HNF-1β和NapsinA联合检测在卵巢透明细胞癌诊断中的价值

Diagnostic value of combined detection of HNF-1 β and Napsin A in the diagnosis of ovarian clear cell carcinoma

目的比较HNF-1β和NapsinA在卵巢透明细胞癌、浆液性癌、子宫内膜样腺癌和转移性Krukenherg瘤中的表达，探讨HNF-1β和NapsinA联合检测对卵巢透明细胞癌的诊断价值。方法应用免疫组织化学EnVision法检测38例卵巢透明细胞癌、30例高级别浆液性癌、22例子宫内膜样腺癌和16例转移性Krukenberg瘤中HNF—1β和NapsinA的表达，比较HNF-1β和NapsinA在这些肿瘤中表达阳性率，分析HNF-1β和NapsinA单独或联合检测对卵巢透明细胞癌诊断的灵敏度和特异度。结果HNF-1β在卵巢透明细胞癌组织中的阳性率为100％（38／38），明显高于高级别浆液性癌和子宫内膜样腺癌（P〈0．01），但与转移性Krukenberg瘤差异无统计学意义（P〉0．05）。NapsinA在97．4％（37／38）卵巢透明细胞癌中表达，而高级别浆液性癌和子宫内膜样腺癌组织的NapsinA阳性率分别为6．7％（2／30）和22．7％（5／22），转移性Krukenberg瘤组织中NapsinA不表达，NapsinA在卵巢透明细胞癌中的阳性率明显高于浆液性癌、子宫内膜样癌和转移性Krukenberg瘤（P〈0．01）。HNF-1β对卵巢透明细胞癌诊断的灵敏度和特异度分别为100％和55．9％；NapsinA对卵巢透明细胞癌诊断的灵敏度和特异度分别为97．4％和89．7％。联合检测HNF-1β和NapsinA对卵巢透明细胞癌诊断的灵敏度和特异度分别为97．4％和91．2％，HNF-1β或NapsinA检测对卵巢透明细胞癌诊断的灵敏度和特异度分别为100％和52．9％。结论HNF-1β是诊断卵巢透明细胞癌比较敏感的标志物，NapsinA是卵巢透明细胞癌比较特异的标志物，HNF-1β和NapsinA联合检测可有助于卵巢透明细胞癌的诊断和与转移性Krukenberg瘤的鉴别诊断。

Objective To study the diagnostic value of HNF-1B and Napsin A for ovarian clear cell carcinomas, serous carcinomas, endometrioid adenocarcinomas and metastatic Krukenberg tumors. Methods Immunohistochemical EnVision method was used to detect the expression of HNF-1β and Napsin A in 38 cases of ovarian clear cell carcinoma, 30 cases of high-grade serous carcinoma, 22 cases of endometrioid adenocarcinoma and 16 cases of metastatic Krukenberg tumor. Expression of HNF-1B and Napsin A were compared, and sensitivity and specificity of clear cell carcinoma of the ovary were analysed. Results The positive rate of HNF-1β in the ovarian clear cell carcinoma was 100% （38/38）, higher than those in high- grade serous carcinoma and endometrioid adenocarcinoma （ P 〈 0. 05 ） , although significant difference was not observed from that of metastatic Krukenberg tumor （ P 〉 0. 05 ）. Napsin A expressed in 97.4% （37/38） of ovarian clear cell carcinoma, 6. 7% （ 2/30 ） of high-grade serous carcinoma, 22. 7% （ 5/22 ） of endometrioid adenocarcinoma. Napsin A expression in clear cell carcinoma was higher than those in high- grade serous carcinoma and endometrioid adenocarcinoma （ P 〈 0. 01 ） , and no expression of Napsin A was seen in metastatic Krukenberg tumor （ P 〉 0. 05）. The sensitivity and specificity of HNF-1β in the diagnosis of ovarian clear cell carcinoma were 100% and 52. 9% , those of Napsin A were 97.4% and 91.2% , those of both HNF-1β and Napsin A were 97.4% and 91.2% , respectively. The sensitivity and specificity of HNF-1β or Napsin A in the diagnosis of ovarian clear cell carcinoma were 100% and 52. 9% , respectively. Conclusions HNF-1β is a more sensitive marker for the diagnosis of ovarian clear cell carcinoma, whereas Napsin A is a more specific marker. The combined detection of HNF-1β and Napsin A may be helpful for the diagnosis of clear cell carcinoma of the ovary.