title: Comparison of the expression levels of napsin A, thyroid transcription factor-1, and p63 in nonsmall cell lung cancer using cytocentrifuged bronchial brushings.
abstract: BACKGROUND
  Appropriate treatment of nonsmall cell lung cancer (NSCLC) depended on histologic type. The aim of this study was to evaluate the expression levels of Napsin A, thyroid transcription factor-1 (TTF-1), and p63 by immunostaining using CytoRich Red preserved cytocentrifuged bronchial brushings.
  
  
  METHODS
  The expression levels of Napsin A, TTF-1, and p63 were semiquantitatively evaluated using proportion and intensity scores in 12 patients from whom both bronchial brushing cytology and bronchial biopsy samples had been obtained, as well as in a selection of 64 resected NSCLC tissue samples, and 8 normal or benign bronchial brushing cytology samples.
  
  
  RESULTS
  The nuclear expressions of TTF-1 and p63 allowed for good visualization of cancer cells, whereas the cytoplasmic expression of Napsin A in cancer cells was often more difficult to evaluate because medium-sized and large macrophages also expressed Napsin A. Napsin A and TTF-1 were reliable adenocarcinoma markers, and p63 was a reliable squamous cell carcinoma marker in cytology, and histology samples. The average scores of Napsin A, TTF-1, and p63 were highly correlated in bronchial brushing cytology and bronchial biopsy samples, whereas TTF-1 expression was significantly lower than Napsin A expression in resected NSCLC tissue samples (P < .001).
  
  
  CONCLUSIONS
  Immunostaining of bronchial brushings fixed with CytoRich Red was useful in determining histologic types in NSCLC. It was suggested that the panels of Napsin A, TTF-1, and p63 were effective in identifying histologic type in NSCLC, and that a combination of either Napsin A and p63 or TTF-1 and p63 should be chosen, depending on morphology.
authors: Department of Diagnostic Pathology, Kurume University Hospital, Japan.
authors: Emiko
authors: E
authors: Aikawa
authors: Akihiko
authors: A
authors: Kawahara
authors: Satoshi
authors: S
authors: Hattori
authors: Tomohiko
authors: T
authors: Yamaguchi
authors: Hideyuki
authors: H
authors: Abe
authors: Tomoki
authors: T
authors: Taira
authors: Koichi
authors: K
authors: Azuma
authors: Masayoshi
authors: M
authors: Kage
mesh_terms: D016282:Aspartic Acid Endopeptidases / Q000096:biosynthesis*; D014408:Biomarkers, Tumor / Q000096:biosynthesis; D001706:Biopsy; D001980:Bronchi / Q000378:metabolism* / Q000473:pathology; D002289:Carcinoma, Non-Small-Cell Lung / Q000378:metabolism* / Q000473:pathology; D003581:Cytodiagnosis / Q000379:methods; D006801:Humans; D007150:Immunohistochemistry; D008175:Lung Neoplasms / Q000378:metabolism* / Q000473:pathology; D009687:Nuclear Proteins / Q000096:biosynthesis*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D000074482:Thyroid Nuclear Factor 1; D014157:Transcription Factors / Q000096:biosynthesis*; D025521:Tumor Suppressor Proteins / Q000096:biosynthesis*
chemical_list: D014408:Biomarkers, Tumor; C000614412:NKX2-1 protein, human; D009687:Nuclear Proteins; C115051:TP63 protein, human; D000074482:Thyroid Nuclear Factor 1; D014157:Transcription Factors; D025521:Tumor Suppressor Proteins; D016282:Aspartic Acid Endopeptidases; C498549:NAPSA protein, human