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Ajcpath142 0320
Ajcpath142 0320
DOI: 10.1309/AJCPGA0IUA8BHQEZ
Napsin A is an aspartic proteinase that is normally ❚Table 1❚. Appropriate positive and negative controls were
expressed in type II pneumocytes. It is expressed in 65.3% used for all IHC studies. Positive IHC staining was defined
to 87% of pulmonary adenocarcinomas.2-6 Only a limited as staining in at least 1% of tumor cells. For TTF-1, p63, and
number of cases of neuroendocrine tumors, including 16 p40, only nuclear staining was recorded as positive. Each
TCs,4-6 one AC,5 and 86 SCLCs,2-6 have been studied and the case was scored as positive or negative, and the percentage of
experience to date suggests that lack of napsin A expression positively staining tumor cells was recorded.
is characteristic of pulmonary neuroendocrine tumors. TTF-1
has been more extensively evaluated in lung neuroendocrine
tumors, but the results are variable.7-9 To our knowledge,
Results
no previous study has examined p40 expression in lung
neuroendocrine tumors. Literature on the expression of p63 IHC staining results are summarized in ❚Table 2❚ and
❚Table 1❚
Primary Antibodies Used in the Study
A B
E F
❚Image 1❚ H&E staining and corresponding representative napsin A staining in typical carcinoid tumor (A, B), atypical carcinoid
tumor (C, D), and small cell carcinoma (E, F) (×200).
❚Table 2❚
Napsin A, TTF-1, p63, p40, and CK5/6 IHC in Pulmonary Neuroendocrine Tumors
TC 0/52 (0) 17/52 (5%-80%) 0/52 (0) 0/52 (0) 0/52 (0)
AC 0/8 (0) 4/8 (5%-80%) 0/8 (0) 0/8 (0) 0/8 (0)
SCLC 0/7 (0) 5/7 (80%-100%) 0/7 (0) 0/7 (0) 0/7 (0)
LCNEC 0/1 (0) 0/1 (0) 0/1 (0) 0/1 (0) 0/1 (0)
AC, atypical carcinoid tumor; IHC, immunohistochemistry; LCNEC, large cell neuroendocrine carcinoma; SCLC, small cell carcinoma; TC, typical carcinoid tumor.
leukocytes.12,13 In situ hybridization studies as well as IHC rate of TTF-1 is seen in spindle cell carcinoid tumors.18
The results of our study reveal a distinct but nonspecific 10. Wang BY, Gil J, Kaufman D, et al. P63 in pulmonary
staining pattern of pulmonary neuroendocrine tumors using a epithelium, pulmonary squamous neoplasms, and other
pulmonary tumors. Hum Pathol. 2002;33:921-926.
common IHC panel for NSCLCs. These tumors are consistently
11. Tatnell PJ, Powell DJ, Hill J, et al. Napsins: new human
negative for napsin A, which helps to differentiate them from aspartic proteinases. Distinction between two closely related
adenocarcinomas. CK5/6, p63, and p40 are equally effective in genes. FEBS Lett. 1998;441:43-48.
differentiating squamous cell carcinoma from carcinoid tumors. 12. Hirano T, Auer G, Maeda M, et al. Human tissue distribution
TTF-1 is not useful in the differential diagnosis between of TA02, which is homologous with a new type of aspartic
proteinase, napsin A. Jpn J Cancer Res. 2000;91:1015-1021.
pulmonary neuroendocrine tumors and adenocarcinomas.
13. Chuman Y, Bergman A, Ueno T, et al. Napsin A, a member
of the aspartic protease family, is abundantly expressed
Address reprint requests to Dr Myers: 2G332 UH, 1500 E Medical in normal lung and kidney tissue and is expressed in lung
Center Dr, Ann Arbor, MI 48109-0054. adenocarcinomas. FEBS Lett. 1999;462:129-134.