The Discriminating Role of Thyroid Transcripsion Factor-1 TTF-1 in the Primary and Methastatic Cansers of the Lung.

Year 2016, , 30 - 38, 01.01.2016

İpek Erdem Sevda Özdoğan Nagehan Özışık Fatma Merve Tepetam Özlem Oruç Ali Fidan Benan Çağlayan

https://doi.org/10.5505/abantmedj.2016.48568

Abstract

INTRODUCTION: Lung cancer incidence is increasing and becoming the first cause of death due to cancer.One of the most frequent clinical problem is to determine whether the malignity is primary due to lung cancer or metastatic lung cancer. Thyroid Transcription Factor-1 TTF- 1 is a nuclear protein which is expressed in adenocarcinomas or adenosquamos carcinomas by bronchiolar epithelium cells.TTF-1 is almost negative in the other carcinomas of organs. We aimed to analyze the discriminating role of TTF-1 in the primary and metastatic cancers of the lung.METHODS: We analyzed 50 lung cancer patients, 30 patients had primary pulmonary cancers and 20 patients had metastatic pulmonary carcinomas. Immunohistochemical dyeing study was performed on the specimens using mouse monoclonal antibody against TTF-1 8 G7G3/1, Neomarkers, USA .RESULTS: We analyzed 50 lung cancer patients, 30 patients had primary pulmonary cancers and 20 patients had metastatic pulmonary carcinomas. Immunohistochemical dyeing study was performed on the specimens using mouse monoclonal antibody against TTF-1 8 G7G3/1, Neomarkers, USA .DISCUSSION AND CONCLUSION: In this study it is found that positive TTF-1 results indicate primary pulmonary cancer when thyroid-originated metastatic lung cancers were excluded, but the negative results for TTF-1 could not exclude the pulmonary origin. Also, considering the highest positivity rate is 76 % for TTF-1, the results suggest that not only using TTF-1 alone but using it within an antibody panel may be more useful for discriminating the primary adenocarcinomas from metastatic adenocarcinomas.

Keywords

Lung Cancer, metastatic, primary, Thyroid Transcription Factor-1

Akciğerin Primer ve Metastatik Adenokarsinomlarının Ayrımında Tiroid Transkripsiyon Faktör-1 TTF-1 'in Yeri.

Abstract

GİRİŞ ve AMAÇ: Akciğer AC kanseri insidansı gün geçtikçe artmakta olup günümüzde kanserden ölümlerin başlıca nedenleri arasındadır. Malignitenin primer akciğer AC kaynaklı ya da metastatik olduğunun belirlenmesi klinikte sıkça karşılaşılan sorunlardandır. Tiroid transkripsiyon faktör-1 TTF-1 daha çok bronşiyal epitel hücrelerinden kaynaklanan adenokarsinomalarda ve adenoskuamöz karsinomalarda tespit edilmektedir. Diğer organların adenokarsinomalarmda TTF-1 büyük çoğunlukla negatiftir. Çalışmamızın amacı, AC'in primer ve metastatik adenokarsinomalarında TTF-1 immunhistokimyasal belirtecinin kullanımının ayırıcı tanıya katkısını belirlemektir.YÖNTEM ve GEREÇLER: Çalışmamıza 30 primer ve 20 metastatik olmak üzere toplam 50 AC kanseri hastası değerlendirildi. TTF-1 sunumunu belirlemek amacıyla TTF-1 Ab-1 8 G7G3/1, Neomarkers, USA kullanıma hazır mouse monoklonal antikoru ile immunhistokimyasal boyama prosedürü uygulandı.BULGULAR: Toplam 50 primer ve metastatik AC adenokarsinoma vakasının 11 tanesinde nükleer TTF-bir pozitifliği görüldü. Bu vakaların klinikleri değerlendirildiğinde hepsinin primer AC adenokarsinoma vakaları olduğu görüldü 11/30, %36,67 . Metastatik AC adenokarsinoma vakalarının hiç biri TTF-1 ile pozitif boyanma göstermediTARTIŞMA ve SONUÇ: Çalışmamızda TTF-1 pozitifliğinin tiroid kaynaklı AC metastazlar dışlandığında, primer pulmoner orijini işaret ettiği ancak TTF-1 ile negatif boyanmanın pulmoner orijini ekarte edemediği görülmüştür. Ayrıca bildirilen en yüksek pozitiflik oranının %76 olduğu göz önüne alınırsa tanı aşamasında TTF-1’in tek başına değil, bir antikor paneli içerisinde kullanılmasının uygun olacağı görüşüne varılmıştır.

Keywords

Akciğer kanseri, metastatik, primer, Tiroid Transkripsiyon Faktör-1.

