The expression of TTF-1 and Napsin A in early-stage lung adenocarcinoma correlates with the results of surgical treatment
The expression of TTF-1 and Napsin A in early-stage lung adenocarcinoma correlates with the results of surgical treatment
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DOI：
10.1007/s13277-015-3478-z
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发表时间：
2015-09-01
期刊：
影响因子：
--
通讯作者：
Chen, Keneng
中科院分区：
文献类型：
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作者：
Ma, Yunfan;Fan, Mengying;Chen, Keneng
非小细胞肺癌(NSCLC)占肺癌的80%，肺腺癌(ADC)是NSCLC的主要类型之一。虽然关于肺ADC免疫组织化学诊断标记物(甲状腺转录因子1(TTF-1)和Napsin A)与生存的关系已有几项研究，但这些研究的某些方面仍有待改进。我们研究了常用的肺ADC诊断标记物，包括TTF-1、Napsin A和CK7在早期肺ADC预后中的意义。从2000年1月至2009年12月的肺癌前瞻性数据库中选择119例早期肺腺样变(N-0)病例。应用组织芯片(TMA)和免疫组织化学(IHC)分析库存标本中TTF-1、Napsin A和CK7的表达水平，并检测各标志物的表达水平对患者生存的影响。各指标诊断肺ADC的敏感性和特异性分别为：TTF-1，87.0%和90.1%，Napsin A，72.2%和90.4%，CK7，94.6%和76.0%。TTF-1和Napsin A高表达及TTF-1/Napsin A高共表达患者的生存率高于低表达患者(P<；0.05)。CK7的表达水平与患者的生存无关。多因素分析显示，napsin A和TTF-1/napsin A的表达水平是影响患者生存的独立预后因素。术后早期肺ADC患者应常规行IHC检测标本中TTF-1和Napsin A。其意义不仅在于鉴别诊断，更在于判断预后。
Non-small cell lung cancer (NSCLC) accounts for 80 % of lung cancers, and lung adenocarcinoma (ADC) is one of the main types of NSCLC. Although there are several studies on the relationship between lung ADC immunohistochemical diagnostic markers (thyroid transcription factor 1 (TTF-1) and Napsin A) and survival, some aspects of those studies could be improved. We examined the significance of the commonly used lung ADC diagnostic markers, including TTF-1, Napsin A, and CK7, in the prognosis of early-stage lung ADC. One hundred and nineteen cases of early-stage lung ADC (N-0) were selected from the prospective database of lung cancer (Jan 2000 to Dec 2009). The expression levels of TTF-1, Napsin A, and CK7 in inventoried specimens were analyzed using tissue microarray (TMA) and immunohistochemical (IHC) analysis, and the effect of the expression level of each marker on patients' survival was examined. The diagnostic sensitivity and specificity of each marker for lung ADC were as follows: TTF-1, 87.0 and 90.1 %; Napsin A, 72.2 and 90.4 %; and CK7, 94.6 and 76.0 %, respectively. Patients with high expression levels of TTF-1 and Napsin A, and high co-expression levels of TTF-1/Napsin A had better survival rates than those with low levels of expression (P < 0.05). The expression levels of CK7 were not related to patients' survival. Multivariate analysis showed that the expression levels of Napsin A and TTF-1/Napsin A are independent prognostic factors for survival. The IHC detection of TTF-1 and Napsin A in specimens should be routinely performed in postoperative early-stage lung ADC patients. Its significance lies not only in the differential diagnosis, but also in determining the prognosis.