Evaluating the utility of trefoil factor 1 as a mammary-specific immunostain compared and in conjunction with GATA-3 and mammaglobin in the distinction between carcinoma of breast and lung.
OBJECTIVE
The distinction between metastatic breast carcinomas (BCs) and primary lung carcinomas (PLCs) can be difficult. This study tested the utility of trefoil factor 1 (TFF1) for this purpose and compared it with mammaglobin and GATA protein binding 3 (GATA-3).


METHODS
Tissue microarrays containing 365 BCs and 338 PLCs were stained with TFF1, mammaglobin, and GATA-3, and an H-score was calculated. Sensitivity, specificity, and accuracy were calculated, and logistical regression analysis was performed.


RESULTS
Accuracy of correctly classifying the tumor type was 81.9%, 71.3%, and 64.0% for GATA-3, mammaglobin, and TFF1, respectively. Odds ratios for selecting BCs were 25.69, 93.15, and 4.17, respectively, with P values less than .001. With a single exception, the best immunopanel included GATA-3 and mammaglobin in all comparisons.


CONCLUSIONS
TFF1 demonstrated breast specificity but was inferior to mammaglobin and GATA-3. Therefore, its routine clinical use may not be justified. TFF1 showed little benefit when added to an immunopanel.
From the Departments of Pathology and Laboratory Medicine and.
Justin M
JM
Wells
From the Departments of Pathology and Laboratory Medicine and.
Paula S
PS
Ginter
From the Departments of Pathology and Laboratory Medicine and.
Yifang
Y
Liu
Healthcare Policy and Research, Weill Cornell Medical College, New York, NY.
Zhengming
Z
Chen
From the Departments of Pathology and Laboratory Medicine and.
Navneet
N
Narula
From the Departments of Pathology and Laboratory Medicine and sjshin@med.cornell.edu.
Sandra J
SJ
Shin
D014408:Biomarkers, Tumor / Q000032:analysis; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000378:metabolism; D002277:Carcinoma / Q000175:diagnosis; D003937:Diagnosis, Differential; D005260:Female; D050990:GATA3 Transcription Factor / Q000378:metabolism*; D006801:Humans; D007150:Immunohistochemistry; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000473:pathology; D060785:Mammaglobin A / Q000378:metabolism*; D012680:Sensitivity and Specificity; D000071163:Trefoil Factor-1; D025521:Tumor Suppressor Proteins / Q000378:metabolism*
D014408:Biomarkers, Tumor; D050990:GATA3 Transcription Factor; D060785:Mammaglobin A; C051838:TFF1 protein, human; D000071163:Trefoil Factor-1; D025521:Tumor Suppressor Proteins
Breast; Carcinoma; GATA-3; Immunohistochemistry; Lung; Mammaglobin; Metastatic; Trefoil factor 1