Clinical Research Of Five Antibodies Including Napsin A And TTF-1 In Identifying The Original Site Of Adenocarcinoma Cell In Effusion Fluid

Object: With the immunocytochemistry staining applied, we selected five antibodies, including: thyroid transcription factor 1(TTF-1), noval aspartic proteinase of the pepsin family A(Napsin A), caudal type homeobox 2(CDX-2), gross cystic disease fluid protein 15(GCDFP-15) and cancer antigen 125(CA125), and observed their expressions and positive rates in different adenocarcinoma cells, which was to find those who have high sensitivity and specificity to a specific adenocarcinoma cell, in order to identify the original site of adenocarcinoma cell in serous cavity effusion and provide evidence for accurate treatment.Methods: We collected 88 specimens that went through cytopathology examination and were diagnosed as adenocarcinoma cell, which according with the pathological diagnostic result, from March 2013 to October 2015 in the first hospital of Jilin university. O f the 88 cancerous specimens, 42 came from pleural effusion, 45 from ascites, 1 from pericardial effusion. After centrifuged serous cavity effusion, we collected the sediment and buried it with paraffin in cell block. With the immunocytochemistry staining of Max Vision method, we observed and compared the sensitivity and specificity of antibodies TTF-1,Napsin A,CDX-2,GCDFP-15 and CA125 in adenocarcinoma cells of different original sites after the color reaction by DAB.Results:(1) The most common original sites of the adenocarcinoma cells in pleural effusion were lung(81.8%) for male, lung(60%) and breast(25%) for female. The most common original sites of the adenocarcinoma cells in ascites were gastrointestinal tract(60%) for male, ovary(63.3%) for female.(2) The sensitivity of Napsin A and TTF-1 diagnosed adenocarcinoma cell from lung were 86.7%,66.7% and specificity were 100%,98.3%,separately. The sensitivity and specificity of GCDFP-15 diagnosed adenocarcinoma cell from breast were 85.7% and 100%. The sensitivity and specificity of CA125 diagnosed adenocarcinoma cell from ovary were 89.5% and 89.9%. The sensitivity and specificity of CDX-2 diagnosed adenocarcinoma cell from colon were 83.3%,90.2%.(3) In the 30 cases of lung adenocarcinoma cells, Napsin A expressed in 26 cases and the sensitivity was 86.7% while TTF-1 expressed in 20 cases and the sensitivity was 66.7%. Napsin A and TTF-1 both expressed in 20 cases, with 6 cases that Napsin A were positive while TTF-1 negative. No case that TTF-1 was positive while Napsin Anegative occurred.Conclusion:(1) The sensitivity and specificity of Napsin A diagnosed adenocarcinoma cell from lung was higher than TTF-1 and the combination of them didn’t elevate the positive rates.(2) The combined detection of fiveantibodieswas useful in identifying the original sites of adenocarcinoma cell. Someantibodies had a high expression rate in specific adenocarcinoma and could be used to diagnose original site of adenocarcinoma cell, like TTF-1 and Napsin A for lung, GCDFP-15 for breast, CDX-2 for adenocarcinoma from digestive systemand CA125 for ovary.(3) TTF-1 and Napsin A should be the first panel option to identify the original site of adenocarcinoma cell in pleural effusion for male, while TTF-1, Napsin A and GCDFP-15 for female. CDX-2 should be the first panel option to identify the original site of the adenocarcinoma cell in ascites for male, while C A125、CDX-2 and GCDFP-15 for female.