TTF-1、CK7、p63、CK5/6免疫组化检测在低分化非小细胞肺癌分类中的应用  

Application of immunohistochemical detection of TTF-1,CK7,p63 and CK5/6 in the discrimination of poorly differentiated non-small cell lung cancer

作　　者：周文勤[1] 闫雪波[1] 王木子 赵红星 王炯[1] ZHOU Wen-qin;YAN Xue-bo;Wang Mu-zi;ZHAO Hong-xing;WANG Jiong(Department of Geriatric Respiratory and Critical Care,the First Affiliated Hospital of Anhui Medical University,Hefei,Anhui230022,China;Department of Geriatric Respiratory and Critical Care,Anhui Provincial Hospital,Hefei,Anhui230001,China;Department of General Practice,the Second Affiliated Hospital of Anhui Medical University,Hefei,Anhui230601,China)

机构地区：[1]安徽医科大学第一附属医院老年呼吸与危重症医学科,安徽合肥230022 [2]安徽省立医院呼吸与危重症医学科,安徽合肥230001 [3]安徽医科大学第二附属医院全科医学科,安徽合肥230601

出　　处：《临床肺科杂志》2022年第8期1176-1180,共5页Journal of Clinical Pulmonary Medicine

基　　金：安徽高校科学研究项目(No.KJ2021A0279)。

摘　　要：目的探讨TTF-1、CK7、P63、CK5/6免疫组化检测在低分化非小细胞肺癌的表达情况及亚分类中的应用。方法选取安徽医科大学第一附属医院、安徽医科大学第二附属医院、安徽省立医院共104例经病理组织学确诊的低分化非小细胞肺癌,其中低分化腺癌62例、低分化鳞癌42例,采用免疫组织SP法检测,镜下观察TTF-1、CK7、P63、CK5/6在不同细胞中的表达情况,比较不同临床病理特征非小细胞肺癌TTF-1、CK7、P63、CK5/6的表达差异及影响其阳性表达的因素。结果TTF-1、CK7阳性诊断低分化腺癌的灵敏度分别为87.88%、78.94%特异度分别为93.10%、95.83%;两者联合诊断低分化腺癌的灵敏度、特异度分别为90.91%、96.55%。CK5/6、P63阳性诊断低分化鳞癌的灵敏度分别为93.55%、83.33%,特异度分别为93.55%、96.15%;两者联合诊断低分化鳞癌的灵敏度、特异度分别为96.66%、90.91%。肿瘤的分期、大小、及有无淋巴结转移等特征对TTF-1、CK7、CK5/6、P63的阳性表达无明显影响。结论免疫组化分子标记物单独或联合检测在低分化非小细胞肺癌鉴别诊断中具有重要意义。Objective To investigate the expression of TTF-1,CK7,p63 and CK5/6 in the poorly differentiated non-small cell lung cancer and their application in the discrimination of sub-classification of non-small cell lung cancer.Methods 104 cases of poorly differentiated non-small cell lung cancer diagnosed by histopathology in the First Affiliated Hospital of Anhui Medical University,the Second Affiliated Hospital of Anhui Medical University and Anhui provincial hospital were selected,including 62 cases of poorly differentiated adenocarcinoma and 42 cases of poorly differentiated squamous cell carcinoma.They were detected by immunohistochemical SP method.The expressions of TTF-1,CK7,p63 and CK5/6 in different cells were observed under microscope,and the differences of TTF-1,CK7,p63 and CK5/6 in non-small cell lung cancer with different clinicopathological features were compared,and the factors affecting their positive expression were analyzed.Results The sensitivity of TTF-1 and CK7 in the diagnosis of poorly differentiated adenocarcinoma was 87.88%and 78.94%respectively,and the specificity was 93.10%and 95.83%.The sensitivity and specificity of the combined diagnosis of poorly differentiated adenocarcinoma was 90.91%and 96.55%,respectively.The sensitivity of CK5/6 and p63 in the diagnosis of poorly differentiated squamous cell carcinoma was 93.55%and 83.33%,and the specificity was 93.55%and 96.15%respectively.The sensitivity and specificity of combined CK5/6 and p63 in the diagnosis of poorly differentiated squamous cell carcinoma was 96.66%and 90.91%respectively.The characteristics of tumor stages,size,lymph nodes and metastasis had no significant effect on the positive expression of TTF-1,CK7,p63 and CK5/6.Conclusion The detection of immunohistochemical molecular markers alone or in combination has great significance in the differential diagnosis of poorly differentiated non-small cell lung cancer.

关 键 词：低分化非小细胞肺癌 TTF-1 CK5/6 

分 类 号：R734.2[医药卫生—肿瘤]