Zhang Peng, Han Yi-Ping, Huang Ling, Li Qiang, Ma DA-Lie
Department of Respiratory Medicine, Changhai Hospital, Shanghai 200433, P.R. China.
Oncol Lett. 2010 Sep;1(5):899-903. doi: 10.3892/ol_00000160. Epub 2010 Sep 1.
Napsin A is a newly discovered functional aspartic proteinase that is expressed in normal lung parenchyma in type II pneumocytes and is thought to be associated with primary lung adenocarcinoma. Thyroid transcription factor-1 (TTF-1) is a widely used relatively restricted marker for lung adenocarcinoma. The present study aimed to compare the usefulness of napsin A with TTF-1 for the identification of primary lung adenocarcinoma. Immunohistochemical expression of napsin A and TTF-1 was analyzed in 351 lung cancer tissues, including 27 metastases. Napsin A was expressed in 180 of 212 (84.9%) primary lung adenocarcinomas, while no expression was noted in all 27 metastatic lung cancer specimens, including 19 metastatic adenocarcinomas. In contrast, TTF-1 expression was not only noted in 179 of 212 (84.4%) primary lung adenocarcinomas, but also in 12 of 18 (66.7%) small-cell carcinomas and some of the squamous carcinomas, as well as in one metastatic adenocarcinoma from the thyroid. The sensitivity and specificity of napsin A for primary lung adenocarcinoma (84.9 and 93.8%, respectively) were higher than the sensitivity and specificity of TTF-1 (84.4 and 83.9%, respectively). By combining napsin A and TTF-1, sensitivity increased to 91.0%. Furthermore, the sensitivity and specificity expression was associated with gender, smoking history, performance status, pathological type, primary tumor size and nodal metastasis. Therefore, napsin A is a useful novel marker in the differential diagnosis of primary lung adenocarcinoma.
Napsin A是一种新发现的功能性天冬氨酸蛋白酶，在II型肺细胞的正常肺实质中表达，被认为与原发性肺腺癌有关。甲状腺转录因子-1（TTF-1）是一种广泛应用的相对局限的肺腺癌标志物。本研究旨在比较Napsin A与TTF-1在原发性肺腺癌鉴别诊断中的应用价值。对351例肺癌组织（包括27例转移瘤）进行了Napsin A和TTF-1的免疫组化表达分析。212例原发性肺腺癌中有180例（84.9%）表达Napsin A，而在所有27例转移性肺癌标本（包括19例转移性腺癌）中均未发现表达。相比之下，TTF-1不仅在212例原发性肺腺癌中的179例（84.4%）中表达，还在18例小细胞癌中的12例（66.7%）、部分鳞癌以及1例甲状腺转移性腺癌中表达。Napsin A对原发性肺腺癌的敏感性和特异性（分别为84.9%和93.8%）高于TTF-1的敏感性和特异性（分别为84.4%和83.9%）。联合使用Napsin A和TTF-1，敏感性提高到91.0%。此外，敏感性和特异性表达与性别、吸烟史、体能状态、病理类型、原发肿瘤大小和淋巴结转移有关。因此，Napsin A是原发性肺腺癌鉴别诊断中一种有用的新型标志物。
