CK7和P63对非小细胞肺癌的诊断和联合诊断价值  

CK7 and P63 in NSCLC diagnosis and diagnostic value of combination

作　　者：郑姮[1] 段楚骁[1] 付圣灵[1] 徐沁孜[1] 付向宁[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院胸外科,武汉市430030

出　　处：《实用医学杂志》2013年第21期3524-3527,共4页The Journal of Practical Medicine

摘　　要：目的:通过大样本量免疫组化研究对细胞角蛋白7(cytokeratin 7,CK7)和P63在非小细胞肺癌(non-small cell lung cancer,NSCLC)中的表达进行探究,以得出其对非NSCLC诊断和鉴别诊断的价值。方法:收集同济医院1 067例原发性NSCLC患者的病理组织标本及临床资料。采用EnVision两步法分别检测CK7和P63在NSCLC中的表达并对结果进行分析。结果:CK7和P63在NSCLC中的阳性表达率分别为72.1%和59.6%。CK7主要表达于肺腺癌,其诊断敏感性和特异性分别为97.3%和69.4%,准确度为85.8%。P63主要表达于肺鳞癌,其诊断敏感性和特异性分别为97.0%和74.8%,准确度为85.5%。两者联合检测共150例,P63(+)/CK7(-)共51例,鳞癌占98.0%;P63(-)/CK7(+)共49例,腺癌占83.7%。P63和CK7的阳性表达呈负相关(r=-0.506,P<0.001)。结论:在NSCLC中P63和CK7分别是鳞癌和腺癌的重要标志物,其联合诊断大大提高了NSCLC诊断和鉴别诊断的准确度。Objective To investigate the expression and diagnostic value of CK7 and P63 for non-small cell lung cancer NSCLC specimens with uncertain histomorphology, immunohistoehemistry. Methods The expressions of CK7 and p63 in 1 067 NSCLC pathological specimens were detected by immunohistochemical EnVision two-step method, and the patients＇ clinical data was also collected. Results The positive rates of CK7 and P63 in NSCLC tissues were 72.1% and 59.6%, respectively. The accuracy of CK7 was 85.8%, and its sensitivity and specificity to adenocarcinoma（AdC） was 97.3% and 69.4%,respectively. The P63 expression was more frequent in squamous cell carcinoma（SCC） with sensitivity of 97.0%, specificity of 74.8% and accuracy of 85.5%. The 98.0% of the NSCLC specimens with P63 （＋）/CK7 （-） were SCC, while 83.7% of the NSCLC specimens with P63 （-）/CK7 （＋） were AdC. The CK7 expression was negatively correlated with the P63 expression （r = -0.506, P 〈 0.001）. Conclusions CK7 and P63 can be used as effective diagnostic markers for AdC and SCC in NSCLC, respectively. The combination of CK7 and P63 greatly improves the accuracy for the identification and differential of lung cancer, and it may be an useful marker panel.

关 键 词：癌 非小细胞肺 免疫组化化学 CK7 P63 

分 类 号：R734.2[医药卫生—肿瘤]