Use of thyroid transcription factor 1, PE-10, and cytokeratins 7 and 20 in discriminating between primary lung carcinomas and metastatic lesions in fine-needle aspiration biopsy specimens.
Abstract | BACKGROUND: METHODS: In the current study, the authors evaluated the utility of TTF-1 and PE-10 immunostaining and also compared the staining with expression of CK7 and CK20 in the discrimination between primary lung tumors and metastatic lesions in 55 specimens from fine-needle aspiration (FNA) biopsies of the lung. Formalin fixed, paraffin embedded cell blocks from 35 primary lung tumors (16 adenocarcinomas, 8 squamous cell carcinomas, 6 large cell undifferentiated carcinomas, and 5 small cell carcinomas) and 20 metastatic carcinomas (6 breast lesions, 6 colon lesions, 3 urinary bladder lesions, 2 kidney lesions, 1 biliary tract lesion, 1 endometrial lesion, and 1 thyroid lesion) were immunostained with monoclonal antibodies to TTF-1, PE-10, CK7, and CK 20. Positive immunostaining for CK7, CK20, and PE-10 was based on cytoplasmic staining, whereas TTF-1 positive staining was based on nuclear staining of the neoplastic cells. RESULTS: Positive immunostaining with TTF-1 and PE-10 was noted in six primary lung tumors (17%). One metastatic lesion (5%) and two metastatic lesions (10%) were positive for TTF-1 and PE-10, respectively. The CK7 positive/CK20 negative immunophenotype was noted in 30 primary lung tumors (86%) and in 11 metastatic lesions (55%). The CK7 negative/CK20 negative immunophenotype was seen in four metastatic lesions and in the remaining five primary lung tumors. The CK7 negative/CK20 positive and CK7 positive/CK20 positive immunophenotypes were seen in two and three metastatic lesions, respectively, but in none of the primary lung tumors. When a CK7 positive/CK20 negative adenocarcinoma also demonstrated either TTF-1 positive or PE-10 positive staining, it was likely that the adenocarcinoma was of pulmonary origin (P < 0.035; Fisher exact test). The specificity of such a combination for discriminating between primary and metastatic adenocarcinomas was 94%. CONCLUSIONS: The results suggest that TTF-1, PE-10, or CK7/CK20 alone did not distinguish reliably between primary pulmonary tumors carcinomas and metastatic neoplasms of the lung in FNA biopsy specimens because of low sensitivity and specificity. The use of a panel of antibodies that includes CK7/CK20, TTF-1, and PE-10 may be helpful in discriminating between primary and metastatic adenocarcinomas of the lung. An adenocarcinoma is likely a primary lung tumor when it is of the CK7 positive/CK20 negative phenotype and demonstrates either TTF-1 positive or PE-10 positive staining.
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Authors | D C Chhieng, J F Cangiarella, M F Zakowski, S Goswami, J M Cohen, H T Yee |
Journal | Cancer
(Cancer)
Vol. 93
Issue 5
Pg. 330-6
(Oct 25 2001)
ISSN: 0008-543X [Print] United States |
PMID | 11668468
(Publication Type: Evaluation Study, Journal Article)
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Copyright | Copyright 2001 American Cancer Society. |
Chemical References |
- Biomarkers, Tumor
- Intermediate Filament Proteins
- KRT20 protein, human
- KRT7 protein, human
- Keratin-20
- Keratin-7
- NKX2-1 protein, human
- Nuclear Proteins
- Pulmonary Surfactants
- Thyroid Nuclear Factor 1
- Transcription Factors
- Keratins
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Topics |
- Adenocarcinoma
(immunology, secondary)
- Biomarkers, Tumor
(analysis)
- Biopsy, Needle
- Carcinoma, Large Cell
(immunology, secondary)
- Carcinoma, Small Cell
(immunology, secondary)
- Carcinoma, Squamous Cell
(immunology, secondary)
- Humans
- Immunohistochemistry
(standards)
- Intermediate Filament Proteins
(analysis)
- Keratin-20
- Keratin-7
- Keratins
(analysis)
- Lung Neoplasms
(immunology, pathology)
- Neoplasm Metastasis
- Nuclear Proteins
(analysis)
- Predictive Value of Tests
- Pulmonary Surfactants
(analysis, immunology)
- Sensitivity and Specificity
- Thyroid Gland
- Thyroid Nuclear Factor 1
- Transcription Factors
(analysis)
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