Application immunohistochemical markers such as TTF-1 in the diagnosis of non-small cell lung adenocarcinoma and lung squamous carcinoma in different ethnic groups

MU Xiaofei; GAO Wen

doi:10.3969/j.issn.1674-4136.2025.01.012

Abstract：Objective To investigate whether immunohistochemical markers TTF-1,Napsin-A,P63,p40 and Ki-67,which diagnose non-small cell lung cancer(NSCLC)and differentiate adenocarcinoma from squamous carcinoma,differ among Han,Uyghur and Kazakh ethnic patients.Methods The study collected electronic medical records of Han,Uyghur and Kazakh patients who diagnosed with treatment-naive of NSCLC at Yili Kazakh Autonomous Prefecture Friendship Hospital between January 2017 and December 2022.After obtaining lung tissue specimens from the patients'biopsies,hematoxylin-eosin(HE)staining as well as immunohistochemical staining was performed and the data were analysed by x2 and ROC evaluation of the working characteristic curves to investigate whether the immunohistochemical markers TTF-1,Napsin-A,P63,p40 and Ki-67 for lung adenocarcinoma and lung squamous carcinoma differed between Han,Uyghur and Kazakh ethnic patients and of the diagnostic value of each marker.Results In this study,a total of 263 patients with NSCLC were included,including 166 males and 97 females;63 Uyghur patients,45 Kazakh patients and 155 Han patients;the median age of all patients was 65 years(42-81 years),97 squamous carcinoma and 166 adenocarcinoma.There were no significant statistical differences in age,gender and pathological type among Uyghur patients,Kazakh patients and Han patients.Immunohistochemistry results showed gender-significant differences in the expression levels of TTF-1,Ki-67,Napsin-A,P63,and P40(P＜0.05);and ethnically-significant differences in the expression of Napsin-A,P63,and P40(P＜0.05).Four markers,TTF-1,Napsin-A,P63,and P40,showed statistically significant differences in the patients'tumor pathology types.However,TTF-1,Ki-67,Napsin-A,P63,and P40 were not statistically different in patients'age profiles.In terms of diagnostic value,the specificity of TTF-1 and Ki-67 in diagnosing lung adenocarcinoma was basically the same,but the diagnostic sensitivity of TTF-1 was higher.Napsin-A had the highest sensitivity in diagnosing lung adenocarcinoma,but its specificity was poorer.P40 had higher specificity in diagnosing lung squamous carcinoma in all cases,but its diagnostic sensitivity was poorer.The results of the ROC curve analysis showed that TTF-1 had the highest accuracy in diagnosing lung adenocarcinoma.The area under the curve(AUC)was 0.848,while the diagnostic accuracy of Napsin-A and Ki-67 were similar,with AUC of 0.785 and 0.778,respectively.P40 and P63 both had higher diagnostic accuracy for lung squamous carcinoma with AUC of 0.848 and 0.833,respectively.Conclusions Napsin-A,p63 and p40 are three markers with statistically significant differences in the ethnic profile of patients.TTF-1 had the highest accuracy in diagnosing lung adenocarcinoma;Napsin-A had the highest sensitivity.