[TTF-1、NapsinA、P63、CK5/6在肺癌中的表达及其对组织学分类的诊断价值]

[Expression of TTF-1, NapsinA, P63, CK5/6 in Lung Cancer and Its Diagnostic Values for Histological Classification].

作者信息

Yu He, Li Lei, Liu Dan, Li Wei-Min

机构信息

Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu 610041, China.

出版信息

Sichuan Da Xue Xue Bao Yi Xue Ban. 2017 May;48(3):336-341.

PMID:28616902

Abstract

OBJECTIVES

To investigate the expressions of thyroid transcription factor-1(TTF-1), NapsinA, P63 and CK5/6 in lung cancer tissues and their diagnostic value for histological classification.

METHODS

The protein expression in a total of 964 lung cancer samples was detected by immunohistochemistry, of which 929 cases for TTF-1, 113 cases for NapsinA, 282 cases for P63, and 277 for CK5/6, respectively. The correlations between the protein expressions of the four markers and clinicopathological features in lung cancer patients were analyzed. The area under the curves () of ROC curves, sensitivity and specificity were calculated to determine the diagnostic values for the four markers.

RESULTS

There were 552 cases of lung adenocarcinoma (ADC), 146 cases of lung squamous cell carcinoma (SCC), 253 cases of small cell carcinoma (SCLC), and 13 cases of large cell carcinoma (LCC). The median age was 56 years old, and 63.4% was male. The positive expression rates of TTF-1, NapsinA, P63, and CK5/6 were 76.3% (709/929), 67.3% (76/113) , 47.2% (133/282) and 34.7% (96/277), respectively. The positive expression rates of TTF-1 and NapsinA were higher in lung ADC, and the sensitivity and specificity of TTF-1 in the diagnosis of ADC were 81.15% and 30.41% respectively, those of NapsinA were 82.05% and 65.71% respectively. The for TTF-1 and NapsinA were 0.557 8 (=0.002 6, 95%:0.520 0-0.595 6) and 0.738 8 (<0.000 1, 95%:0.633 4-0.844 2) respectively. The positive expression rates of P63 and CK5/6 were significantly higher in lung SCC, and their sensitivities to diagnose SCC were 80.68% and 81.25%, with specificity 68.04% and 84.26% respectively. Thefor P63 and CK5/6 were 0.743 6 (<0.000 1, 95%:0.681 9-0.805 3) and 0.827 6 (<0.000 1, 95%:0.770 0-0.885 2) respectively. Logistic regression model with small sample (44 cases, ADC or SCC) showed that NapsinA was an independent factor to distinguish ADC and SCC (partial regression coefficient=2.826, =0.022), while the other three markers showed no statistical significance (>0.05).

CONCLUSIONS

TTF-1 and NapsinA can be used as prognositic markers for lung ADC. P63 and CK5/6 can be used as prognostic markers for lung SCC. NapsinA may be used to distinguish ADC and SCC.

摘要

目的

探讨甲状腺转录因子-1（TTF-1）、NapsinA、P63和CK5/6在肺癌组织中的表达及其对组织学分类的诊断价值。

方法

采用免疫组织化学法检测964例肺癌样本中的蛋白表达，其中TTF-1检测929例，NapsinA检测113例，P63检测282例，CK5/6检测277例。分析这四种标志物蛋白表达与肺癌患者临床病理特征之间的相关性。计算ROC曲线下面积（AUC）、敏感性和特异性，以确定这四种标志物的诊断价值。

结果

肺腺癌（ADC）552例，肺鳞状细胞癌（SCC）146例，小细胞癌（SCLC）253例，大细胞癌（LCC）13例。中位年龄56岁，男性占63.4%。TTF-1、NapsinA、P63和CK5/6的阳性表达率分别为76.3%（709/929）、67.3%（76/113）、47.2%（133/282）和34.7%（96/277）。TTF-1和NapsinA在肺ADC中的阳性表达率较高，TTF-1诊断ADC的敏感性和特异性分别为81.15%和30.41%，NapsinA分别为82.05%和65.71%。TTF-1和NapsinA的AUC分别为0.557 8（P=0.002 6，95%CI：0.520 0-0.595 6）和0.738 8（P<0.000 1，95%CI：0.633 4-0.844 2）。P63和CK5/6在肺SCC中的阳性表达率显著较高，它们诊断SCC的敏感性分别为80.68%和81.25%，特异性分别为68.04%和84.26%。P63和CK5/6的AUC分别为0.743 6（P<0.000 1，95%CI：0.681 9-0.805 3）和0.827 6（P<0.000 1，95%CI：0.770 0-0.885 2）。小样本（44例，ADC或SCC）的Logistic回归模型显示，NapsinA是区分ADC和SCC的独立因素（偏回归系数=2.826，P=0.022），而其他三种标志物无统计学意义（P>0.05）。