title: Expression of thyroid transcription factor-1 in brain metastases: a useful indicator of pulmonary origin.
abstract: Determining the primary site of a brain metastasis can be difficult, particularly if there is no organ-specific tumor histology. Thyroid transcription factor-1 (TTF-1) is a marker commonly expressed in lung and thyroid carcinomas. We studied the value of TTF-1 staining to identify brain metastases from a lung primary. Forty-three consecutive patients metastatic carcinomas of the brain were reviewed from a 4 year period. Twenty-one (75%) of the 28 metastatic pulmonary carcinomas were TTF-1 positive (+), whereas only one metastatic papillary thyroid carcinoma (7%) out of 15 metastatic non-pulmonary carcinomas was TTF-1 (+). We also studied the cytokeratin profile of these tumors. However, cytokeratin profile, either alone or combined with TTF-1 staining, was not better than TTF-1 staining alone in identifying brain metastases of pulmonary origin. Overall, TTF-1 positivity is a useful indicator of pulmonary origin in brain metastases, with a very high positive predictive value (95%) and a moderate negative predictive value (67%).
authors.affiliation: Department of Pathology, Chang Gung Memorial Hospital and Chang Gung Children's Hospital, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
authors.forename: Wen-Yu
authors.initials: WY
authors.lastname: Chuang
authors.forename: Chi-Ju
authors.initials: CJ
authors.lastname: Yeh
authors.forename: Pao-Hsien
authors.initials: PH
authors.lastname: Chu
authors.forename: Cheng-Chih
authors.initials: CC
authors.lastname: Liao
authors.forename: Chieh-Tsai
authors.initials: CT
authors.lastname: Wu
authors.forename: Chi-Cheng
authors.initials: CC
authors.lastname: Chuang
authors.forename: Ping-Ching
authors.initials: PC
authors.lastname: Pai
authors.forename: Chen-Kan
authors.initials: CK
authors.lastname: Tseng
authors.forename: Shih-Ming
authors.initials: SM
authors.lastname: Jung
authors.forename: Kuo-Chen
authors.initials: KC
authors.lastname: Wei
authors.forename: Chen-Nen
authors.initials: CN
authors.lastname: Chang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001932:Brain Neoplasms / Q000378:metabolism* / Q000556:secondary*; D002277:Carcinoma / Q000378:metabolism* / Q000556:secondary*; D016207:Cytokines / Q000378:metabolism; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009687:Nuclear Proteins / Q000235:genetics / Q000378:metabolism*; D000074482:Thyroid Nuclear Factor 1; D014157:Transcription Factors / Q000235:genetics / Q000378:metabolism*
chemical_list: D016207:Cytokines; C000614412:NKX2-1 protein, human; D009687:Nuclear Proteins; D000074482:Thyroid Nuclear Factor 1; D014157:Transcription Factors