甲状腺转录因子-1,细胞角蛋白8/18,P63和HMW联合检测对肺鳞癌和肺腺癌鉴别诊断价值  

Value of the detection of thyroid tramscription factor-1, cytkoeratin 8 /18, P63 and HMW in differential diagnosis of lung squamous cell carcinoma and adenocarcinoma

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430030

出　　处：《中华肺部疾病杂志（电子版）》2014年第1期47-51,共5页Chinese Journal of Lung Diseases(Electronic Edition)

摘　　要：目的探讨甲状腺转录因子-1(TTF-1)、细胞角蛋白8/18(CK8/18)、P63细胞角蛋白HMW(CK-HMW)联合检测在鉴别肺鳞癌和肺腺癌中的价值。方法收集2010年1月至2012年12月入住华中科技大学武汉同济医院1028例肺鳞癌和肺腺癌患者的病理组织标本及相关临床资料。采用免疫组化EnVision两步法分别检测TTF-1、CK8/18、P63及HMW在肺鳞癌和肺腺癌中的表达并对结果进行分析。结果单个免疫组化标志物中,P63对于诊断肺鳞癌和肺腺癌有较高的灵敏性和准确度,TTF-1诊断肺腺癌的敏感性为86.3%,特异度为87.7%,准确度为86.8%;CK8/18诊断肺腺癌的敏感性为100%,特异度为16.0%,准确度为68.7%;P63诊断肺鳞癌的敏感性为97.2%,特异度为79.0%,准确度为90.5%;HMW诊断肺鳞癌的敏感性为100%,特异度为25.0%,准确度为80.3%。P63和HMW共同阳性表达对于诊断肺鳞癌的特异度和准确度均大大提高,为76.9%和92.2%,而TTF-1和CK8/18共同阳性表达对肺腺癌的特异度和准确度也大大提高,为100%和96.6%。结论 TTF-1、CK8/18、P63和HMW的联合检测对鉴别肺鳞癌和肺腺癌有很高的价值,P63和HMW、TTF-1和CK8/18的联合检测可以显著提高肺鳞癌和肺腺癌诊断的准确度。[ Abstract] Objective To evaluate the value of the detection of a thyroid tramscription factor-1 （TT- 1 ） , cytokeratin8/18（ CK8/18）, P63, HMW panel in the differential diagnosis of primary lung squamous cell carcinoma（SCC） and adenocareinoma（AdC）. Methods The expression of TTF-1, CK8/18, P63 and HMW from 1028 pathological tissue specimens were detected by immunohistochemical EnVision two-step method, together with their clinical data. Results For single immunohistochemical indicator, P63 had high sensitivity and specificity for the differential diagnosis of lung SCC and AdC. The sensitivity, specificity and accuracy of TTF-1 were 86.3%, 87.7% and 86.8%, respectively; the sensitivity, specificity and accuracy of CK8/18 were 100% , 16.0% and 68.7% , respectively; the sensitivity, specificity and accuracy of P63 were 97.2%, 79.0% and 90.5% , respectively; the sensitivity, specificity and accuracy of HMW were 100% , 25.0% and 80.3%, respectively. The combined diagnosis of TTF-1 and CK8/18, P63 and HMW significantly contribute to the differential diagnosis of SCC and AdC. The accuracy of them were 92.2% and 96.6% , respectively and the specificity of them were 76.9% , 100%, respectively. Conclusions TTF-1, CK8/18, P63 and HMW have significant clinical importance in the differential diagnosis of primary lung squamous cell carcinoma and adenocarcinoma to improve the specificity and diagnosis accuracy. The combined diagnosis of TTF-1 and CKS/ 18, P63 and HMW significantly contribute to the differential diagnosis of SCC and AdC.

关 键 词：腺癌 鳞癌 肺 免疫组化化学 联合诊断 甲状腺转录因子-1 CK8 18 P63 HMW 

分 类 号：R743.2[医药卫生—神经病学与精神病学]