The Expression And Significance Of Napsin A、Ki-67and P53Protein In Metastatic Lymph Node Of Human Lung Adenocarcinoma

Objective: To investigate the value of Napsin A expression in metastatic lymphnode adenocarcinoma in the differential diagnosis of primary pulmonary carcinomaand extra-pulmonary adenocarcinoma (except renal cell carcinoma) and itsprognostic implication.Methods: The expressions of Napsin A in50specimens of the lymph node metastases ofprimary pulmonary adenocarcinoma and50specimens of extra-pulmonaryadenocarcinoma (except renal cell carcinoma),20specimens of cervical lymph node TBlesions and20specimens of superficial acute and chronic lymphatic inflammatory lesions,and the Ki-67and P53protein expression of pulmonary lymph node metastaticadenocarcinoma were evaluated by immunohistochemistry PV-9000two-step methods．Results:(1) The positive expression rate of Napsin A in pulmonary lymph nodemetastatic adenocarcinoma was82.0%(41/50). However,50specimens of the lymphnode metastases of extra-pulmonary adenocarcinoma (except renal cell carcinoma),20specimens of cervical lymph node TB lesions and20specimens of superficial acuteand chronic lymphatic inflammatory lesions were all negative expression.(2) NapsinA expression of the pulmonary lymph node metastatic adenocarcinoma was notassociated with patient’s age, the amount of smoking, gross specimen type, surgicalspecimen type, TNM stage，PS score and Lymph node sites (P>0.05). However, thedifferences from gender and degree of differentiation was significantly different (P=0.009和0.004), expression of the female patients （19/19,100%）was higher thanthat in male patients（9/22,70.1%）, and the positive expression rate of Napsin A inwel1and moderately differentiated lung adenocarcinoma（31/33,93.9%）was higherthan that in poorly differentiated lung adenocarcinom（a10/17，58.8%）.(3) Expressionof Napsin A and Ki-67protein in pulmonary lymph node metastatic adenocarcinomawas significant negative correlation (R=-0.383,P=0.000), the same situation wasfound between Napsin A and P53protein expression(R=-0.235,P=0.036).Conclusions:(1) Napsin A expression of lymph node metastatic adenocarcinoma hadhigh sensitivity and specificity in the differential diagnosis of primary pulmonaryadenocarcinoma and extra-pulmonary adenocarcinoma (except renal cell carcinoma),and it had important clinical application value to look for the primary lesions of lymph nodemetastatic adenocarcinoma (sensitivity82%, specificity100%, authenticity is91%,positive predictive value100%, negative predictive value79.6%).(2) Napsin A expressionof the lymph node metastasis adenocarcinoma and adenocarcinoma cell proliferativeactivity was significant negative correlation, and may be used as a good prognosticindicator of pulmonary adenocarcinoma.