TTF-1 and Napsin A Double Stain A Useful Marker for Diagnosing Lung Adenocarcinoma on Fine-Needle Aspiration Cell Blocks
TTF-1 and Napsin A Double Stain A Useful Marker for Diagnosing Lung Adenocarcinoma on Fine-Needle Aspiration Cell Blocks
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DOI：
10.1002/cncy.20135
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发表时间：
2011-04-25
影响因子：
3.4
通讯作者：
Siddiqui, Momin T.
中科院分区：
文献类型：
--
作者：
Fatima, Nazneen;Cohen, Cynthia;Siddiqui, Momin T.
背景：甲状腺转录因子-1(TTF-1)的免疫组织化学(IHC)用于确认肺腺癌的诊断。在肺腺癌中，Napsin A也呈阳性。TTF-1和Napsin A的联合双重染色已被提出以获得更高的敏感性和特异性。在这项研究中，作者评估了这种双重染色在诊断细针抽吸物(FNA)细胞块中诊断肺腺癌的作用。方法：研究对象包括35例肺腺癌FNA细胞块和24例肺鳞癌FNA细胞块(SqCCA)。免疫组织化学染色：TTF-1为棕黄色核染色，Napsin A为红色胞浆染色。结果：35例肺腺癌中TTF-1/Napsin A双重阳性26例(74%)，单独TTF-1阳性2例(5%)，Napsin A单独阳性3例(8%)。在TTF-1/Napsin A双重染色中，3例(12%)肺SqCca两者均为阳性。24例中有6例(25%)单独表达TTF-1，无一例单独表达Napsin A。对于肺腺癌，TTF-1/Napsin A的敏感性为74%，特异性为87%，准确性为79%，阳性预测值为%。结论：TTF-1/Napsin A双重免疫组化染色对FNA细胞块材料中的肺腺癌具有诊断价值。单独使用Napsin A显示了更高的准确度，并且作为单一的IHC染色在诊断上似乎是有用的。癌症(癌症细胞病理学)2011；119：127-33。(C)2011年美国癌症协会。
BACKGROUND: Immunohistochemistry (IHC) for thyroid transcription factor-1 (TTF-1) is used to confirm the diagnosis of lung adenocarcinoma. Napsin A also has shown positivity in lung adenocarcinoma. A combined double stain for TTF-1 and napsin A has been proposed to achieve higher sensitivity and specificity. In this study, the authors evaluated the utility of this double stain in the diagnosis of lung adenocarcinoma in cell blocks of fine-needle aspirates (FNA). METHODS: The authors used a cohort comprising 35 FNA cell blocks of lung adenocarcinoma and 24 FNA cell blocks of lung squamous cell carcinoma (SqCCA). IHC was performed; expressions of TTF-1 as brown nuclear stain and of napsin A as red cytoplasmic stain were identified. RESULTS: Twenty-six of 35 (74%) lung adenocarcinomas were positive for double staining with TTF-1/napsin A. Of 35 lung adenocarcinomas, only 2 (5%) were positive for TTF-1 alone and 3 (8%) were positive for napsin A alone. For the double stain TTF-1/napsin A, 3 of 24 (12%) lung SqCCAs were positive for both. Six of 24 (25%) cases were positive for TTF-1 alone, and none were positive for napsin A alone. For lung adenocarcinoma, TTF-1/napsin A has a sensitivity of 74%, specificity of 87%, accuracy of 79%, and a positive predictive value of 89%. CONCLUSIONS: The double IHC stain, TTF-1/napsin A, for the identification of pulmonary adenocarcinoma in FNA cell block materials was diagnostically useful. The use of napsin A alone demonstrated a greater degree of accuracy and appeared diagnostically useful as a single IHC stain. Cancer (Cancer Cytopathol) 2011;119:127-33. (C) 2011 American Cancer Society.