Peroperative frozen section analysis of TTF-1 antigen expression

Camilleri-Broët, S.; Alifano, Marco; Morcos, Mary Attia; Compérat, Éva; Magdeleinat, Pierre; Marmey, B; Molina, Thierry Jo; Jf, Regnard; Audouin, Josée

doi:10.1136/jcp.57.1.98

Cited by 11 publications

(10 citation statements)

References 7 publications

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“…18 As for its good sensitivity, we have demonstrated that it could be applied on frozen-section diagnosis by using rapid immunohistochemical technique. 8 In the present work, we noticed that the nuclear expression of TTF-1 in normal pneumocytes tested with SPT24 clone was stronger than that with 8G7G3/1 clone. Also, a slight staining with Dako's antibody in 1/10 dilution (data not shown) could be observed in the same positive zone of a metastatic colorectal carcinoma detected with Novocastra's.…”

Section: Discussionsupporting

confidence: 53%

“…[9][10][11][12] In the literature, TTF-1 expression in nuclei has been shown in rare cases of adenocarcinomas arising outside from lung or thyroid: one weakly positive case of metastatic ovarian carcinoma 13 and one focal positive case of endometrial carcinoma. 14 Recently, our group has shown one positive adenocarcinoma of colorectal origins, 8 whereas no such positivity was reported in literature ( Table 2).…”

Section: Discussionmentioning

confidence: 84%

“…We previously reported one case of lung metastasis of colorectal origin, which showed a focal nuclear staining with the anti-TTF-1 antibody (clone SPT24) on both paraffin-embedded and cryostat sections. 8 To our knowledge, this was the first TTF-1-positive colorectal carcinoma reported.…”

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confidence: 78%

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Variable sensitivity and specificity of TTF-1 antibodies in lung metastatic adenocarcinoma of colorectal origin

et al. 2005

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Thyroid transcription factor-1 (TTF-1) is considered as a reliable marker for differential diagnosis in distinguishing primary adenocarcinomas of the lung from extrathoracic origins. We previously reported the first case of lung metastasis of colorectal origin, with nuclear expression of TTF-1. As most previous studies were performed on series of extrathoracic primary tumors, we raised the question of a possible role of lung microenviroment in TTF-1 expression. We investigated the rate of TTF-1 expression in lung metastases of extrathoracic adenocarcinomas and compared results of immunohistochemistry performed with different primary antibodies. Two different clones of antibodies (8G7G1/1 from Dako, SPT24 from Novocastra) raised against TTF-1 were used on 56 lung-metastatic malignant tumors, 41 from colorectal origin. A series of primary colorectal (90 cases) and primary pulmonary adenocarcinomas (86 cases) were also investigated. Four of 41 (10%) lung metastases of colorectal adenocarcinomas displayed a nuclear staining for TTF-1 with SPT24 clone. Three of the four positive cases displayed similar nuclear staining in primary and/or other extrathoracic metastatic sites as well as four of 90 (5%) primary colorectal adenocarcinomas, ruling out the role of lung microenvironment. None of them was positive with 8G7G1/1 clone. Sensitivity between two sets of antibodies was compared in 86 primary pulmonary adenocarcinomas. Nuclear staining was detected in 72 cases (84%) with Novocastra's antibody and 56 cases (65%) with Dako's. Significant discordance was observed (Po 0.01). These results suggest that the diagnostic virtue of TTF-1 detection depends on the used antibody's clone. The SPT24 clone seems to have a stronger affinity for TTF-1 protein but may lead to a few positive colorectal adenocarcinomas. Keywords: TTF-1; lung; carcinoma; metastasis; colorectal Thyroid transcription factor-1 (TTF-1) is a tissuespecific transcription factor expressed in the epithelial cells of thyroid and lung (type II pneumocytes and Clara cells). Carcinomas arising from lung and thyroid also show frequent TTF-1 expression. 1,2 As the lung is one of the most common sites of metastasis, TTF-1 is considered as a reliable marker to distinguish between primary lung carcinoma and lung metastasis, especially when dealing with an adenocarcinoma or a large-cell carcinoma. [3][4][5][6] It is also considered as a reliable marker in the differential diagnosis between pleural localization of lung origin carcinoma and malignant mesothelioma. 7 Two main commercial available clones of monoclonal antibodies have been raised against TTF-1 for immunohistochemical use, 8G7G1/1 and SPT24, their diagnostic value in determining the lung or thyroid origin of adenocarcinoma has not yet been compared. Most of the studies show the high specificity of TTF-1 detection and have been published used the 8G7G1/1 clone. We previously reported one case of lung metastasis of colorectal origin, which showed a focal nuclear staining with the anti-TTF-1 antibody (clone SPT24)...

