Utility of thyroid transcription factor-1 expression in the differential diagnosis of metastatic adenocarcinoma of serous effusion specimens prepared using the cell transfer technique.
OBJECTIVE
Pulmonary adenocarcinoma is a common malignancy of the pleural cavity. The cell transfer technique can be used to create multiple slides from a single smear. The goal of this study was to investigate the pulmonary origin of metastatic adenocarcinoma by evaluating the immunocytochemical reactivity to thyroid transcription factor-1 (TTF-1) of slides of serous effusion specimens prepared by the cell transfer technique.


METHODS
In 2001, a total of 76 archived serous effusion specimens containing adenocarcinoma from patients were used in this study. The primary site of metastatic adenocarcinoma was determined by a review of the medical records. The cell transfer technique was used to create multiple slides from a single Papanicolaou-stained smear. If more than 10% of the target cells reacted with perceptible intensity, nuclear staining was considered to indicate a positive TTF-1 result.


RESULTS
Positive rates of TTF-1 for body fluids collected from patients with lung, stomach, ovarian, breast, colorectal and liver carcinomas were 41/50, 0/11, 0/6, 0/5, 0/2 and 0/1, respectively. Lung adenocarcinoma showed TTF-1 positivity in 82% of specimens, and all other adenocarcinomas had negative TTF-1 staining results.


CONCLUSIONS
This study demonstrated that TTF-1 immunostaining in serous effusion specimens prepared using the cell transfer technique is a sensitive and highly specific marker for metastatic lung adenocarcinoma.
Jan
I-Shiow
IS
Department of Laboratory Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan.
Chung
Ping-Fung
PF
Weng
Ming-Hsiang
MH
Huang
Min-Se
MS
Lee
Ya-Ting
YT
Kuo
Sow-Hsong
SH
D000230:Adenocarcinoma / Q000276:immunology* / Q000473:pathology / Q000556:secondary*; D000906:Antibodies; D014408:Biomarkers, Tumor / Q000032:analysis* / Q000276:immunology; D003581:Cytodiagnosis; D003937:Diagnosis, Differential; D016591:Histocytological Preparation Techniques / Q000379:methods*; D006801:Humans; D007150:Immunohistochemistry; D008175:Lung Neoplasms / Q000276:immunology* / Q000473:pathology*; D009687:Nuclear Proteins / Q000032:analysis* / Q000276:immunology; D016066:Pleural Effusion, Malignant / Q000378:metabolism*; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D000074482:Thyroid Nuclear Factor 1; D014157:Transcription Factors / Q000032:analysis* / Q000276:immunology
D000906:Antibodies; D014408:Biomarkers, Tumor; C000614412:NKX2-1 protein, human; D009687:Nuclear Proteins; D000074482:Thyroid Nuclear Factor 1; D014157:Transcription Factors