TTF-1 and p63 for distinguishing pulmonary small-cell carcinoma from poorly differentiated squamous cell carcinoma in previously pap-stained cytologic material

Abstract

In histology and cell block sections, antibodies to thyroid transcription factor-1 (TTF-1) and p63 have been demonstrated to be useful markers for distinguishing between small-cell lung carcinoma and poorly differentiated pulmonary squamous cell carcinoma. In this study, we assessed the utility of TTF-1 and p63, as an antibody panel, for differentiating between these two neoplasms in previously Papanicolaou (Pap)-stained cytologic smears and cytospin slides. Twenty-six lung carcinomas (13 small-cell lung carcinomas, 13 poorly differentiated pulmonary squamous cell carcinomas) were evaluated. One or two previously 95% ethanol-fixed, Pap-stained smears or cytospin slides were selected from each case. The cytologic material from these slides was transferred to positively charged slides. Unstained recuts were obtained from the corresponding histologic specimens or cell blocks. Immunohistochemical staining for TTF-1 and p63 was performed on the paired samples from each tumor. All (13/13) small-cell lung carcinomas were negative for p63 and 92% (12/13) were positive for TTF-1. Conversely, all (13/13) poorly differentiated pulmonary squamous cell carcinomas expressed p63 and did not express TTF-1. Immunoreactivity for p63 was also noted in bronchial reserve cells and metaplastic squamous cells. The immunostaining results obtained from the cytology slides were concordant with those of the histology or cell block sections in all cases. The results of this study show that TTF-1 and p63 immunostaining can be successfully applied to previously Pap-stained cytologic material, as an antibody panel, to facilitate pathologic differentiation between small-cell lung carcinomas and poorly differentiated pulmonary squamous cell carcinomas. p63 immunostaining, however, must be interpreted in conjunction with cytomorphology to distinguish between poorly differentiated pulmonary squamous cell carcinomas and benign cellular constituents of the lung.

Accuracy of cell typing in nonsmall cell lung cancer by EBUS/EUS-FNA cytological samples

“…In the absence of these, accuracy of cell typing for NSCLC is only 44%, but when cell blocks are prepared and immunohistochemical staining is performed, this increases to .80%, which is comparable with that reported previously for bronchial biopsies [18]. Other groups have described methodologies for immunohistochemical staining of previously stained Papanicolaou slides [21] and while this might allow some further information to be obtained in those cases where no cell block is available, the ability to use a panel of antibodies to optimise diagnosis is not possible with this approach. The importance of having cell blocks containing tumour cells for immunohistochemistry has, in our personal experience, also been useful in identifying or confirming the presence of metastatic carcinoma from sites other than lung.…”

Etoposide-Cisplatin Alternating with Vinorelbine-Cisplatin Versus Etoposide-Cisplatin Alone in Patients with Extensive Disease Combined with Small Cell Lung Cancer

“…Immunohistochemistry markers, such as cyto-keratin 7/8 (CK7/8), P63, and thyroid transcription factor-1 (TTF-1) were chosen to discriminate components of non-small cell lung cancer. Neuron specific enolase (NSE), and chromogranin (ChrA) were commonly used to recognize SCLC components (Kalhor et al, 2006;Bishop et al, 2010). This study was approved by the Institutional review board of Shanghai pulmonary hospital and the Informed Consent Forms (ICF) was signed by each eligible patient before the initiation of any trial related procedure.…”

Claudin-1 and claudin-5 expression patterns differentiate lung squamous cell carcinomas from adenocarcinomas

“…Immunohistochemistry with antibodies such as p63, TTF-1 and keratins 5/6/7/14/17, CD15 and thrombomodulin is currently used to distinguish pulmonary squamous cell carcinomas from adenocarcinomas. [4][5][6] Epithelial cells are characterized by tight junctions, which seal their apical regions in a gasket-like manner, thus preventing the free diffusion of solutes (including growth factors and pathogens) across extracellular luminal and basal compartments. Recent studies have shown that some tight junction proteins are involved in the regulation of epithelial proliferation and differentiation (reviewed by Matter et al 7 ).…”