Al-Maghrabi Jaudah A, Butt Nadeem S, Anfinan Nisrin, Sait Khalid, Sait Hesham, Marzouki Anas, Khabaz Mohamad Nidal
Departments of *Pathology ‡Obstetrics and Gynecology, Gynecology Oncology Unit §Obstetrics and Gynecology Department, Faculty of Medicine Departments of †Family and Community Medicine ∥Pathology, Rabigh Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.
Appl Immunohistochem Mol Morphol. 2017 Oct;25(9):632-638. doi: 10.1097/PAI.0000000000000350.
Many studies described napsin A as a specific diagnostic marker that aids in differentiating lung adenocarcinomas from other respiratory tumors. This study describes the expression phenotype of napsin A in endometrial neoplasms, it investigates the relationship between this expression profile and the clinicopathologic parameters, and assess its utilization as an independent predictive marker.
A total of 76 cases of previously diagnosed endometrial carcinoma (including 53 endometrioid adenocarcinomas, 6 endometrioid adenocarcinomas with squamous differentiation, 9 serous adenocarcinomas, 6 clear cell adenocarcinomas, and 2 malignant mixed mullerian tumors) and 30 tissue samples of noncancerous endometrium (including 16 proliferative endometriums, 10 secretory endometriums and 4 endometrial polyps) were retrieved from the archives of Pathology Department at King Abdulaziz University, Jeddah, Saudi Arabia. For napsin A detection, tissue microarrays and immunostaining were used.
A total number of 12 (15.78%) cases were positive for napsin A immunostaining. Brown granular cytoplasmic expression of napsin A was detected in 9.4% of endometrioid adenocarcinomas, 16.7% of endometrioid adenocarcinomas with squamous differentiation, 22.2% of papillary serous endometrial carcinomas, and 66.7% of clear cell carcinomas. Three (10%) control cases showed similar granular cytoplasmic expression. Positive napsin A immunostaining was more frequent in clear cell carcinoma, and there is a significant association between positive napsin A immunostaining and clear cell carcinoma (P-value=0.007). Significant associations have been found also between napsin A expression and older ages (above 60 y) and higher stage (IVB), the P-values of which were 0.035 and 0.043, respectively, but not with the tumor recurrence or survival rate.
Although napsin A is infrequently expressed in endometrial carcinomas, positive results of napsin A immunostaining in endometrial neoplasms might support the diagnosis of clear cell carcinoma when the pathologic differential diagnosis includes other histologic subtypes.
许多研究将 napsin A 描述为一种有助于将肺腺癌与其他呼吸道肿瘤区分开来的特异性诊断标志物。本研究描述了 napsin A 在子宫内膜肿瘤中的表达表型，研究了这种表达谱与临床病理参数之间的关系，并评估其作为独立预测标志物的实用性。
从沙特阿拉伯吉达阿卜杜勒阿齐兹国王大学病理科档案中检索出76例先前诊断的子宫内膜癌病例（包括53例子宫内膜样腺癌、6例伴有鳞状分化的子宫内膜样腺癌、9例浆液性腺癌、6例透明细胞腺癌和2例恶性混合性苗勒管肿瘤）以及30例非癌性子宫内膜组织样本（包括16例增殖期子宫内膜、10例分泌期子宫内膜和4例子宫内膜息肉）。采用组织微阵列和免疫染色检测 napsin A。
共有12例（15.78%）病例 napsin A 免疫染色呈阳性。在9.4%的子宫内膜样腺癌、16.7%伴有鳞状分化的子宫内膜样腺癌、22.2%的乳头状浆液性子宫内膜癌和66.7%的透明细胞癌中检测到 napsin A 的棕色颗粒状细胞质表达。3例（10%）对照病例显示出类似的颗粒状细胞质表达。napsin A 免疫染色阳性在透明细胞癌中更为常见，且 napsin A 免疫染色阳性与透明细胞癌之间存在显著关联（P值=0.007）。在 napsin A 表达与老年（60岁以上）和更高分期（IVB期）之间也发现了显著关联，其P值分别为0.035和0.043，但与肿瘤复发或生存率无关。
虽然 napsin A 在子宫内膜癌中表达较少，但当病理鉴别诊断包括其他组织学亚型时，子宫内膜肿瘤中 napsin A 免疫染色阳性结果可能支持透明细胞癌的诊断。
