Science and Research

TTF-1 is a highly sensitive but not fully specific marker for pulmonary and thyroidal cancer: a tissue microarray study evaluating more than 17,000 tumors from 152 different tumor entities

Thyroid transcription factor 1 (TTF-1) immunohistochemistry (IHC) is routinely used for the distinction of primary pulmonary adenocarcinomas. However, TTF-1 can also occur in other malignancies. A tissue microarray containing 17,772 samples from 152 different tumor types was analyzed. Napsin-A, CK20, SATB2, FABP1, and Villin-1 IHC data were available from previous studies. TTF-1 staining was seen in 82 of 152 tumor categories including thyroidal cancers (19-100%), adenocarcinomas (94%), neuroendocrine tumors (67%) of the lung, small cell neuroendocrine carcinomas (71-80%), mesenchymal tumors (up to 42%), and thymomas (39%). Comparative analysis of TTF-1 and Napsin-A revealed a sensitivity/specificity of 94%/86% (TTF-1), 87%/98% (Napsin-A), and 85%/99.1% (TTF-1 and Napsin-A) for the distinction of pulmonary adenocarcinomas. Combined analysis of TTF-1 and enteric markers revealed a positivity for TTF-1 and at least one enteric marker in 22% of pulmonary adenocarcinomas but also a TTF-1 positivity in 6% of colorectal, 2% of pancreatic, and 3% of gastric adenocarcinomas. TTF-1 is a marker of high sensitivity but insufficient specificity for pulmonary adenocarcinomas. A small fraction of TTF-1-positive gastrointestinal adenocarcinomas represents a pitfall mimicking enteric-type pulmonary adenocarcinoma. Combined analysis of TTF-1 and Napsin-A improves the specificity of pulmonary adenocarcinoma diagnosis.

  • Möller, K.
  • Gulzar, T.
  • Lennartz, M.
  • Viehweger, F.
  • Kluth, M.
  • Hube-Magg, C.
  • Bernreuther, C.
  • Bawahab, A. A.
  • Simon, R.
  • Clauditz, T. S.
  • Sauter, G.
  • Schlichter, R.
  • Hinsch, A.
  • Kind, S.
  • Jacobsen, F.
  • Burandt, E.
  • Frost, N.
  • Reck, M.
  • Marx, A. H.
  • Krech, T.
  • Lebok, P.
  • Fraune, C.
  • Steurer, S.

Keywords

  • Diagnosis
  • Immunohistochemistry
  • Pulmonary adenocarcinomas
  • Ttf-1
  • Tissue microarray
Publication details
DOI: 10.1007/s00428-024-03926-1
Journal: Virchows Arch
Work Type: Original
Location: Assoziierter Partner, ARCN
Disease Area: LC
Partner / Member: BIH, Ghd
Access-Number: 39377914

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