TTF-1等免疫组化标志物在不同民族非小细胞肺腺癌及肺鳞癌诊断中的应用  

Application immunohistochemical markers such as TTF-1 in the diagnosis of non-small cell lung adenocarcinoma and lung squamous carcinoma in different ethnic groups

作　　者：穆小飞 高雯[1] MU Xiaofei;GAO Wen(First Clinical Research Institute,Nanjing Medical University,Nanjing 210000,China;Department of Oncology,The First Affiliated Hospital of Nanjing Medical University/Jiangsu Provincial People's Hospital,Nanjing 210029,China;Oncology Department 2,Yili Kazakh Autonomous Prefecture Friendship Hospital,Yining 835000,China)

机构地区：[1]南京医科大学第一临床研究院,江苏南京210000 [2]南京医科大学第一附属医院/江苏省人民医院肿瘤内科,江苏南京210029 [3]伊犁哈萨克自治州友谊医院肿瘤二科,新疆伊宁835000

出　　处：《中国肿瘤外科杂志》2025年第1期69-74,共6页Chinese Journal of Surgical Oncology

基　　金：新疆伊犁州级临床研究院研究基金项目(82141121,BK20211380,Y12022PY13)。

摘　　要：目的探究诊断非小细胞肺癌(NSCLC)及区分腺癌与鳞癌的免疫组化标志物TTF-1、Napsin-A、P63、P40和Ki-67在汉、维吾尔及哈萨克族患者之间是否存在差异。方法研究收集了2017年1月至2022年12月期间于伊犁州友谊医院就诊并确诊为初治NSCLC的汉、维吾尔及哈萨克族患者的电子病历信息。对获取的活检肺组织标本进行苏木精伊红染色以及免疫组化染色后,结果经χ^(2)分析和受试者特征曲线ROC分析以探究肺腺癌及肺鳞癌的免疫组化标志物TTF-1、Napsin-A、P63、P40以及Ki-67是否在汉、维吾尔、哈萨克族患者之间存在差异,以及各个标记物的诊断价值。结果研究纳入NSCLC患者共263例,男性166例,女性97例,维吾尔族63例,哈萨克族45例,汉族155例,年龄中位数是65岁(42~81岁),鳞癌97例,腺癌166例。各族患者的年龄、性别、病理类型差异无统计学意义。免疫组化结果显示TTF-1、Ki-67、Napsin-A、P63和P40的表达水平在性别上差异有统计学意义(P<0.05);Napsin-A、P63以及P40的表达在民族上差异有统计学意义(P<0.05)。TTF-1、Napsin-A、P63以及P404种标记物在患者的肿瘤病理类型资料中差异具有统计学意义。然而,TTF-1、Ki-67、Napsin-A、P63、P40在患者的年龄资料中差异无统计学意义。在诊断价值方面,TTF-l和Ki-67诊断肺腺癌的特异性基本一致,但TTF-l的诊断敏感性较高。Napsin-A诊断肺腺癌的敏感性最高,但特异性较差。P40诊断肺鳞癌的特异性均较高,但其诊断敏感性也较差。ROC曲线分析结果表明,TTF-1诊断肺腺癌的准确性最高,曲线下面积(AUC)为0.848,而Napsin-A和Ki-67的诊断准确性相近,AUC分别为0.785和0.778。P40和p63诊断肺鳞癌准确性均较高,AUC分别为0.848和0.833。结论Napsin-A、P63以及P40这3种标记物在所研究的种族之间差异具有统计学意义;TTF-1诊断肺腺癌的准确性最高;Napsin-A诊断肺腺癌的敏感性最高。Objective To investigate whether immunohistochemical markers TTF-1,Napsin-A,P63,p40 and Ki-67,which diagnose non-small cell lung cancer(NSCLC)and differentiate adenocarcinoma from squamous carcinoma,differ among Han,Uyghur and Kazakh ethnic patients.Methods The study collected electronic medical records of Han,Uyghur and Kazakh patients who diagnosed with treatment-naive of NSCLC at Yili Kazakh Autonomous Prefecture Friendship Hospital between January 2017 and December 2022.After obtaining lung tissue specimens from the patients'biopsies,hematoxylin-eo sin(HE)staining as well as immunohistochemical staining was performed and the data were analysed byχ^(2) and ROC evaluation of the working characteristic curves to investigate whether the immunohistochemical markers TTF-1,Napsin-A,P63,p40 and Ki-67 for lung adenocarcinoma and lung squamous carcinoma differed between Han,Uyghur and Kazakh ethnic patients and of the diagnostic value of each marker.Results In this study,a total of 263 patients with NSCLC were included,including 166 males and 97 females;63 Uyghur patients,45 Kazakh patients and 155 Han patients;the median age of all patients was 65 years(42-81 years),97 squamous carcinoma and 166 adenocarcinoma.There were no significant statistical differences in age,gender and pathological type among Uyghur patients,Kazakh patients and Han patients.Immunohistochemistry results showed gender-significant differences in the expression levels of TTF-1,Ki-67,Napsin-A,P63,and P40(P<0.05);and ethnically-significant differences in the expression of Napsin-A,P63,and P40(P<0.05).Four markers,TTF-1,Napsin-A,P63,and P40,showed statistically significant differences in the patients'tumor pathology types.However,TTF-1,Ki-67,Napsin-A,P63,and P40 were not statistically different in patients'age profiles.In terms of diagnostic value,the specificity of TTF-l and Ki-67 in diagnosing lung adenocarcinoma was basically the same,but the diagnostic sensitivity of TTF-l was higher.Napsin-A had the highest sensitivity in diagnosing lung adenoc

关 键 词：非小细胞肺癌 生物标志物 免疫组化 种族 准确性 

分 类 号：R734.2[医药卫生—肿瘤]