Thyroid transcription factor-1 is the superior immunohistochemical marker for pulmonary adenocarcinomas and large cell carcinomas compared to surfactant proteins A and B.
OBJECTIVE
Antibodies against the thyroid transcription factor-1 (TTF-1) and the surfactant proteins A and B (SPA, SPB) were compared as paraffin-reactive immunohistochemical markers for non-small cell carcinomas of pulmonary origin.


RESULTS
We studied 138 carcinomas of pulmonary origin (98 adenocarcinomas, 20 non-neuroendocrine large cell carcinomas, 20 squamous cell carcinomas) and a total of 276 extrapulmonary carcinomas of various primary origins. Using the monoclonal antibody 8G7G3/1, TTF-1 was detectable in 75% of non-mucinous pulmonary adenocarcinomas and in 40% of large cell carcinomas but in only 10% of mucinous adenocarcinomas and not in squamous cell carcinomas. In contrast, both SPA and SPB were positive in only 45% of pulmonary adenocarcinomas and in 10% and in 5% of the large cell carcinomas, respectively. TTF-1 had a specificity of 0.98 for pulmonary carcinomas as 5/7 thyroid carcinomas were the only TTF-1-positive extrapulmonary tumours. Anti-SPB and anti-SPA had specificities of 1. 00 and 0.97, respectively.


CONCLUSIONS
The monoclonal antibody 8G7G3/1 against TTF-1 should be the first choice as a component of an antibody panel aiming to prove or to exclude the pulmonary origin of non-mucinous adenocarcinomas and non-neuroendocrine poorly differentiated carcinomas, especially in patients presenting with metastatic carcinomas of unknown primary site.
Kaufmann
O
O
Institute of Pathology, Charité Hospital, Berlin, Germany. olaf.kaufmann@charite.de
Dietel
M
M
D000230:Adenocarcinoma / Q000737:chemistry* / Q000473:pathology; D000911:Antibodies, Monoclonal; D014408:Biomarkers, Tumor / Q000032:analysis*; D018287:Carcinoma, Large Cell / Q000737:chemistry* / Q000473:pathology; D002294:Carcinoma, Squamous Cell / Q000737:chemistry / Q000473:pathology; D005069:Evaluation Studies as Topic; D005260:Female; D018398:Homeodomain Proteins / Q000032:analysis*; D006801:Humans; D007124:Immunoenzyme Techniques; D008175:Lung Neoplasms / Q000737:chemistry* / Q000473:pathology; D008297:Male; D009687:Nuclear Proteins / Q000032:analysis*; D011510:Proteolipids / Q000032:analysis*; D037661:Pulmonary Surfactant-Associated Proteins; D011663:Pulmonary Surfactants / Q000032:analysis*; D012680:Sensitivity and Specificity; D000074482:Thyroid Nuclear Factor 1; D014157:Transcription Factors / Q000032:analysis*
D000911:Antibodies, Monoclonal; D014408:Biomarkers, Tumor; D018398:Homeodomain Proteins; C000614412:NKX2-1 protein, human; D009687:Nuclear Proteins; D011510:Proteolipids; D037661:Pulmonary Surfactant-Associated Proteins; D011663:Pulmonary Surfactants; D000074482:Thyroid Nuclear Factor 1; D014157:Transcription Factors