肺小活检中应用免疫组化检验对腺癌及鳞状细胞癌的鉴别诊断价值
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摘要
目的:探讨肺小活检中应用免疫组化检验对腺癌及鳞状细胞癌的鉴别诊断价值。方法:自2014年3月至2018年3月间26例肺原发性鳞状细胞癌、51例肺原发性腺癌患者的活检标本进行研究,测定细胞角蛋白5/6(CK5/6)、p63、napsinA以及甲状腺转录因子1(TTF-1)的表达,分析该4种标记物在腺癌和鳞状细胞癌诊断中的阳性率。结果:鳞状细胞癌患者组中CK5/6阳性率为96.15%,p63的阳性率为100.00%,高于napsinA、TTF-1(P<0.05);腺癌患者中napsinA和TTF-1的阳性率分别为100.00%、98.04%,高于CK5/6和p63(P<0.05)。结论:p63和CK5/6在鳞状细胞癌检测中有较大优势,napsinA和TTF-1在腺癌诊断的阳性率较高,因此在腺癌和鳞状细胞癌的诊断鉴别中可联合该4项指标进行综合评判,提升诊断准确率。
Objective:To probe into the diagnostic value of application of immunohistochemistry in small lung biopsy in differentiation of adenocarcinoma and squamous cell carcinoma. Methods:The biopsy specimen of 26 cases of primary squamous cell carcinoma of the lung and 51 cases of primary lung adenocarcinoma from March, 2014 to March, 2018 were selected as the research objects. And the expressions of cytokeratin 5/6(CK5/6), p63, napsinA and thyroid transcription factor 1(TTF-1) were determined, and the positive rate of 4 markers in the diagnosis of adenocarcinoma and squamous cell carcinoma were analyzed. Results:The positive rate of CK5/6 in the patients with squamous cell carcinoma was 96.15 %, and the positive rate of p63 was 100 %, which was significantly higher than that of napsinA and TTF-1, and the difference was statistically significant(P<0.05). In the patients with adenocarcinoma, the positive rates of napsinA and TTF-1 were 100 % and 98.04 %, respectively, which were significantly higher than those of CK5/6 and p63(P<0.05). Conclusion:The P63 and CK5/6 have great advantage in the detection of squamous cell carcinoma, and the positive rates of napsinA and TTF-1 in diagnosis of adenocarcinoma are higher. Therefore, in the diagnosis and differential diagnosis of adenocarcinoma and squamous cell carcinoma, the 4 indicators can be combined to make comprehensive evaluation, so as to improve the accuracy of diagnosis.
Objective:To probe into the diagnostic value of application of immunohistochemistry in small lung biopsy in differentiation of adenocarcinoma and squamous cell carcinoma. Methods:The biopsy specimen of 26 cases of primary squamous cell carcinoma of the lung and 51 cases of primary lung adenocarcinoma from March, 2014 to March, 2018 were selected as the research objects. And the expressions of cytokeratin 5/6(CK5/6), p63, napsinA and thyroid transcription factor 1(TTF-1) were determined, and the positive rate of 4 markers in the diagnosis of adenocarcinoma and squamous cell carcinoma were analyzed. Results:The positive rate of CK5/6 in the patients with squamous cell carcinoma was 96.15 %, and the positive rate of p63 was 100 %, which was significantly higher than that of napsinA and TTF-1, and the difference was statistically significant(P<0.05). In the patients with adenocarcinoma, the positive rates of napsinA and TTF-1 were 100 % and 98.04 %, respectively, which were significantly higher than those of CK5/6 and p63(P<0.05). Conclusion:The P63 and CK5/6 have great advantage in the detection of squamous cell carcinoma, and the positive rates of napsinA and TTF-1 in diagnosis of adenocarcinoma are higher. Therefore, in the diagnosis and differential diagnosis of adenocarcinoma and squamous cell carcinoma, the 4 indicators can be combined to make comprehensive evaluation, so as to improve the accuracy of diagnosis.
引文
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[2] 赵静,张晓彤,胡克,等.紫杉醇联合卡铂三周方案同步胸部放疗治疗不宜手术的局部晚期非小细胞肺癌疗效和安全性研究:一项来自单中心的回顾性研究[J].中国肺癌杂志,2016,19(11):731-737.
[3] 邹艳花,廖先珍,许可葵,等.6400例城市肺癌高危人群筛查结果分析[J].实用预防医学,2016,23(5):593-594.
[4] 余长艳,甄丽娜,李洪滨,等.肿瘤相关巨噬细胞在三阴性乳腺癌中的表达与临床病理因素及预后关系的研究[J].实用肿瘤学杂志,2017,31(1):1-6.
[5] 聂文军.HIF-1a和COX-2蛋白在非小细胞肺癌中的表达及临床意义[D].泸州:泸州医学院,2009.
[6] 顾秀瑛,顾晓芬,朱俊宇,等.2014-2016年乌鲁木齐市9265例城市居民肺癌筛查结果分析[J].实用肿瘤学杂志,2017,31(3):242-245.
[7] 邵康.肺癌为何不容易早期发现?[J].抗癌之窗,2015,12(4):244-245.
[8] Khayyata S,Yun S,Pasha T,et al.Value of P63 and CK5/6 in distinguishing squamous cell carcinoma from adenocarcinoma in lung fine-needle aspiration specimens[J].Dign Cytopathol,2009,37(3):178-183.
[9] 胡世霖.非小细胞肺癌中医辨证分型与Napsin A、TTF-1在肺癌组织中表达的相关性研究[D].福州:福建中医药大学,2015.