Expression of thyroid transcription factor-1 in malignant pleural effusions

Our plain-English summary of Expression of thyroid transcription factor-1 in malignant pleural effusions, by A. Khoor, A.L. Byrd-Gloster, S.V. Nicosia (Pathology Oncology Research, 2011).

The study

• Authors: A. Khoor, A.L. Byrd-Gloster, S.V. Nicosia
• Journal: Pathology Oncology Research
• Published: 2011;17(2):263-7
• Cited by: 9 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Separating adenocarcinoma of the lung from non-pulmonary adenocarcinoma or malignant mesothelioma is difficult, especially in cytology specimens. Consequently, it is important to identify markers that may facilitate this distinction. Thyroid transcription factor-1 (TTF-1) is a homeodomain containing transcription factor expressed selectively in the thyroid, lung, and diencephalon. TTF-1 is also expressed in adenocarcinomas of the lung and is widely used as a pulmonary adenocarcinoma marker in surgical specimens. However, the utility of TTF-1 has rarely been investigated in cytology. In this study, we evaluated the expression of TTF-1 in malignant pleural effusions. The primary tumors included 26 pulmonary adenocarcinomas, 26 non-pulmonary adenocarcinomas (13 breast, 5 ovarian, 2 gastric, 2 prostatic, 1 esophageal, 1 colonic, 1 pancreatic and 1 renal) and 4 malignant mesotheliomas. Immunocytochemistry was performed on sections of cell blocks, using a mouse monoclonal TTF-1 antibody (clone 8G7G3/1) and a biotin-streptavidin detection system. Nuclear immunoreactivity for TTF-1 was detected in 19 pulmonary adenocarcinomas. All non-pulmonary adenocarcinomas and malignant mesotheliomas were negative. These data indicate that TTF-1 maintains its sensitivity (73%) and specificity (100%) in cell block preparations and is useful in separating adenocarcinoma of the lung from non-pulmonary adenocarcinoma and malignant mesothelioma in cytology specimens.

In plain English

This laboratory study asked whether a protein marker called thyroid transcription factor-1 (TTF-1) can help tell lung adenocarcinoma apart from other cancers in fluid that collects around the lungs because of cancer (malignant pleural effusions). The authors searched three consecutive years of cytopathology files at the H. Lee Moffitt Cancer Center in Florida. They selected 56 cases with known primary sites: 26 adenocarcinomas from the lung, 26 adenocarcinomas from other organs (13 breast, 5 ovarian, 2 gastric, 2 prostatic, and one each esophageal, colonic, pancreatic and renal) and 4 malignant mesotheliomas. Cell samples were stained with a TTF-1 antibody, and two pathologists scored the staining. A combined score of 3 or more counted as positive. TTF-1 was detected in 19 of the 26 lung adenocarcinomas (73%). None of the 26 non-lung adenocarcinomas and none of the 4 malignant mesotheliomas stained. The authors reported a sensitivity of 73% and a specificity of 100%. They concluded that the data validate TTF-1 as a lung adenocarcinoma marker in cell block preparations. The study did not examine asbestos exposure.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Retrospective diagnostic laboratory study (immunocytochemistry) of archived cytology cases
• Who was studied: 56 cases of malignant pleural effusion with known primary sites and available cell blocks, from the H. Lee Moffitt Cancer Center and Research Institute at the University of South Florida. There were 52 metastatic adenocarcinomas (26 lung; 13 breast, 5 ovarian, 2 gastric, 2 prostatic, 1 esophageal, 1 colonic, 1 pancreatic, 1 renal) and 4 malignant mesotheliomas. 21 patients were male and 35 were female. Calendar years are not stated.
• Main results:
  • TTF-1 staining in the cell nucleus was detected in 19 (73%) of the 26 metastatic lung (pulmonary) adenocarcinomas.
  • None of the 26 non-pulmonary adenocarcinomas and none of the 4 malignant mesotheliomas showed any staining.
  • Sensitivity of TTF-1 for lung adenocarcinoma was 73% and specificity was 100% in these cell block preparations.
• The authors' conclusion: The authors concluded that the data validate the use of TTF-1 as a marker for lung (pulmonary) adenocarcinoma in cell block preparations.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Lung cancer.

Medical terms in this study, explained in our Lexicon: Thyroid Transcription Factor-1 (TTF-1), Pleural Effusion, Adenocarcinoma, Malignant Mesothelioma, Cytology, Cell Block, Monoclonal.

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