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Section: Discussionsupporting

confidence: 53%

Section: Discussionmentioning

confidence: 84%

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Variable sensitivity and specificity of TTF-1 antibodies in lung metastatic adenocarcinoma of colorectal origin

et al. 2005

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“…Multiple other studies of pulmonary FS discussed topics other than diagnostic pathologic features, such as the usefulness and importance of cytopathology, margins of resection, lymph node examination, immunohistochemical analysis, and newer molecular techniques. [16][17][18][19][20][21][22] The 100 erroneous FS diagnoses and deferrals of RA, AC, and BAC-AC at Cedars-Sinai Medical Center are listed by diagnostic category in zTable 1z. The DRs and ERs for all these diagnoses were 4.36% and 1.58%, respectively, and 2.7% and 1.5% for all diagnoses.…”

Section: Resultsmentioning

confidence: 99%

Lessons Learned From Mistakes and Deferrals in the Frozen Section Diagnosis of Bronchioloalveolar Carcinoma and Well-Differentiated Pulmonary Adenocarcinoma

2008

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The frozen section diagnosis of lung nodules is difficult because inflammatory atypia and histologic artifacts can simulate a malignancy. From a total of 2,405 frozen sections examined, 143 cases were misdiagnosed or deferred, including 65 with reactive atypia (RA) and 35 bronchioloalveolar carcinomas or well-differentiated adenocarcinomas (BAC-AC), resulting in deferral and error rates of 4.36% and 1.58%, respectively. The presence of 25 pathologic features was evaluated by using an evidence-based pathology (EBP) approach. Of the pathologic features, 11 were significant at a P value of less than .05 but exhibited variable incidence in AC and RA. Positive likelihood ratios allowed for identification of the 5 most useful pathologic features for the diagnosis of AC: multiple growth patterns, anisocytosis, atypia more than 75%, macronucleoli, and atypical mitoses. Granulomas favored the diagnosis of RA. An EBP approach is helpful to stratify pathologic features according to their clinical applicability.

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“…Regarding the gastrointestinal tract, NKX2.1 was found positive in different origin sites with several case reports. As Compérat et al first reported one case of NKX2.1 positive lung metastasis of colorectal origin [11] , Penman et al claimed NKX2.1 was found positive in less than 10 colorectal adenocarcinomas [12] , and some other scientists discovered NKX2.1 positive in 3 gastric adenocarcinomas [13][14] . A previous study directed by Nakamura et al shows none of NKX2.1 expression come out positive in 10 gallbladder adenocarcinomas [15] , while recently Pegolo et al reported 2 cases of adenocarcinoma of the gastrointestinal tract.…”

Section: Nkx21mentioning

confidence: 99%

The homeobox NKX and Neoplasms in Digestive system: a systematic review.

Yao¹,

Zhu²

2017

RAJAR

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ABSTRACT:The incidence of digestive system neoplasms is increasing over these years due to the limitation of prompt diagnosis and effective treatment. Homeobox genes are usually associated with development of cancer. Previous studies indicate that homeobox NKX transcription factors are partly involved in the development and progression of tumors in gastrointestinal tract. To summarize the different impact of NKX genes have on the digestive system, the interrelationship between each NKX genes and gastric-derived tumors is analyzed as much detail as possible. The results turn out that some of NKX genes may be used as a target to distinguish the primary site of cancer, or as a biomarker to predict the therapeutic effect and survival which is instructive and meaningful to the future medical managements. This review is a systematic synopsis of research on the homeobox genes NKX and digestive system neoplasms, with the focus on their functions and clinical significance.

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Peroperative frozen section analysis of TTF-1 antigen expression

Cited by 11 publications

References 7 publications

Variable sensitivity and specificity of TTF-1 antibodies in lung metastatic adenocarcinoma of colorectal origin

Variable sensitivity and specificity of TTF-1 antibodies in lung metastatic adenocarcinoma of colorectal origin

Lessons Learned From Mistakes and Deferrals in the Frozen Section Diagnosis of Bronchioloalveolar Carcinoma and Well-Differentiated Pulmonary Adenocarcinoma

The homeobox NKX and Neoplasms in Digestive system: a systematic review.

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