Abstract

Background: An antibody panel is needed to definitively differentiate between adenocarcinoma (AC) and squamous cell carcinoma (SCC) in order to meet more stringent requirements for the histologic classification of lung cancers. Staining of desmosomal plaque-related proteins may be useful in the diagnosis of lung SCC.

Materials and methods: We compared the usefulness of six conventional (CK5/6, p40, p63, CK7, TTF1, and Napsin A) and three novel (PKP1, KRT15, and DSG3) markers to distinguish between lung SCC and AC in 85 small biopsy specimens (41 ACs and 44 SCCs). Correlations were examined between expression of the markers and patients’ histologic and clinical data.

Results: The specificity for SCC of membrane staining for PKP1, KRT15, and DSG3 was 97.4%, 94.6%, and 100%, respectively, and it was 100% when the markers were used together and in combination with the conventional markers (AUCs of 0.7619 for Panel 1 SCC, 0.7375 for Panel 2 SCC, 0.8552 for Panel 1 AC, and 0.8088 for Panel 2 AC). In a stepwise multivariate logistic regression model, the combination of CK5/6, p63, and PKP1 in membrane was the optimal panel to differentiate between SCC and AC, with a percentage correct classification of 96.2% overall (94.6% of ACs and 97.6% of SCCs). PKP1 and DSG3 are related to the prognosis.

Conclusions: PKP1, KRT15, and DSG3 are highly specific for SCC, but they were more useful to differentiate between SCC and AC when used together and in combination with conventional markers. PKP1 and DSG3 expressions may have prognostic value.

摘要

背景：为了满足对肺癌组织学分类更严格的要求，需要一个抗体组来明确区分腺癌 (AC) 和鳞状细胞癌 (SCC)。桥粒斑块相关蛋白的染色可能有助于肺 SCC 的诊断。

材料和方法：我们比较了六种常规（CK5/6、p40、p63、CK7、TTF1 和 Napsin A）和三种新型（PKP1、KRT15 和 DSG3）标志物在区分肺 SCC 和 AC 在 85 个小活检标本（41 个 AC 和 44 个 SCC）。检查了标志物的表达与患者的组织学和临床数据之间的相关性。

结果： PKP1、KRT15、DSG3膜染色对SCC的特异性分别为97.4%、94.6%和100%，同时与常规标志物联合使用时的特异性为100%（AUCs为面板 1 SCC 为 0.7619，面板 2 SCC 为 0.7375，面板 1 AC 为 0.8552，面板 2 AC 为 0.8088。在逐步多变量逻辑回归模型中，膜中 CK5/6、p63 和 PKP1 的组合是区分 SCC 和 AC 的最佳组合，总体正确分类百分比为 96.2%（94.6% 的 AC 和 97.6% SCC）。PKP1和DSG3与预后有关。

结论： PKP1、KRT15 和 DSG3 对 SCC 具有高度特异性，但当它们一起使用或与常规标志物结合使用时，它们更有助于区分 SCC 和 AC。PKP1 和 DSG3 表达可能具有预后价值。