肺鳞状细胞癌组织中p63、CK5/6和p40的表达及其病理诊断价值  

Expressions and pathological diagnostic value of p63,CK5/6 and p40 in lung squamous carcinoma tissues

作　　者：杜倩 赵焕芬[1] 康林[1] 李冰洁 陈琛[1] 马晓丽[1] 张秀智[1] Du Qian;Zhao Huanfen;Kang Lin;Li Bingjie;Chen Chen;Ma Xiaoli;Zhang Xiuzhi(Pathology Department,Hebei General Hospital,Hebei Shijiazhuang 050051,China)

机构地区：[1]河北省人民医院病理科,河北石家庄050051

出　　处：《现代肿瘤医学》2019年第11期1907-1910,共4页Journal of Modern Oncology

基　　金：河北省医学适用技术跟踪项目(编号:G2015003)

摘　　要：目的:探讨p63蛋白、细胞角蛋白5/6(cytokeratin5/6,CK5/6)和p40(ΔNp63)蛋白在人非小细胞肺癌(non-small cell lung cancer,NSCLC)组织中的表达及其表达对于肺鳞状细胞癌和肺腺癌的诊断和鉴别诊断价值。方法:采用免疫组化(SP法)检测p63、CK5/6和p40在100例病理确诊的NSCLC组织中的表达情况,并结合NSCLC的临床病理特征进行分析。结果:p63、CK5/6和p40在肺鳞状细胞癌组织中的阳性表达率分别为98.28%、100.00%和98.28%。p63、CK5/6和p40在肺腺癌组织中的阳性表达率分别为45.24%、30.95%和21.43%。肺鳞状细胞癌组织中p63、CK5/6和p40的阳性表达率明显高于肺腺癌组织(P<0.01)。p63、CK5/6和p40诊断肺鳞癌的灵敏度分别为98.28%、100.00%和98.28%,特异度分别为54.76%、69.05%和78.57%。p63、CK5/6和p40在肺鳞状细胞癌中的诊断准确率分别为80%、87%和90%。三者联合检测时三项均阳性诊断肺鳞癌的特异度达90.48%,诊断准确率为95%;三项中至少一项阳性诊断肺鳞癌的灵敏度达100.00%,诊断准确率为75%。结论:p63、CK5/6和p40主要表达在肺鳞状细胞癌组织中。单个指标中p40对诊断肺鳞状细胞癌具有较高的灵敏度和特异度。p63、CK5/6和p40联合检测对肺鳞状细胞癌与肺腺癌的鉴别诊断有重要价值。Objective:To investigate the expressions of p63,CK5/6 and p40 in non-small cell lung cancer(NSCLC) and to explore their value in the differential diagnosis of lung SCC and AC.Methods:Using the technology of immunohistochemical SP method,the expressions of p63,CK5/6 and p40 were detected in 100 cases specimens of lung carcinoma and the clinical pathological features of NSCLC were analyzed statistically.Results:The positive expression rates of p63,CK5/6 and p40 in SCC were 98.28%,100.00% and 98.28%.The positive expression rates of p63,CK5/6 and p40 in AC were 45.24%,30.95% and 21.43%.The positive expression rates of p63,CK5/6 and p40 in SCC were significantly higher than those in AC(P<0.01). The sensitivity of p63,CK5/6 and p40 for lung squamous cell carcinoma was 98.28%, 100.00% and 98.28%,and the specificity of p63,CK5/6 and p40 for lung squamous cell carcinoma was 54.76%,69.05%and 78.57%.The diagnostic accuracy of p63,CK5/6 and p40 in SCC was 80%,87%and 90%.The specificity of all three indicators positive tests for lung SCC was 90.48% and the diagnostic accuracy was 95%.The sensitivity of at least one of the three indicators positive for lung SCC was 100.00% and the diagnostic accuracy was 75%.Conclusion:p63,CK5/6 and p40 were mainly expressed in lung SCC.For the single immunohistochemical indicator,p40 had high sensitivity and specificity in the differential diagnosis of lung SCC.The combined detection of p63,CK5/6 and p40 had a great value to the differential diagnosis of lung SCC and AC.

关 键 词：非小细胞肺癌 肺鳞状细胞癌 P63 CK5/6 P40 

分 类 号：R734.2[医药卫生—肿瘤]