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出 处:《中国医师杂志》2015年第3期391-394,共4页Journal of Chinese Physician
摘 要:目的:评估支气管镜活检组织中甲状腺转录因子-1(TTF-1)、细胞角蛋白7(CK7)、P63、细胞角蛋白5/6( CK5/6)免疫组织化学染色在非小细胞肺癌鉴别诊断中的价值。方法收集本院2012年11月至2014年1月经病理学证实的非小细胞肺癌患者143例,计算支气管镜活检组织免疫组织化学染色中TTF-1、CK7、P63、CK5/6对肺腺癌和肺鳞癌诊断敏感度和特异度,评估上述指标在非小细胞肺癌鉴别诊断中的应用价值。结果 TTF-1、CK7在肺腺癌中的表达高于在肺鳞癌中的表达( P <0.01),而P63、CK5/6在肺鳞癌的表达高于肺腺癌( P <0.01);TTF-1在肺腺癌诊断中的敏感度为85.1%(63/74),特异度为98.6%(68/69);CK7在肺腺癌诊断中的敏感度为82.4%(61/74),特异度为91.3%(63/69)。 P63在肺鳞癌诊断中的敏感度97.1%(67/69),特异度89.2%(66/74);CK5/6在肺鳞癌诊断中的敏感度79.7%(55/69),特异度89.2%(66/74)。肺腺癌患者中CK7(+)/TTF-1(+)的比例明显高于肺鳞癌患者( P <0.01);肺鳞癌患者中P63(+)/CK5/6(+)的阳性率明显高于肺腺癌患者( P <0.01)。结论支气管镜活检组织进行TTF-1、CK7、P63、CK5/6联合免疫组织化学染色有助于肺腺癌与肺鳞癌的鉴别。Objective To evaluate the clinical value of the immunochemistry staining of thyroid transcription factor-1 (TTF-1), cytokeratin7 (CK7), P63, and cytokeratin5/6 (CK5/6) in the bronchoscop-ic forceps biopsy specimen in the differential diagnosis of non-small cell lung cancers.Methods Totally 143 cases of non-small cell lung cancers from Department of Respiratory and Department of Oncology from Nov 2012 to Jan 2014 were diagnosed with pathological examinations of the bronchoscopic forceps biospy.The sen-sitivity and specificity of TTF-1, CK7, P63, and CK5/6 of forceps biopsy at the diagnosis of lung adenocarci-noma and squamous cell carcinoma were calculated.Results The expressions of TTF-1 and CK7 in the pul-monary adenocarcinomas were higher than the pulmonary squamous cell cancer ( P 〈0.01).The diagnosis sensitivity and specificity of TTF-1 in the pulmonary adenocarcinoma were 85.1%(63/74) and 98.6%(68/69), respectively.The diagnosis sensitivity and specificity of CK7 in the pulmonary adenocarcinoma were 82.4%(61/74) and 91.3%(63/69), respectively.The diagnosis sensitivity and specificity of P63 in the pulmonary squamous cell cancer were 97.1% ( 67/69 ) and 89.2% ( 66/74 ) , respectively.The diagnosis sensitivity and specificity of CK5/6 in the pulmonary squamous cell cancer were 79.7%(55/69) and 89.2%(66/74), respectively.The combined expression of CK7(+)/TTF-1(+) in the pulmonary adenocarcinoma was higher than the pulmonary squamous cell cancer ( P 〈0.01).The combined expression of P63(+)/CK5/6(+) in the pulmonary squamous cell cancer was higher than the pulmonary adenocarcinoma ( P 〈0.01).Conclusions The combination use of the immunochemistry staining of TTF-1, CK7, P63, and CK5/6 helps to differentiate lung adenocarcinoma and squamous cell cancer.
关 键 词:癌 非小细胞肺/代谢/诊断 转录因子/代谢 角蛋白质类/代谢 磷蛋白类/代谢 反式激活因子类/代谢
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