联合检测在非小细胞肺癌中鉴别诊断的价值

Value of immunohistochemical detection in the differential diagnosis of NSCLC

目的探讨细胞角蛋白5/6(CK5/6)、细胞角蛋白HMW(CK-HMW)、甲状腺转录因子-1(TTF-1)和细胞角蛋白8/18(CK8/18)联合检测在低分化非小细胞肺癌中鉴别诊断鳞癌和腺癌的价值。方法采用免疫组化(En Vision法)检测CK5/6、HMW、TTF-1和CK8/18在478例肺鳞癌和腺癌中的表达情况并对结果进行分析。结果单个免疫组化指标中,CK5/6和TTF-1对于肺鳞癌和腺癌的鉴别诊断具有较高价值。CK5/6和HMW联合诊断能提高肺鳞癌诊断的特异性和准确度。TTF-1和CK8/18联合诊断能提高肺腺癌诊断的特异性和准确度。结论 CK5/6、HMW、TTF-1和CK8/18的联合检测对于低分化肺鳞癌和腺癌的鉴别诊断具有很高的价值。

Objective To evaluate the value of the combined detection of CK5/6, HMW, TTF-1 and CK8/ 18 in the differential diagnosis of primary lung squamous cell carcinoma （SCC） and adenocarcinoma （ADC） in patients with poorly differentiated non-small cell lung cancer （NSCLC）. Methods The expression of CK5/6, HMW, TTF-1 and CK8/18 from 478 pathological tissue specimens were detected by immunohistochemical technique （EnVision two-step method）. Results For single immunohistochemical indicator, CK5/6 and TTF-1 had high sensitivity and specificity for the differential diagnosis of lung SCC and ADC. The combined diagnosis of CK56, HMW, TTF-1 and CK8/18 contributed significantly to the differential diagnosis of SCC and ADC. Conclusion The combined detection of CK56, HMW, TTF-1 and CK8/18 has significant value on the differential diagnosis of SCC and ADC.