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目的探讨天门冬氨酸蛋白酶A(novel aspartie proteinase A,Napsin A)与甲状腺转录因子-1(thyroidtranscription factor 1,TTF-1)及P63蛋白联合检测在肺鳞癌与腺癌鉴别诊断中的应用价值。方法采用免疫组织化学EnVision二步法检测Napsin A,TTF-1和P63蛋白在178份肺癌组织标本中的表达情况。结果 Napsin A,TTF-1和P63蛋白在肺癌组织中总体阳性表达分别为44.94%,53.93%和40.44%;Napsin A与TTF-1在肺腺癌中的阳性表达率(81.25%,79.17%)分别明显高于肺鳞癌(0)(P<0.01);P63蛋白在肺腺癌中的阳性表达率(10.41%)明显低于肺鳞癌(96.20%)(P<0.01);Napsin A对肺腺癌的敏感性和特异性均高于TTF-1,但差异无统计学意义(P>0.05)。结论 Napsin A,TTF-1及P63蛋白联合检测对肺鳞癌与肺腺癌的鉴别诊断有重要价值。
Objective To investigate the value of combined detection of Napsin A and thyroid transcription factor-1 (TTF-1) and P63 protein in the differential diagnosis between squamous cell carcinoma and adenocarcinoma . Methods The immunohistochemical EnVision two-step method was used to detect the expression of Napsin A, TTF-1 and P63 in 178 samples of lung cancer. Results The positive rates of Napsin A, TTF-1 and P63 in lung cancer were 44.94%, 53.93% and 40.44%, respectively. The positive rates of Napsin A and TTF-1 in lung adenocarcinoma were 81.25% and 79.17% (P <0.01). The positive rate of P63 protein in lung adenocarcinoma (10.41%) was significantly lower than that in lung squamous cell carcinoma (96.20%) (P <0.01) The sensitivity and specificity of lung adenocarcinoma were higher than that of TTF-1, but the difference was not statistically significant (P> 0.05). Conclusion The combined detection of Napsin A, TTF-1 and P63 proteins has important value in the differential diagnosis between lung squamous cell carcinoma and lung adenocarcinoma.