Napsin A對分辨肺腺癌與轉移性腺癌的限制與利用研究

The utility and limitation of Napsin A study in distinguishing primary lung adenocarcinoma and metastatic lung adenocarcinoma

對臨床醫師而言，要確定肺部癌症的原發器官並不容易，特別是如果癌症組織型態爲腺癌時更是困難。故本文嘗試評估napsin A是否能成爲一個偵測肺腺癌的標記。我們收集了30個原發性肺鱗狀上皮癌與85個原發性肺腺癌及數個大腸腺癌，胃腺癌，膽管癌，卵巢癌與子宮頸腺癌作免疫染色病以鱗狀上皮癌與一部份肺腺癌作RT-PCR研究，結果顯示napsin A在肺腺癌的表現率甚高，故顯示napsin A値得作爲分辨轉移性腺癌與肺腺癌的一個輔助工具。

In the aspect of clinical approach, it is difficult to demonstrate the primary origin of cancer residing in lung tissue, especially for adenocarcinoma. This study was aimed to evaluate the potentiality of napsin A as a new specific marker for primary lung adenocarcinoma. We collected 115 cases originated from lung (squamous cell carcinoma: 30 cases; adenocarcinoma: 85 cases) to perform immunohistochemical study and reverse transcriptase PCR (RT-PCR) method. In addition, adenocarcinoma originated from colon, stomach, breast, ovary and uterine cervix were selected randomly for immunohistochemical study of napsin A. Significant expression of napsin A was detected by RT-PCR and in seventy-two out of eighty-five adenocarcinoma of lung by immunohistochemical stain. In contrast, negative expression was observed in squamous cell carcinoma. In other organ system, negative or low expression of napsin A is seen. Based on these results, it was concluded that napsin A was a useful marker in distinguishing primary lung adenocarcinoma from metastatic lung adenocarcinoma.