title: Value of thyroid transcription factor (TTF)-1 for diagnosis and prognosis of patients with locally advanced or metastatic small cell lung cancer.
abstract: BACKGROUND
  The aim of this study was to analyze the frequency of Thyroid Transcription Factor (TTF)-1 expression in small cell lung cancer (SCLC) and its value for the diagnosis of SCLC, the response to first line treatment as well as the prognostic impact on overall survival (OS).
  
  
  METHODS
  We analyzed a total of 294 patients (m, n = 184; f, n = 110) with SCLC (stage IIIA, n = 32; IIIB, n = 87; IV, n = 175) diagnosed in our institution between January 2005 and December 2008. Patient's characteristics comprising age, gender, histology and first line treatment were included into the analyses. For the follow-up of patients the governmental death registrar was used. The TTF-1 immunostaining was prospectively performed. CT scans of all patients were reviewed and response to treatment was evaluated using the Response Evaluation Criteria In Solid Tumors 1.0 (RECIST) criteria.
  
  
  RESULTS
  A total of 221 of the 294 patients were eligible for analysis. Patients with TTF-1-positive SCLC had a median OS of 374 (95% CI 306-442) days. The OS of patients with TTF1-negative SCLC was 290 (95% CI 191-389) days, which was not significantly shorter (p = 0.254). Also stratification for tumor stage did not reveal significant difference in OS. Analyzing the disease control rate (DCR) in patients with metastatic disease (stage IV), we observed a significantly (p = 0.006) improved response to treatment in the group of patients with TTF-1-expression (DCR 86% vs. 56%). Regarding the overall response rates (ORR) in the entire population, there was no difference observed between both subgroups. (TTF-1-pos. 75.3% vs. TTF-1-neg. 71.4%; p = 0.642).
  
  
  CONCLUSIONS
  The diagnostic information of TTF-1 in SCLC seems to be limited. TTF-1 had no prognostic value concerning OS, but may serve as a predictor for response to first line chemotherapy.
  The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/5811254651472285.
authors.affiliation: Department of Pneumology, Lungenklinik Heckeshorn, HELIOS Klinik Emil von Behring, Walterhöferstr. 11, 14165, Berlin, Germany. daniel.misch@helios-kliniken.de.
authors.forename: Daniel
authors.initials: D
authors.lastname: Misch
authors.affiliation: Department of Pneumology, Lungenklinik Heckeshorn, HELIOS Klinik Emil von Behring, Walterhöferstr. 11, 14165, Berlin, Germany. torsten-gerriet.blum@helios-kliniken.de.
authors.forename: Torsten
authors.initials: T
authors.lastname: Blum
authors.affiliation: Department of Pneumology, Lungenklinik Heckeshorn, HELIOS Klinik Emil von Behring, Walterhöferstr. 11, 14165, Berlin, Germany. christian.boch@helios-kliniken.de.
authors.forename: Christian
authors.initials: C
authors.lastname: Boch
authors.affiliation: Department of Pneumology, Lungenklinik Heckeshorn, HELIOS Klinik Emil von Behring, Walterhöferstr. 11, 14165, Berlin, Germany. timo.weiss@helios-kliniken.de.
authors.forename: Timo
authors.initials: T
authors.lastname: Weiss
authors.affiliation: Department of Pneumology, Lungenklinik Heckeshorn, HELIOS Klinik Emil von Behring, Walterhöferstr. 11, 14165, Berlin, Germany. catharina.crolow@helios-kliniken.de.
authors.forename: Catharina
authors.initials: C
authors.lastname: Crolow
authors.affiliation: Institute of Pathology, HELIOS Klinikum Emil von Behring, Berlin, Germany. sergej.griff@helios-kliniken.de.
authors.forename: Sergej
authors.initials: S
authors.lastname: Griff
authors.affiliation: Institute of Pathology, HELIOS Klinikum Emil von Behring, Berlin, Germany. thomas.mairinger@helios-kliniken.de.
authors.forename: Thomas
authors.initials: T
authors.lastname: Mairinger
authors.affiliation: Department of Pneumology, Lungenklinik Heckeshorn, HELIOS Klinik Emil von Behring, Walterhöferstr. 11, 14165, Berlin, Germany. torsten.bauer@helios-kliniken.de.
authors.forename: Torsten T
authors.initials: TT
authors.lastname: Bauer
authors.affiliation: Department of Pneumology, Lungenklinik Heckeshorn, HELIOS Klinik Emil von Behring, Walterhöferstr. 11, 14165, Berlin, Germany. jens.kollmeier@helios-kliniken.de.
authors.forename: Jens
authors.initials: J
authors.lastname: Kollmeier
mesh_terms: D000368:Aged; D014408:Biomarkers, Tumor / Q000032:analysis*; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D053208:Kaplan-Meier Estimate; D008175:Lung Neoplasms / Q000737:chemistry* / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009687:Nuclear Proteins / Q000032:analysis*; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D055752:Small Cell Lung Carcinoma / Q000737:chemistry* / Q000401:mortality / Q000556:secondary* / Q000628:therapy; D000074482:Thyroid Nuclear Factor 1; D013997:Time Factors; D014157:Transcription Factors / Q000032:analysis*; D016896:Treatment Outcome
chemical_list: D014408:Biomarkers, Tumor; C000614412:NKX2-1 protein, human; D009687:Nuclear Proteins; D000074482:Thyroid Nuclear Factor 1; D014157:Transcription Factors