References

• 1-Liu J. Immunostaining for thyroid transcription factor-1 on fine-needle aspiration specimens of lung tumors: A comparison of direct smears and cell block preparations. 92nd Annual Meeting of the United States and Canadian Academy of Pathology, Washington, DC, 22 March 2003 to 28 March 2003.
• 2- Bejarano PA, Baughman RP, Biddinger PW, Miller MA, Fenoglio-Preiser C, alKafaji B, Di Lauro R, Whitsett JA. Surfactant proteins and thyroid transcription factor-1 in pulmonary and breast carcinomas.Mod Pathol., 1996;9(4):445-52.
• 3-Ordonez NG. Value of thyroid transcription factor-1, E-cadherin, BG8, WT1, and CD44S immunostaining in distinguishing epithelial pleural mesothelioma from pulmonary and nonpuimonary adenocarcinoma.Am J SurgPathol 2000;24:598-606.
• 4-Moldvay J, Jackel M, Bogos K, Soltesz I, Agocs L, Kovacs G, Schaff Z. The Role of TTF-1 in Differentiating Primary and Metastatic Lung Adenocarcinomas.Pathology Oncology Research 2004; 10(2): 85-88.
• 5- Lau SK, Luthringer DJ, Eisen RN. Thyroid transcription factor-1: a review. ApplImmunohistochemMolMorphol, 2002; 10(2):97-102.
• 6-Pelosi G, Fraggetta F, Pasini F, Maisonneuve P, Sonzogni A, Iannucci A, Terzi A, Bresaola E, Valduga F, Lupo C, Viale G. Immunoreactivity for thyroid transcription factor- 1 in stage I non-small cell carcinomas of the lung. Am J SurgPathol., 2001;25:363-72.
• 7-Goldstein NS, Thomas M. Mucinous and nonmucinousbronchioloalveolaradenocarc inomas have distinct staining patterns with thyroid transcription factor and cytokeratin 20 antibodies. Am J ClinPathol2001; 116:319 -25
• 8-Dongfeng T, Li Q, DeebG, RamnathN, Slocum HK, Brooks J, Cheney R, Wiseman S, Anderson T, Loewen C. Thyroid transcription factor-1 expression prevalence and its clinical implications in non-small cell lung cancer: a highthroughput tissue microarray and immunohistochemistry study. Plum Pathol.2003;34(6):597-604.
• 9-Zamecnik J, Kodet R. Value of thyroid transcription factor-1 and surfactant apoprotein A in the differential diagnosis of pulmonary carcinomas: a study of 109 cases. Virchows Arch., 2002;440(4):353- 61.
• 10--Saad RS, Liu YL, Han H, Landreneau RJ, Silverman JF.Prognostic significance of thyroid transcription factor-1 expression in both early-stage conventional adenocarcinoma and bronchioloalveolar carcinoma of the lung.Hum Pathol.2004 ;35(l):3-7.
• 11-Secaucus NJ.Pathologic evaluation of lung cancer. Fossella F. Lung cancer, New York: Springer-Verlag, 2002:57-79.
• 12- Rosai J. Achermans surgical pathology, 8. Baskı, St. Lois, Mosloy-Year Book, 1996:969-1014.
• 13- Ockner RK. Gastrointestinal diseases.Wyngaarden JB, Smith LH, Bennett JC. Cecil textbook of medicine , 19. Baskı, New York, W.B. Saunders Company, 1992:620-752.
• 14- Gill GN. Endocrine and reproductive diseases.Wyngaarden JB, Smith LH, Bennett JC. Cecil textbook of medicine, 19.Baskı, New York, W.B. Saunders Company, 1992:1194- 1397.
• 15- Giordano TJ, Shedden KA, Schwartz RR, Kuick R, Taylor JMG, Lee N, Misek DE, Greenson JK, Kardia SLR, Beer DG, Rennert G, Cho KR, Gruber SB, Fearon ER, Hanash S. Organ-Specific Molecular Classification of Primary Lung, Colon, and Ovarian Adenocarcinomas Using Gene Expression Profiles. American Journal of Pathology,2001;159( 4): 1231-1238.
• 16-Fujita J, Ohtsuki Y, Bandoh S, Ueda Y, Kubo A, Tojo Y, Yamaji Y, Ishida T.Expression of thyroid transcription factor-1 in 16 human lung cancer cell lines. Lung Cancer 2003 Jan;39 (3): 1-6.
• 17-Stenhouse G, Fyfe N, King G, Chapman A, Kerr KM. Thyroid transcription factor 1 in pulmonary adenocarcinoma. J ClinPathol.2004 ;57(4):383-7.
• 18-Bejarano PA, Mousavi P. Incidence and Significance of Cytoplasmic Thyroid Transcription Factor-1 Immunoreactivity. Arch pathol lab med 2003 vol 127:193-95.
• 19-Hecht JL, Pinkus JL, Weinstein LJ, Pinkus GS.The value of thyroid transcription factor-1 in cytologic preparations as a marker for metastatic adenocarcinoma of lung origin.Am J ClinPathol 2001; 1 16:483/8.
• 20-Harlamert HA, Mira J, Bejarano PA, Baughman RP, Miller MA, Whitsett JA, Yassin R. Thyroid transcription factor-1 and cytokeratins 7 and 20 in pulmonary and breast carcinoma. ActaCytol 1998;42(6): 1382-8.
• 21-Ng WK, Chow JC, Ng PK. Thyroid transcription factor-1 is highly sensitive and specific in differentiating metastatic pulmonary from extrapulmonary adenocarcinoma in effusion fluid cytology specimens. Cancer, 2002;96(l):43-8.
• 22-MyongNH. Thyroid Transcription Factor-1 (TTF-1) Expression in Human Lung Carcinomas: Its Prognostic Implication and Relationship with Expressions of p53 and Ki-67 Proteins.JKoreanMedSci2003;18:494-500.