The value of cytokeratin 5/6, p63 and thyroid transcription factor-1 in adenocarcinoma, squamous cell carcinoma and non-small-cell lung cancer of the lung

Abstract

Objective: It is now important to distinguish between adenocarcinoma and squamous cell carcinoma of the lung because of target-specific treatments. Our study aimed to study the efficiency of Thyroid Transcription Factor-1 (TTF-1), cytokeratin 5/6 (CK5/6) and p63 in distinguishing between adenocarcinoma and squamous cell carcinoma and to study the contribution of these markers to the diagnosis in non-small cell lung cancer. Material and Method:Immunohistochemically, TTF-1, CK 5/6 and p63 were used in 72 cases of squamous cell carcinoma, 19 cases of adenocarcinoma, and 29 cases of non-small cell lung cancer whose final diagnosis was decided with the subsequent resection material. The specificity, sensitivity, and positive and negative predictive value were calculated for each marker.Results: TTF-1 positivity was seen in none of the 72 squamous cell carcinomas but in all of 19 adenocarcinoma cases. CK5/6 negativity was seen in all cases of adenocarcinoma and in two cases of squamous cell carcinoma. p63 was positive in all squamous cell carcinomas and in 4 adenocarcinomas. Cytokeratin 5/6, p63 positivity and TTF-1 negativity were observed in 17 non-small cell lung cancers whose final diagnosis was squamous cell carcinoma. None of the 12 non-small cell lung cancers whose final diagnosis was adenocarcinoma exhibited positive staining for CK5/6. However, p63 staining was not seen in the biopsy but was focal in the surgical specimen in one case. All the 12 non-small cell lung cancers whose certain diagnosis was adenocarcinoma were positive for TTF-1. TTF-1, CK 5/6 and p63 seem to be useful for differentiating adenocarcinoma from squamous cell carcinoma with 100% specificity, 100% sensitivity and 100% specificity, 97% sensitivity and 87% specificity, and 100% sensitivity, respectively. Conclusion:We concluded that TTF-1 is a reliable marker for subtyping lung cancer. Different staining patterns can be seen with CK5/6 and p63; however, if they are used together with TTF-1 and interpreted correctly, they can be of help for the final diagnosis even in cases in which the morphology is unclear.Key Words: Adenocarcinoma, Squamous cell carcinoma, Immunohistochemistry, Lung cancer ÖZ Amaç: Günümüzde, hedefe yönelik tedaviler nedeniyle, akciğerin skuamöz hücreli karsinomunun adenokarsinomundan ayrımı çok önemlidir. Çalışmada, skuamöz hücreli karsinom ile adenokarsinomun ayrımında, Tiroid Transkripsiyon Faktör-1 (TTF-1), sitokeratin 5/6 (SK5/6) ve p63 kullanımının etkinliğinin ve bu belirteçlerin küçük hücreli dışı akciğer karsinomunun tanısına katkısı araştırıldı. Gereç ve Yöntem:İmmunhistokimyasal olarak; 72 skuamöz hücreli karsinom, 19 adenokarsinom ve 29 küçük hücreli dışı akciğer karsinom (kesin tanısı rezeksiyon materyalinde verilen) olgusunda, TTF-1, SK5/6 ve p63 kullanılmıştır. Her belirteç için duyarlılık, özgüllük, pozitif ve negatif prediktif değer hesaplanmıştır. Bulgular: TTF-1 pozitifliği, 19 adenokarsinom olgusunun tersine, 72 skuamöz hücreli karsinom olgusunun hiçbirinde izlenmemiştir. CK5/6 negatifliği tüm...

The Role of Immunohistochemical Markers (P63 and TTF-1) in the Diagnosis and Classification of Non-Small Cell Lung Carcinoma

“…In their study NSCLC accounts for about 93% and among these 55% was adenocarcinoma and rest of the 45% is composed of squamous cell carcinoma, adenosquamous carcinoma and NSCLC-NOS. This study can also be comparable with the studies done by Argon A et al [4] in 2015 and Peh Sun Loo et al [5] in 2010.…”

“…Chi-square test was done for both p63 and TTF-1 expression and got P value < 0.001, which was statistically significant. This study is comparable with the studies conducted by Peh Sun Loo et al [5] in 2010 and Argon A et al [4] in 2015.…”

The Role of Immunohistochemistry in Diagnosis of Lung Cancer With Correlation of Serum Tumour Marker Carcinoembryonic Antigen

“…performed following basic IHC panel to differentiate between adenocarcinoma and squamous cell carcinoma of lung. results of this study were consistent with studies done by Peh Sun Loo et al 2 and Argon A et al3 table gives Chi square value 177 with DF of 9 and p value <0.0001. table gives Chi square value of 177.143 with DF of 9 and P value<0.0001 and contingency coefficient of 0.830.…”

Epidemiologic and Histopathologic Feature of Lung Cancer in Central Iran (2012-2018)

“…Out of total lung cancer patients, 135 cases (51.9%) had a positive family history of cancer of whom 92 (68.1%) cases have at-least a first-degree relative with cancer. The most common malignancies among the affected family members were in lung (32,23.7%), breast (17, 12.6%) and stomach (17, 12.6%), respectively. (Table 1) Altogether, 164 (63.1%) and 150 (57.6%) patients had metastasis at the time of study and diagnosis, respectively ( Table 2).…”

“…, the frequency of different types of lung cancer were 36.9% cases of adenocarcinomas, 14.2% cases of squamous cell carcinoma,9.6% cases of bronchogenic carcinoma and 8.1% cases small cell lung cancer, respectively. There was significant relationship between different types of lung cancerIn the study at Yazd( Iran)(8) 34.9% of patients had SCC and In study at Tehran (23), 19% of patients were SCC(Table 6).According to the results, totally 93 patients (35.7%) had IHC assay reports in which 53 different diagnostic, prognostic, and predictive biomarkers had been measured (Table 5,7).Although all of the measured biomarkers have a diagnostic significance(29)(30)(31)(32)(33)(34), the most relevant biomarkers which have been recently identified, CK20 and CK7, have an important prognostic value in lung cancer patients(35). Moreover, predictive markers like LCA(31) has been checked in a few patients.…”