检测三种转录调节因子的表达在鉴别非小细胞肺癌病理类型中的作用

摘要

目的：探讨肌肉细胞特异性泛素蛋白连接酶29(TRIM29)、p40蛋白和甲状腺转录因子-1（TTF-1）联合应用在肺鳞癌和肺腺癌鉴别诊断中的价值。方法：应用组织芯片及免疫组化EliVision法，检测35例肺鳞癌、33例肺腺癌中TRIM29、p40和TTF-1的表达以及灵敏度和特异度。结果：TRIM29、p40、TTF-1单一抗体标记，在肺鳞癌中的阳性率分别为96.97%、93.94%、6.06%，在肺腺癌中的阳性率分别为22.85%、8.57%、88.57%；联合TRIM29和p40共同标记检测在肺鳞癌中的阳性率为93.94%，在肺腺癌中共同表达的阳性率为5.71%(P＜0.001)；单一抗体检测时TRIM29和p40在肺鳞癌中的灵敏度分别是96.97%和93.94%，特异度分别是77.14%和91.43%；TTF-1在肺腺癌中的灵敏度是88.57%，特异度是93.94%；两者同时阳性的灵敏度是93.94%，特异性是94.28%。结论：TRIM29和p40两种抗体联合TTF-1检测标记肺鳞癌和肺腺癌，在鉴别诊断中具有更高的准确性。%objective To investigate the value of combined application of TRIM29, p40 and TTF-1 in the differential diagnosis between lung squamous cell carcinoma and lung adenocarcinoma. Methods The expres⁃sions of TRIM29, p40 and TTF-1 protein were detected in 35 cases of lung squamous cell carcinoma and 33 cas⁃es of lung adenocarcinoma using tissue microarray and immunohistochemical method. The sensitivity and speci⁃ficity were calculated in diagnosis. The statistical analysis was performed using SPSS 17.0 software (SPSS, Inc., Chicago, IL, USA). χ2 test was applied to compare the numerical data among groups. P<0.05 was considered to indicate a statistically significant result. Results The positive rates of TRIM29, p40 and TTF-1 protein ex⁃pression in lung squamous cell carcinoma were 96.97%, 93.94% and 6.06%, respectively. And the positive rates of TRIM29, p40 and TTF-1 protein expression in lung adenocarcinoma were 22.85%, 8.57% and 88.57%, re⁃spectively. When combined application of TRIM29 and p40 in lung cancer, the rates were 93.94% in squamous cell carcinoma and 5.71% in adenocarcinoma. Therefore the curative effect of combined application of TRIM29 and p40 in lung cancer was better than application of anyone alone(P<0.001). Applicating TRIM29 or p40 in lung squamous cell carcinoma, the sensitivity was 96.97% and 93.94%, and specificity was 77.14% and 91.43%. Applicating TTF-1 in lung adenocarcinoma, sensitivity was 93.94%, and specificity was94.28%. Conclusion Using TRIM29 or p40 combined with TTF-1 in differential diagnosis between lung squamous cell carcinoma and lung adenocarcinoma was useful in lung cancer diagnosis and clinic treatment guidance.