Napsin A and thyroid transcription factor-1 expression in carcinomas of the lung, breast, pancreas, colon, kidney, thyroid, and malignant mesothelioma
Napsin A and thyroid transcription factor-1 expression in carcinomas of the lung, breast, pancreas, colon, kidney, thyroid, and malignant mesothelioma
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DOI：
10.1016/j.humpath.2009.06.014
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发表时间：
2010-01-01
期刊：
影响因子：
3.3
通讯作者：
Illei, Peter B.
中科院分区：
文献类型：
--
作者：
Bishop, Justin A.;Sharma, Rajni;Illei, Peter B.
肺腺癌治疗的最新进展增加了对非小细胞癌准确分型的需求。甲状腺转录因子-1的免疫组化被广泛用于肺腺癌的诊断，因为它标志着大约75%的肺腺癌，在大多数鳞状细胞癌和其他器官的腺癌中是阴性的。Napsin A是参与表面活性蛋白B成熟的天冬氨酸蛋白酶。在2型肺细胞和肺泡巨噬细胞的细胞质中检测到，并且是肺腺癌的假定标记物。我们使用95例腺癌、48例鳞状细胞癌、6例肺神经内分泌肿瘤、5例结肠癌、31例胰腺癌、17例乳腺癌、38例恶性间皮瘤、118例肾细胞癌和81例甲状腺肿瘤的组织微阵列对napsin A和甲状腺转录因子-1进行免疫组化。组织微阵列还包括15种不同的良性组织。95例肺腺癌中有79例（83%）napsin A阳性，而甲状腺转录因子-1阳性的95例中有69例（73%）。有13个napsin A阳性/甲状腺转录因子-1阴性和2个甲状腺转录因子-1阳性/napsin A阴性肿瘤，增加了至少一种标志物阳性的病例数至81/95（85%）。有限数量的神经内分泌肿瘤检测为napsin A阴性。所有鳞状细胞癌，结肠腺癌，胰腺癌和乳腺癌，间皮瘤均为阴性。在肾肿瘤中，napsin A在大多数乳头状肾细胞癌（79%）、约三分之一（34%）的透明细胞肾细胞癌和一例嫌色细胞肾细胞癌（3%）中呈阳性。在甲状腺，只有2例甲状腺乳头状癌（5%），都与高细胞形态，napsin A阳性，而所有其他乳头状和滤泡状癌均为阴性。正如预期的那样，所有肾脏肿瘤均为甲状腺转录因子-1阴性，除一例乳头状癌外，所有甲状腺肿瘤均为甲状腺转录因子-1阳性。Napsin A是肺腺癌的敏感标志物，也在肾细胞癌的一个子集中表达，特别是乳头状型，以及在乳头状甲状腺癌的罕见病例中。联合应用napsin A和甲状腺转录因子-1可提高鉴别原发性肺肿瘤和转移性肺腺癌的敏感性和特异性。(c)2010年爱思唯尔公司All rights reserved.
Recent advances in the treatment of pulmonary adenocarcinoma have increased the need for accurate typing of non small cell carcinomas. Immunohistochemistry for thyroid transcription factor-1 is widely used in the diagnosis of pulmonary adenocarcinomas because it marks approximately 75% of lung adenocarcinomas and is negative in most squamous cell carcinomas and adenocarcinomas of other organs. Napsin A is an aspartic proteinase involved in the maturation of surfactant protein B. It is detected in the cytoplasm of type 2 pneumocytes and alveolar macrophages and is a putative marker for pulmonary adenocarcinomas. We performed immunohistochemistry for napsin A and thyroid transcription factor-1 using tissue microarrays of 95 adenocarcinomas, 48 squamous cell carcinomas, 6 neuroendocrine tumors of the lung, as well as 5 colonic, 31 pancreatic, and 17 breast adenocarcinomas, 38 malignant mesotheliomas, 118 renal cell carcinomas, and 81 thyroid tumors. The tissue microarrays also included 15 different benign tissues. Pulmonary adenocarcinomas were napsin A positive in 79 (83%) of 95 cases compared with 69 (73%) of 95 cases that were thyroid transcription factor-1 positive. There were 13 napsin A-positive/thyroid transcription factor-1 negative and 2 thyroid transcription factor-1 positive/napsin A negative tumors, increasing the number of cases that were positive with at least one of the markers to 81 (85%) of 95. The limited number of neuroendocrine tumors tested was napsin A negative. All squamous cell carcinomas, adenocarcinomas of the colon, pancreas and breast, and mesotheliomas were negative for both markers. Of the renal tumors, napsin A was positive in most of papillary renal cell carcinomas (79%), about one third (34%) of clear cell renal cell carcinomas, and in a single case of chromophobe renal cell carcinoma (3%). In the thyroid, only 2 cases of papillary thyroid carcinoma (5%), both with tall cell morphology, were positive for napsin A, whereas all other papillary and follicular carcinomas were negative. As expected, all renal tumors were thyroid transcription factor-1 negative, and all thyroid tumors, except for one papillary carcinoma, were thyroid transcription factor-1 positive. Napsin A is a sensitive marker for pulmonary adenocarcinoma and is also expressed in a subset of renal cell carcinomas, particularly of the papillary type, as well as in rare cases of papillary thyroid carcinomas. The combined use of napsin A and thyroid transcription factor-1 results in improved sensitivity and specificity for identifying pulmonary adenocarcinoma in primary lung tumors and in a metastatic setting. (c) 2010 Elsevier Inc. All rights reserved.