Abstract: Objective To investigate the relationship between the expression of aspartic peptidase A (Napsin A), thyroid transcription factor -1(TTF-1) and cytokeratin 7(CK7) in lung adenocarcinoma (AdC) and its clinicopathological features and epidermal growth factor receptor (EGFR) gene mutation. Methods A total of 229 patients with AdC admitted to Kaifeng Central Hospital from January 2022 to February 2025 were selected as the research objects. The expression of Napsin A, TTF1 and CK7 in cancer tissues was detected by immunohistochemistry, and gene detection was carried out to count the mutation of EGFR gene. Results The positive expression rates of Napsin A, TTF1 and CK7 in cancer tissues of 229 patients with AdC were 64.19%, 82.97% and 77.73%, respectively. The incidence of EGFR gene mutation was 39.74%. The positive rate of Napsin A in patients with AdC with stage Ⅲ, low differentiation and lymph node metastasis was lower (P<0.05). Conversely, the positive rates of TTF-1 and CK7 were significantly higher in patients with AdC with a tumor diameter ≥ 3 cm, clinical stage Ⅲ disease, poor differentiation, and lymph node metastasis (P<0.05). The incidence of EGFR gene mutation was significantly higher in lung adenocarcinoma patients with clinical stage IIIA disease, poor differentiation, and lymph node metastasis (P<0.05). The positive expression rate of Napsin A was lower, while the positive expression rates of TTF1 and CK7 were higher, in patients with EGFR gene mutations compared to those with wild-type EGFR(P<0.05). Conclusion The expression of Napsin A, TTF1 and CK7 in cancer tissues of patients with AdC is closely associated with their clinicopathological features and EGFR gene mutation status.

Key words: lung adenocarcinoma, aspartate peptidase A, thyroid transcription factor-1, cytokeratin 7, clinicopathological features, epidermal growth factor receptor

摘要： 目的 研究原发性肺腺癌（ADC）组织天冬氨酸肽酶A（Napsin A）、甲状腺转录因子-1（TTF-1）、细胞角蛋白7（CK7）表达与其临床病理特征及表皮生长因子受体（EGFR）基因突变的关系。方法 以2022年1月—2025年2月开封市中心医院收治的229例ADC患者为研究对象,采用免疫组化法检测其癌组织Napsin A、TTF1、CK7表达情况,并进行基因检测,统计其EGFR基因突变情况。结果 229例ADC患者癌组织Napsin A、TTF1、CK7阳性表达率分别为64.19%、82.97%、77.73%;EGFR基因突变发生率为39.74%。临床分期Ⅲ期、低分化、淋巴结转移ADC患者Napsin A阳性率更低（P<0.05）;肿瘤直径≥3 cm、临床分期Ⅲ期、低分化、淋巴结转移ADC患者TTF-1、CK7阳性率更高（P<0.05）。临床分期Ⅲ期、低分化、淋巴结转移ADC患者EGFR基因突变发生率更高（P<0.05）。EGFR基因突变患者Napsin A阳性表达量低于野生型EGFR基因患者,TTF1、CK7阳性表达量高于野生型EGFR基因患者（P<0.05）。结论 ADC患者癌组织Napsin A、TTF1、CK7表达情况与其临床病理特征及EGFR基因突变密切相关。

关键词: 原发性肺腺癌, 天冬氨酸肽酶A, 甲状腺转录因子-1, 细胞角蛋白7, 临床病理特征, 表皮生长因子受体