TTF－1、CK7、P63、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  

The value of immunochemistry staining of TTF1, CK7, P63 and CK5/6 in the differential diagnosis of non-small cell lung cancer

作　　者：方强[1] 刘宁[1] 

机构地区：[1]沈阳市胸科医院呼吸内科,沈阳110044

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 

分 类 号：R734.2[医药卫生—肿瘤]