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Cytokeratin 5/6, p63 and TTF-1 Immunomarker Use in Tiny Non...
2025-05-10
Cytokeratin 5/6, p63 and TTF-1 Immunomarker Use in Tiny Non-small Cell Lung Cancer - 百度学术
摘要：
Introduction Worldwide , including Iraq, lung cancer (LC) is the second most commonly diagnosed cancer. Behind pulmonary cancer, lie a diverse and heterogeneous number of subtypes rendering it a serious threat to human life and a leading cause of cancer-related death. 1-5 This heterogeneity is reflected in the wide range of therapeutic strategies developed to combat the disease. The relationship of therapies and patient outcome with specific histologies and predictive biomarkers has made the handling of small biopsy specimens being the key factor for therapeutic and prognostic purposes. Hence the diagnosis should be reasonable. 6,7 The reproducibility rate of the pathologic diagnoses, based on the routine light microscopic features is satisfactory for distinguishing small cell lung carcinoma (SCLC) from non-small cell lung carcinoma (NSCLC) and for identifying of glandular versus squamous differentiation in low grade adenocarcinoma (AC) and squamous cell carcinoma (SCC). However, it is less than satisfactory for categorization high grade NSCLC cases especially in tiny tissues 8-10. The emerging evidence for differential responses of NSCLC specific subtypes to the new targeted therapies highlighted the increased need for a greater accuracy in such subtyping. Novel target therapy of lung cancer necessitates accurate diagnosis of non-small cell lung carcinoma. Several recent studies have addressed the issue of using immunohistochemistry (IHC) panels to correctly distinguish lung AC from SCC which form the commonest NSCLC. 8-12 To our best knowledge, the relative analysis of the sensitivity and specificity of specific immuno markers addressed for identifying subtypes of NSCLC in small bioptic specimens is limited in our locality and no previous study has been conducted in Kurdistan Region-Iraq in the same field. In this study, we focused on the immuno histochemical characterization of NSCLC in small biopsy samples using specific monoclonal antibodies (CK5/6 and p63 and TTF-1) to discriminate between SCC and AC and to find out the specificity and sensitivity rates of these three markers used for the same purpose.. Of these, only 88 tiny (bronchoscopic and tru cut) biopsies were newly diagnosed NSCLC with no prior chemo or radiotherapy and thus were enrolled in the study. Information related to the patient s age at presentation and gender were obtained from patient s request forms. Two cases were excluded because of inadequate data and histopathological/immunohistochemical testing was performed on 88 patients in Histopathology Department, Central General Laboratories in Duhok-Iraq. Specimens were already fixed in 10% formalin for at least 2hours, processed and embedded in paraffin wax. Four micron-thick tissue sections were taken from the tumor and re-stained with Hematoxylin and Eosin (H E) stains to confirm the diagnosis. The immunohistochemical technique applied was streptavidin-biotin, using monoclonal antibodies manufactured by Ventana corporation (Ventana, Rocklin, California) with 3-3 -diaminobenzidine tetrahydrochloride used as chromogen (DAB) and standard DAB detection kit (Ventana) was applied according to instructions described previously. 13-18 The primary antibodies used were monoclonal antibodies directed against cytokeratin 5/6 Abstract Background and objectives: Using immunomarkers nowadays becomes a routine histologic practice. This study is designed to declare the use of p63, CK5/6 and TTF-1 immunomarkers for categorization of non-small cell lung cancer in tiny biopsy specimens.
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