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The expression of TTF-1 and Napsin A in early-stage lung adenocarcinoma correlates with the results of surgical treatment

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Tumor Biology

Abstract

Non-small cell lung cancer (NSCLC) accounts for 80 % of lung cancers, and lung adenocarcinoma (ADC) is one of the main types of NSCLC. Although there are several studies on the relationship between lung ADC immunohistochemical diagnostic markers (thyroid transcription factor 1 (TTF-1) and Napsin A) and survival, some aspects of those studies could be improved. We examined the significance of the commonly used lung ADC diagnostic markers, including TTF-1, Napsin A, and CK7, in the prognosis of early-stage lung ADC. One hundred and nineteen cases of early-stage lung ADC (N0) were selected from the prospective database of lung cancer (Jan 2000 to Dec 2009). The expression levels of TTF-1, Napsin A, and CK7 in inventoried specimens were analyzed using tissue microarray (TMA) and immunohistochemical (IHC) analysis, and the effect of the expression level of each marker on patients’ survival was examined. The diagnostic sensitivity and specificity of each marker for lung ADC were as follows: TTF-1, 87.0 and 90.1 %; Napsin A, 72.2 and 90.4 %; and CK7, 94.6 and 76.0 %, respectively. Patients with high expression levels of TTF-1 and Napsin A, and high co-expression levels of TTF-1/Napsin A had better survival rates than those with low levels of expression (P < 0.05). The expression levels of CK7 were not related to patients’ survival. Multivariate analysis showed that the expression levels of Napsin A and TTF-1/Napsin A are independent prognostic factors for survival. The IHC detection of TTF-1 and Napsin A in specimens should be routinely performed in postoperative early-stage lung ADC patients. Its significance lies not only in the differential diagnosis, but also in determining the prognosis.

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Grant support

This work was supported by the Beijing Academic Leaders Program (Grant 2009-2-17), Beijing Natural Science Foundation (Grant 7102029), Capital Medical Developed Research Found (Grant 2007–1023), New Scholar Star Program of the Ministry of Education, and National Basic Research Program of China (973 programs) (Grant 2011CB504300), Specialized Research Fund for the Doctoral Program of Higher Education (Grant 20130001110108), National Natural Science Foundation (Grant 81301748), and the Education Ministry Innovative Research Team in University (IRT13003).

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Authors and Affiliations

  1. Key laboratory of Carcinogenesis and Translational Research (Ministry of Education), The First Department of Thoracic Surgery, Peking University Cancer Hospital & Institute, 52 Fucheng Rd. Haidian District, Beijing, China, 100142

    Yunfan Ma, Mengying Fan, Liang Dai, Xiaozheng Kang, Wanpu Yan, Zhen Liang, Hongchao Xiong & Keneng Chen

  2. Key laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Pathology, Peking University Cancer Hospital & Institute, Beijing, 100142, China

    Yiqiang Liu & Yu Sun

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  1. Yunfan Ma
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  2. Mengying Fan
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Correspondence to Keneng Chen.

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Yunfan Ma and Mengying Fan contibute equally to this work.

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Ma, Y., Fan, M., Dai, L. et al. The expression of TTF-1 and Napsin A in early-stage lung adenocarcinoma correlates with the results of surgical treatment. Tumor Biol. 36, 8085–8092 (2015). https://doi.org/10.1007/s13277-015-3478-z

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  • DOI: https://doi.org/10.1007/s13277-015-3478-z

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