Thyroid transcription factor 1

Abstract

BACKGROUND Adenocarcinomas are the most common epithelial malignancies in body cavity fluids. Subclassification of adenocarcinomas according to primary site can be a challenging task. Thyroid transcription factor 1 (TTF‐1) is a nuclear transcription factor that is expressed in normal lung, in thyroid, and in their neoplasms. Because thyroid carcinomas rarely metastasize to the serosal surfaces, the authors used TTF‐1 as a marker to distinguish adenocarcinomas of the lung from carcinomas of other organs. METHODS The authors studied 113 body cavity fluids (92 pleural fluid samples and 21 ascitic samples) from 113 patients with a diagnosis of adenocarcinoma on the basis of routine cytology. The primary sites of origin were confirmed clinically or histologically for all patients. There were 39 adenocarcinomas of the lung, 24 adenocarcinomas of the breast, 34 adenocarcinomas of the genitourinary tract, and 16 adenocarcinomas of the gastrointestinal tract. Archival Papanicolaou‐stained, cytocentrifuged slides were used without destaining for immunocytochemistry with the monoclonal TTF‐1 antibody using a commercial available method. RESULTS TTF‐1 was expressed in 21 of 39 lung adenocarcinomas (54%). Intense nuclear staining was present in tumor cells that occurred in groups or in isolated form. In contrast, none of the other types of adenocarcinomas expressed TTF‐1. CONCLUSIONS TTF‐1 is a highly specific marker for adenocarcinomas of the lung in body cavity fluids. Immunocytochemistry using this antibody can be performed easily on archival Papanicolaou‐stained, cytocentrifuged slides of fluid specimens. Cancer (Cancer Cytopathol) 2002;96:289–93. © 2002 American Cancer Society.

Utility of Napsin A and Thyroid Transcription Factor 1 in Differentiating Metastatic Pulmonary from Non-Pulmonary Adenocarcinoma in Pleural Effusion

“…In the present study, TTF-1 was positive in 30/53 (57%) cases of pulmonary ACs and all non-pulmonary ACs were negative for TTF-1, similar to other reports [5,6,7]. Non-pulmonary AC did not include thyroid cancer.…”

“…The reported sensitivity values in cells from serous effusions were between 54 and 88%, with specificity values between 97 and 100% [5,6,7]. Occasional carcinomas of other origin than the lung and thyroid, such as carcinoma of the uterine cervix, small cell carcinoma of the sinusoidal tract and metastatic ACs of the colon have been found to be positive for TTF-1 [4].…”

“…Several studies indicated that sensitivity values were between 55 and 100% and specificity values between 97 and 100% on histologic sections [4,5]. The reported sensitivity values in cells from serous effusions were between 54 and 88%, with specificity values between 97 and 100% [6,7]. …”

Nkx2-1: a novel tumor biomarker of lung cancer

“…Gomez-Fernandez et al (2002) examined body cavity fluids from 113 patients with lung ADC on the basis of cytology and found that Nkx2-1 was expressed in 54% of lung ADC, but was completely absent in other types. In another study using immunohistochemical staining to detect Nkx2-1, Nkx2-1, along with cytokeratin 20 (CK20) and neurofilaments (NF), was found to be effective for distinguishing Merkel cell carcinoma (MCC) from SCLC (Bobos et al, 2006).…”

Thyroid Transcription Factor 1 and Napsin A Double Staining in Lung Adenocarcinoma in Pleural Fluid

“…Gomez-Fernandez et al [20 ]reported a lower TTF-1 sensitivity of 54%, likely due to the fact that their IHC stains were performed on Pap-stained slides, rather than on the FFPE cell blocks used in other studies. The sensitivity of napsin A on metastatic lung adenocarcinoma in pleural fluid was reported by 2 groups to be 83% [21,22].…”