胸腔积液中腺癌细胞甲状腺转录因子-1 mRNA表达的定量研究

Quantitative study of the expression of thyroid transcription factor-1 mRNA in the metastatic adenocarcinoma cells in pleural effusion

目的探讨甲状腺转录因子-1(thyroid transcription factor-1,TTF-1)mRNA在胸腔积液不同组织来源的腺癌细胞中的表达情况并进行定量测试分析。方法应用原位杂交技术和Leica Q500 MC图像分析系统,对TTF-1 mRNA的表达进行定量测试和诊断试验评价分析。结果37例肺腺癌胸水标本中有21例标本TTF-1mRNA呈不同程度的阳性表达,阳性率达56.76%(21/37),11例肺外腺癌胸水标本均未检测出TTF-1 mRNA,即阳性率为0%(0/11),两者差异有显著性(X2=11.099,P=0.001)。癌性胸水中转移性肺腺癌细胞与肺外腺癌细胞TTF-mRNA的PU值相比差异亦有显著性(t=9.901,P=0.000)。诊断试验评价结果显示TTF-1 mRNA的表达对癌性胸水中肺腺癌细胞诊断的灵敏度和特异度分别为56.75%和100%。结论TTF-1 mRNA在胸腔积液转移性肺腺癌的检测中具有较高的特异度和灵敏度,在排除甲状腺癌的可能性后,TTF-1 mRNA的检测可作为判断胸腔积液中转移性肺腺癌的组织特异性指标。

Objective To quantitatively study the expression of thyroid transcription factor - 1 （ TTF - 1 ） mRNA in the matastatic adenocarcinoma ceils in pleural effusion. Methods The Expression of TTF - 1 mRNA was examined by in situ hybridisation and assessed quantitatively by Leiea Q500 MC image analysis system on the cell block sections. Restilts TTF - 1 mRNA was expressed in 21 of 37 eases metastatic lung adenocareinomas but none of the 11 extrapulmonary adenocarcinomas expressed TTF- 1 mRNA. There was a significant difference between the two groups（ P 〈 0. 01 ）. TTF- 1 mRNA positive unit（PU） was significantly greater in adenocareinomas from the lung than that of extrapulmonary adenoeareinomas （ t = 9. 901, P = 0. 000 ）. The sensitivity and specificity for the adenocarcinomas of lung origin were 56. 75% and 100%, respectively. Conclusion TTF - 1 is a sensitive and specific marker for adenocarcinomas of lung origin in malignant pleural effusions. TTF - 1 can be used as an organ specific marker to suggest the primary site of adenocarcinoma from lung if thyroid carcinoma can be excluded.