartic proteinase A （Napsin A）, pulmonary surfatcant-associated protein （SP-A） and thyroid transcription factor-1 （TTF-1）immunostaining in the discrimination between primary adenocarcinomas and lung metastatic tumors. Methods： The expressions of Napsin A, SP- A and TFF-1 were detected in 76 patients with primary non-small cell lung cancer and 40 with metastatic tumors by immunohistochemical Super Pic TureTM Polymer method. Results： It was showed that Napsin A was associated with the differentiation grade of adenocarcinoma （P 〈 0.05）. The expressions of Napsin A,SP- A and TTF-1 were significantly related with types of primary non-small cell lung cancer （P 〈 0.05）. It was found that Napsin A had a higher sensitivity and specificity than those of SP-A and TTF-1. Conclusion： The results suggested that Napsin A was expressed in a large proportion of primary lung adenocarcinomas and was associated with the differentiation grade of adenocarcinoma. It was helpful in discriminating between primary adenocarcinomas and lung metastatic tumors by combining SP-A and TTF-1.