肺腺癌中的TTF-1、NAPSINA病理诊断价值

Diagnostic value of TTF-1 and NAPSINA in lung adenocarcinoma

目的探讨甲状腺转录因子-1(TTF-1)与天冬氨酸蛋白酶A(NapsinA)在肺腺癌病理诊断中的价值。方法选取80例肺腺癌组织标本为实验组,以其它类型肺癌组织标本(包括鳞癌、腺鳞癌、小细胞癌、大细胞癌等)共80例作为对照组。采用免疫组织化学PV-6000两步法分别对肺癌组织标本中的TTF-1与NapsinA两项指标进行检测,分析二者的表达水平和阳性率,并评估联合采用TTF-1与NapsinA两项指标对肺腺癌的诊断价值。结果实验组患者的TTF-1和NapsinA阳性率分别为86.25%和77.5%,显著高于对照组(P<0.05);TTF-1和NapsinA阳性率与患者的年龄及性别无相关性(P>0.05),与肿瘤大小、分化程度、TNM分期等指标具有相关性(P<0.05);TTF-1和NapsinA联合检测的灵敏度和特异度分别为92.74%和98.21%,显著高于两项指标单项检测。结论 TTF-1、NapsinA在肺腺癌中表达的阳性率显著高于其它类型非小细胞癌,且联合应用这两种免疫组化标志物检测的敏感度和特异度优于任意一种标志物单独检测,对肺腺癌准确、及时的诊断具有重要意义,同时为肺腺癌进行靶向治疗提供依据。

Objective To evaluate the values of thyroid transcription factor-1 （TTF-1） and novel aspartie proteinase A （Napsin A） in the pathologic diagnosis of pulmonary adenocarcinoma.Methods 80 patients with primary lung adenocarcinoma were selected in experimental group, and 80 patients with squamous cell carcinoma, small cell carcinoma or large cell carcinoma were selected in control group.Immunohistochemistry of DAB Detection kit （polymer） two-step staining was performed to detect the positive rates and expression levels of TTF-1 and Napsin A, and evaluate the diagnostic value of the combination detection of TTF-1 and Napsin A in lung adenocarcinoma.Results The positive rate of TTF-1 and NapsinA in the experimental group were respectively 86.25% and 77.5%, significantly higher than those of the control group （P〈0.05）.The positive rates of TTF-1 and Napsin A had no significant difference with age and gender （P〉0.05）, and had significant difference with tumor size, differentiation degree and TNM stage （P〈0.05）.The sensitivity and specificity of combination detection of TTF-1 and Napsin Acombined were 92.74% and 98.21%, significantly higher than that of each single detection.Conclusion The positive expression rate of TTF-1 and Napsin-A in lung adenocarcinoma are significantly higher than those of other types of lung cancer, and the sensitivity and specificity of combination detection of TTF-1 and Napsin-A is significantly higher than that of each single detection.There are high positive rates of TTF-1 and Napsin-A in patients with plung adenocarcinoma, and they can raise the diagnostic accuracy in pathological diagnosis.At the same time, it can provide the basis for targeted therapy of lung adenocarcinoma.