肺腺癌组织中TTF-1、Napsin A的表达与EGFR、ALK基因突变的关系  

Correlation between thyroid transcription factor,novel aspartic proteinase A expression and epidermal growth factor receptor,anaplastic lymphoma kinase gene mutation in lung adenocarcinoma

作　　者：屠蒙 张国俊[1] 李靖[1] Tu Meng;Zhang Guojun;Li Jing(Department of Respiratory Medicine,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China)

机构地区：[1]郑州大学第一附属医院呼吸内科,450000

出　　处：《中国实用医刊》2019年第23期1-5,共5页Chinese Journal of Practical Medicine

基　　金：河南省医学科技攻关计划省部共建项目(SBGJ2018032)。

摘　　要：目的分析肺腺癌组织中甲状腺转录因子-1(TTF-1)、天门冬氨酸蛋白酶A(Napsin A)的表达与表皮生长因子受体(EGFR)、间变性淋巴瘤激酶(ALK)基因突变的关系。方法收集郑州大学第一附属医院2018年1月至2018年12月收治的肺腺癌患者227例,采用免疫组织化学法检测TTF-1、Napsin A的表达水平,应用实时荧光聚合酶链式反应或DNA测序法检测EGFR基因突变;应用荧光原位杂交法、增强免疫组化法检测ALK基因突变。结果TTF-1、Napsin A的阳性表达率分别为85.0%(193/227)、76.4%(126/165)。TTF-1、Napsin A阴性患者中ALK基因突变率均为0。TTF-1预测EGFR突变的灵敏度、特异度、阳性预测值、阴性预测值分别为97.8%(132/135)、33.7%(31/92)、68.4%(132/193)、91.2%(31/34)。TTF-1阳性患者EGFR突变率高于阴性患者(68.4%比8.8%,P<0.001),TTF-1的表达与ALK基因突变情况无关(P=0.388)。Napsin A预测EGFR突变的灵敏度、特异度、阳性预测值、阴性预测值分别为94.4%(85/90)、45.3%(34/75)、67.5%(85/126)、87.2%(34/39)。Napsin A阳性患者EGFR突变率高于阴性患者(67.5%比12.8%,P<0.001),Napsin A的表达与ALK基因突变情况无关(P=0.199)。TTF-1、Napsin A并联预测EGFR突变的灵敏度、特异度分别为97.8%(88/90)、33.3%(25/75)。TTF-1、Napsin A串联预测EGFR突变的灵敏度、特异度分别为68.5%(85/124)、87.8%(36/41)。TTF-1、Napsin A并联及串联预测ALK突变的灵敏度均为100.0%(9/9),特异度分别为17.0%(25/147)、25.2%(37/147)。结论TTF-1、Napsin A阳性的肺腺癌患者中EGFR基因突变率较高,TTF-1、Napsin A的表达与ALK基因突变无关。Objective To investigate correlation between thyroid transcription factor-1(TTF-1),novel aspartic proteinase A(Napsin A)expression and epidermal growth factor receptor(EGFR),anaplastic lymphoma kinase(ALK)gene mutation in lung adenocarcinoma.Methods A total of 227 patients with adenocarcinoma were collected in the First Affiliated Hospital of Zhengzhou University from January 2018 to December 2018.Immunohistochemistry was used to detect the expression of TTF-1 and Napsin A.The mutation of EGFR gene was detected by real-time fluorescent polymerase chain reaction or deoxyribonucleic acid sequencing.The mutations of ALK gene were detected by fluorescence in situ hybridization and enhanced immunohistochemistry.Results The positive rates of TTF-1 and Napsin A were 85.0%(193/227)and 76.4%(126/165),respectively.The mutation rate of ALK gene in TTF-1 and Napsin A negative patients was 0.The sensitivity,specificity of TTF-1 for predicting EGFR mutation were 97.8%(132/135),33.7%(31/92),68.4%(132/193)and 91.2%(31/34),respectively.The mutation rate of EGFR in TTF-1 positive patients was higher than that in negative patients(68.4%vs.8.8%,P<0.001).The expression of TTF-1 was not statistically correlated with ALK gene mutation(P=0.388).The sensitivity,specificity,positive predictive value and negative predictive value of Napsin A for predicting EGFR mutation were 94.4%(85/90),45.3%(34/75),67.5%(85/126)and 87.2%(34/39),respectively.The mutation rate of EGFR in Napsin A positive patients was higher than that in negative patients(67.5%vs.12.8%,P<0.001).The expression of Napsin A was not statistically correlated with ALK gene mutation(P=0.199).The sensitivity,specificity of parallel test of TTF-1 and Napsin A for predicting EGFR mutation were 97.8%(88/90),33.3%(25/75),respectively.The sensitivity,specificity of serial test of TTF-1 and Napsin A for predicting EGFR mutation were 68.5%(85/124),87.8%(36/41),respectively.In both parallel test and serial test,the sensitivities of TTF-1 and Napsin A for predicting ALK gene mutation both

关 键 词：肺腺癌 表皮生长因子受体 间变性淋巴瘤激酶 甲状腺转录因子-1 天门冬氨酸蛋白酶A 

分 类 号：R734.2[医药卫生—肿瘤]