Utility of thyroid transcription factor-1 and CDX-2 in determining the primary site of metastatic adenocarcinomas in serous effusions.
OBJECTIVE
To evaluate the usefulness of thyroid transcription factor-1 (TTF-1) and CDX-2 in determining the primary tumor site of metastatic adenocarcinomas (ACs) in serous effusions.


METHODS
Cell blocks were constructed from cells in metastatic AC effusion fluids (n = 97) that had been previously stained with a panel of antibodies against MOC-31, D2-40 and calretinin. Primary tumor sites included the lungs (n = 52), ovaries (n = 6), pancreas (n = 4), breasts (n = 3), bile duct (n = 2) and gastrointestinal (GI) tract (30), including stomach (n = 28) and colon (n = 2). Primary sites were determined by tissue confirmation of the original tumor or review of the clinical charts. Immunocytochemical staining was performed with antibodies against TTF-1 and CDX-2.


RESULTS
The lung ACs showed TTF-1 positivity in 58% (30/52) of cases. All nonpulmonary ACs lacked TTF-1 staining. Among the 30 GI ACs, 9 (30%) (7 from the stomach and 2 from the colon) showed CDX-2 positivity. All non-GI ACs lacked CDX-2 staining. Specificities and positive predictive values for TTF-1 and CDX-2 equaled 100% for metastatic pulmonary and GI ACs, respectively.


CONCLUSIONS
Our results suggested that TTF-1 and CDX-2 are specific markers to separate metastatic pulmonary and GI ACs, respectively, from other metastatic ACs in serous effusions. However, sensitivity values of these markers were low.
Kim
Jo-Heon
JH
Department of Pathology, Chonnam National University Medical School and Hospital, Gwangju, Republic of Korea.
Choi
Yoo Duk
YD
Lee
Ji Shin
JS
Lee
Jae Hyuk
JH
Nam
Jong Hee
JH
Choi
Chan
C
D000230:Adenocarcinoma / Q000378:metabolism* / Q000556:secondary; D001202:Ascitic Fluid / Q000378:metabolism / Q000473:pathology; D014408:Biomarkers, Tumor / Q000378:metabolism*; D000071616:CDX2 Transcription Factor; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000378:metabolism* / Q000556:secondary; D018398:Homeodomain Proteins / Q000378:metabolism*; D006801:Humans; D007124:Immunoenzyme Techniques; D008175:Lung Neoplasms / Q000378:metabolism* / Q000556:secondary; D009382:Neoplasms, Unknown Primary / Q000378:metabolism* / Q000473:pathology; D009687:Nuclear Proteins / Q000378:metabolism*; D016066:Pleural Effusion, Malignant / Q000378:metabolism / Q000473:pathology; D000074482:Thyroid Nuclear Factor 1; D014157:Transcription Factors / Q000378:metabolism*
D014408:Biomarkers, Tumor; D000071616:CDX2 Transcription Factor; C491270:CDX2 protein, human; D018398:Homeodomain Proteins; C000614412:NKX2-1 protein, human; D009687:Nuclear Proteins; D000074482:Thyroid Nuclear Factor 1; D014157:Transcription Factors