INSM1在肺神经内分泌肿瘤活检标本和细胞学样本中的表达
| 作者: |
1张伟,
2李霞,
3孙岳军,
1曹鹏
1 泰兴市人民医院病理科，江苏 泰兴 225400 2 无锡市人民医院病理科，江苏 无锡 214000 3 江阴市人民医院病理科，江苏 江阴 214400 |
| 通讯: |
曹鹏
Email: 25550818@qq.com |
| DOI: | 10.3978/j.issn.2095-6959.2021.01.004 |
摘要
目的：分析胰岛素瘤相关蛋白-1 (insulinoma-associated protein 1，INSM1)在肺神经内分泌肿瘤组织学和细胞学样本中的表达。方法：采用免疫组织化学EnVision两步法检测INSM1在193份活体组织检查(以下简称活检)标本及80份细胞学标本中的表达，其中包括：肺小细胞癌(42份)、肺大细胞神经内分泌癌(6份)、低级别肺神经内分泌肿瘤(19份)、肺腺癌(69份)、肺鳞癌(57份)活检标本及肺小细胞癌(9份)、肺腺癌(48份)和间皮细胞增生(23份)细胞学样本。结果：1) INSM1在肺小细胞癌，肺大细胞神经内分泌癌和低级别肺神经内分泌肿瘤中的阳性率分别为90.5% (38/42)，66.7% (4/6)，94.7% (18/19)，显著高于肺腺癌(2.9%，2/69)、肺鳞癌(1.8%，1/57)中的阳性率(均P<0.01)。2) INSM1在肺小细胞癌细胞学样本中全部呈阳性表达，显著高于肺腺癌(2.1%，1/48)和反应性间皮细胞增生(0，0/23)中的阳性率(均P<0.01)。3) INSM1免疫组织化学染色在32份活检和细胞学配对的标本中检测结果具有高度一致性(κ=1)。4) INSM1在肺神经内分泌肿瘤中的敏感性为90.1% (64/71)，显著高于突触小泡蛋白(synaptophysin，Syn)和嗜铬粒蛋白A (chromogranin A，CgA) (均P<0.001)。5) INSM1在肺神经内分泌肿瘤中的特异性为97.6%，显著高于Syn (P<0.05)，但是与CgA相比差异无统计学意义(均P>0.05)。结论：INSM1在肺神经内分泌肿瘤中高表达，是鉴别诊断肺神经内分泌肿瘤比较可靠的标志物。
关键词：
胰岛素瘤相关蛋白-1；神经内分泌肿瘤；活体组织检查；细胞学标本；肺
Expression of INSM1 in biopsy and cytology specimens for pulmonary neuroendocrine tumors
CorrespondingAuthor: CAO Peng Email: 25550818@qq.com
DOI: 10.3978/j.issn.2095-6959.2021.01.004
Abstract
Objective: To explore the expression of insulinoma-associated protein 1 (INSM1) in tissue and cytology specimens for pulmonary neuroendocrine tumors. Methods: The EnVision two-step immunohistochemical staining method was used to detect the expression of INSM1 in 193 biopsy specimens and 80 cytology specimens. Biopsy specimens include 42 small cell lung carcinomas (SCLCs), 6 large-cell neuroendocrine carcinomas (LCNECs), 19 low-grade neuroendocrine neoplasms, 69 adenocarcinomas, 57 squamous cell carcinomas; cytology specimens include 9 small cell carcinomas, 48 adenocarcinomas and 23 reactive mesothelial cells proliferation. Results: 1) The positive rate of INSM1 for SCLCs, LCNECs and low-grade neuroendocrine neoplasms were 90.5% (38/42), 66.7% (4/6) and 94.7% (18/19) respectively, which is significantly higher than that for adenocarcinomas (2.9%, 2/69) and squamous cell carcinomas (1.8%, 1/57, P<0.05); 2) INSM1 was expressed in all the small cell carcinoma cytology specimens, which is significantly higher than the positive rate for adenocarcinomas (2.1%, 1/48) and reactive mesothelial cells proliferation (0%, 0/23, P<0.05); 3) INSM1 showed perfect agreement between 32 cases of paired biopsy and cytology specimens (κ=1); 4) the sensitivity of INSM1 in lung neuroendocrine neoplasms (90.1%, 64/71) were higher than that of synaptophysin (Syn) and chromogranin A (CgA) (P<0.001); 5) the specificity of INSM1 in lung neuroendocrine neoplasms (97.6%) was similar to CgA (P>0.05), but considerably higher than that of Syn (P<0.05). Conclusion: INSM1 has a high expression in lung neuroendocrine neoplasms and is therefore a reliable marker for lung neuroendocrine neoplasms.
Keywords：
insulinoma-associated protein 1; neuroendocrine tumors; biopsy; cytology specimens; pulmonary