Abstract: Objective To investigate the expression and clinical significance of cytokeratin 7 (CK7) and aspartic peptidase A (NapsinA) in pleural effusion of lung adenocarcinoma (LUAD). Methods A total of 86 patients with LUAD and pleural effusion who were admitted to Kaifeng Central Hospital from February 2023 to February 2025 were selected. Meanwhile, 40 samples of benign pleural effusion (pleural effusion caused by tuberculous pleurisy, heart failure, etc.) were collected. The expression of CK7 and NapsinA in pleural effusion cells was detected by immunohistochemical method. The relationship between CK7, NapsinA and clinicopathological features of patients with LUAD and pleural effusion was analyzed. Results The positive expression rates and scores of CK7 and NapsinA in pleural effusion of patients with LUAD were higher than those in benign pleural effusion (P<0.05). ROC curve showed that CK7 and NapsinA had vertain value in differential diagnosis of LUAD and other diseases (P<0.05). Among 86 patients with LUAD, CK7 expression and NapsinA expression were high in 37 cases (43.02%) and 41 cases (47.67%), respectively. No statistically significant differences were found in the high expression rates of CK7 and NapsinA when compared across patient gender, age, smoking status, T stage, and presence of extrathoracic metastasis (P>0.05). The high expression rate of CK7 in patients with epidermal growth factor receptor (EGFR) gene mutation was significantly higher than that in those without (P<0.05), but there was no statistically significant difference in the high expression rate of NapsinA between the two groups (P>0.05). Conclusion The positive expression rates of CK7 and NapsinA in pleural effusion of LUAD are high. Both have certain value in diagnosing LUAD and can serve as biological markers to distinguish benign and malignant pleural effusion. There is also a correlation between CK7 expression and EGFR gene mutation.

Key words: CK7, NapsinA, lung adenocarcinoma, pleural effusion, EGFR gene mutation

摘要： 目的 探讨细胞角蛋白7（CK7）及天冬氨酸蛋白酶A（NapsinA）在肺腺癌（LUAD）胸腔积液中的表达及其临床意义。方法 选取2023年2月—2025年2月开封市中心医院收治的86例LUAD伴胸腔积液患者作为研究对象,同时选取良性胸腔积液（如结核性胸膜炎、心力衰竭导致的胸腔积液等）标本40例,采用免疫组织化学法比较胸腔积液细胞中CK7及NapsinA的表达,并分析CK7及NapsinA与LUAD伴胸腔积液患者临床病理特征的关系。结果 LUAD胸腔积液中CK7、NapsinA阳性表达率、阳性表达评分均高于良性胸腔积液（P<0.05）;ROC曲线显示,CK7、NapsinA对LUAD与其他疾病有一定鉴别诊断价值（P<0.05）。86例LUAD患者中,CK7、NapsinA高表达分别为37例（43.02%）、41例（47.67%）。患者的性别、年龄、吸烟情况、T分期及肺外转移与CK7及NapsinA高表达率对比,差异均无统计学意义（P>0.05）,而表皮生长因子受体（EGFR）基因突变者CK7高表达率显著高于无突变者（P<0.05）,二者NapsinA高表达率对比,差异无统计学意义（P>0.05）。结论 LUAD胸腔积液CK7和NapsinA阳性表达率高,对LUAD有一定诊断价值,可作为鉴别良恶性胸腔积液的生物学标志物,且CK7表达与EGFR基因突变存在一定相关性。

关键词: CK7, NapsinA, 肺腺癌, 胸腔积液, EGFR基因突变