Kawai Toshiaki, Tominaga Susumu, Hiroi Sadayuki, Kameda Koji, Ogata Sho, Nakashima Hiroshi, Ozeki Yuichi, Nakanishi Kuniaki
Department of Pathology and Laboratory Medicine, National Defense Medical College, Saitama, Japan.
Acta Cytol. 2015;59(6):457-64. doi: 10.1159/000442659. Epub 2015 Dec 23.
The introduction of new therapies has made it important to differentiate between adenocarcinoma and squamous cell carcinoma. To allow the use of various immunocytochemical stains on limited materials, we tried transferring cells from a given smear to multiple slides. Using touch-preparation samples of 215 surgically resected non-small cell lung carcinomas of confirmed histologic classification (adenocarcinoma,n = 101; squamous cell carcinoma,n = 114), we performed immunocytochemistry for thyroid transcription factor-1, napsin A, p40, p63, CK5/6 and desmocollin-3, and compared cytologic staining results with the corresponding resection.
We examined: (a) the expressions of the above 6 antibodies on cells transferred from touch imprints of resected specimens, the extent of staining being considered positive if more than 5% of the area was stained, and (b) the sensitivity, specificity, positive predictive value and negative predictive value for each antibody.
The histologic corresponding rate with Papanicolaou staining was only 73%. Regarding the differentiation of adenocarcinoma from squamous cell carcinoma, the sensitivity and specificity for napsin A in adenocarcinoma were 80 and 97%, respectively, while those for p40 in squamous cell carcinoma were 84 and 98%, respectively.
The immunocytochemical expressions of napsin A and p40 in imprint cytology seem to be of great utility for the accurate histological differentiation of lung cancers.
新疗法的引入使得区分腺癌和鳞状细胞癌变得很重要。为了能在有限的材料上使用各种免疫细胞化学染色方法,我们尝试将来自特定涂片的细胞转移到多张载玻片上。利用215例手术切除的、组织学分类明确的非小细胞肺癌(腺癌,n = 101;鳞状细胞癌,n = 114)的触片标本,我们对甲状腺转录因子-1、 napsin A、p40、p63、CK5/6和桥粒芯蛋白-3进行了免疫细胞化学检测,并将细胞学染色结果与相应的切除标本进行比较。
我们检测了:(a)上述6种抗体在从切除标本的触印转移来的细胞上的表达情况,若染色面积超过5%则认为染色程度为阳性;(b)每种抗体的敏感性、特异性、阳性预测值和阴性预测值。
巴氏染色的组织学符合率仅为73%。关于腺癌与鳞状细胞癌的鉴别,napsin A在腺癌中的敏感性和特异性分别为80%和97%,而p40在鳞状细胞癌中的敏感性和特异性分别为84%和98%。
napsin A和p40在印片细胞学中的免疫细胞化学表达似乎对肺癌的准确组织学鉴别有很大作用。