原发性肺腺癌和转移性肺腺癌TTF-1、NapsinA、CK7的表达与意义

Expression of TTF-1,NapsinA and CK7 in lung primary and metastatic adenocarcinoma and its clinicopathological significance

目的探讨原发性肺腺癌和转移性肺腺癌甲状腺转录因子-1(TTF-1)、天冬氨酸肽酶A(NapsinA)及细胞角蛋白7(CK7)的表达及意义。方法回顾2017年1月至2020年12月湖州市中心医院接受手术治疗的210例原发性肺癌患者和54例转移性肺腺癌患者的组织标本,采用免疫组化法检测肺癌组织中TTF-1、NapsinA、CK7的表达水平。结果原发性肺腺癌中TTF-1、NapsinA、CK7的阳性表达率分别为81.54%(106/130)、88.46%(115/130)、100.00%(130/130),显著高于非腺癌的阳性表达率(13.75%、1.25%、46.25%),差异均有统计学意义(均P<0.01);TTF-1、NapsinA、CK7在鉴别诊断原发性肺腺癌和转移性肺腺癌时灵敏度分别为0.815、0.885、1.000,特异度分别为0.778、1.000、0.363,准确度分别为0.804、0.919、0.864,CK7灵敏度最高,NapsinA特异度和准确度最高。结论TTF-1、NapsinA、CK7均是肺腺癌诊断灵敏度较高的标志物,NapsinA是鉴别诊断转移性肺腺癌特异度较高的标志物,临床上可选择不同的标志物进行有效的临床诊断和鉴别诊断。

Objective To investigate the expression of thyroid transcription factor-1(TTF-1),NapsinA and CK7 in lung primary and metastatic adenocarcinom and to analyze its clinicopathological significance.Methods The clinical and pathological data of 210 patients with primary lung cancer and 54 patients with metastatic lung adenocarcinoma who underwent surgery in Huzhou Central Hospital from January 2017 to December 2020 were retrospectively reviewed.The expressions of TTF-1,NapsinA and CK7 in cancer tissues were detected by immunohistochemical method.Results The positive expression rate of TTF-1,NapsinA and CK7 in 130 cases of primary lung adenocarcinoma was 81.54%,88.46%and 100.00%respectively,which was significantly higher than that in squamous cell carcinoma,large cell carcinoma and small cell carcinoma(13.75%,1.25%and 46.25%)(all P<0.01),respectively.The sensitivity,specificity and accuracy of TTF-1,NapsinA and CK7 expression for differentiating primary lung adenocarcinoma from metastatic lung adenocarcinoma were 0.815,0.885 and 1.000,0.778,1.000 and 0.363,0.804,0.919 and 0.864,respectively.CK7 had the highest sensitivity while NapsinA had the highest specificity and accuracy.Conclusion TTF-1,NapsinA and CK7 were markers for the diagnosis of lung adenocarcinoma.NapsinA as a marker with high specificity may be used for diagnosis of metastatic lung adenocarcinoma.