title: The Utility of Thyroid Transcription Factor 1 (TTF-1), Napsin A, Excision Repair Cross-Complementing 1 (ERCC1), Anaplastic Lymphoma Kinase (ALK) and the Epidermal Growth Factor Receptor (EGFR) Expression in Small Biopsy in Prognosis of Patients with Lung Adenocarcinoma - A Retrograde Single-Center Study from Croatia.
abstract: BACKGROUND The present study was carried out in order to evaluate our institutional experience with small biopsy in diagnosis and molecular testing of lung adenocarcinoma. Few specific and predictive markers have been evaluated and correlated with clinicopathologic characteristics and survival in patients with lung adenocarcinoma who received platinum-based chemotherapy. There have not been such reports from Croatia. MATERIAL AND METHODS A total of 142 cases of lung adenocarcinoma were retrospectively investigated in small biopsies for the immunohistochemical expression of TTF-1, napsin A, ERCC1, ALK, and the EGFR mutation by real-time polymerase chain reaction (rtPCR). RESULTS TTF-1, napsin A, and ERCC1 expression was found in 81%, 78%, and 69% of patients, respectively, and the expressions were not significantly associated with subtype. Expression of ALK was found in 4% and EGFR mutation in 10% of patients. Exon 19 deletions were the most common. Longer survival was significantly associated with TTF-1 positivity (p=0.007) and napsin A positivity (p=0.026). Higher relative risk of death significantly correlated with positive expression of ERCC1 (p=0.041). CONCLUSIONS Positive TTF-1 and napsin A expressions in lung adenocarcinoma tissues were useful diagnostic and favorable prognostic parameters. Positive ERCC1 expression was identified as a negative prognostic marker in patients treated with platinum-based chemotherapy. The percentages of EGFR and ALK mutations corresponded to those in previously published reports for Caucasians.
authors.affiliation: Department of Pathology, Forensic Medicine and Cytology, Clinical Hospital Center Split, Split, Croatia.
authors.forename: Marina
authors.initials: M
authors.lastname: Piljić Burazer
authors.affiliation: Department of Pulmonology, Clinical Hospital Center Split, Split, Croatia.
authors.forename: Suzana
authors.initials: S
authors.lastname: Mladinov
authors.affiliation: Department of Nuclear Medicine, Clinical Hospital Center Split, Split, Croatia.
authors.forename: Vesna
authors.initials: V
authors.lastname: Ćapkun
authors.affiliation: Department of Pathology, Forensic Medicine and Cytology, Clinical Hospital Center Split, Split, Croatia.
authors.forename: Sendi
authors.initials: S
authors.lastname: Kuret
authors.affiliation: Department of Pathology, Forensic Medicine and Cytology, Clinical Hospital Center Split, Split, Croatia.
authors.forename: Merica
authors.initials: M
authors.lastname: Glavina Durdov
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis* / Q000235:genetics / Q000378:metabolism / Q000473:pathology; D000077192:Adenocarcinoma of Lung; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000077548:Anaplastic Lymphoma Kinase; D016282:Aspartic Acid Endopeptidases / Q000096:biosynthesis* / Q000235:genetics / Q000378:metabolism; D014408:Biomarkers, Tumor / Q000096:biosynthesis / Q000235:genetics / Q000378:metabolism; D001706:Biopsy / Q000379:methods; D017523:Croatia; D004268:DNA-Binding Proteins / Q000096:biosynthesis* / Q000235:genetics / Q000378:metabolism; D004720:Endonucleases / Q000096:biosynthesis* / Q000235:genetics / Q000378:metabolism; D066246:ErbB Receptors / Q000096:biosynthesis* / Q000235:genetics / Q000378:metabolism; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000235:genetics / Q000378:metabolism / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009154:Mutation; D011379:Prognosis; D020794:Receptor Protein-Tyrosine Kinases / Q000096:biosynthesis* / Q000235:genetics / Q000378:metabolism; D012189:Retrospective Studies; D015996:Survival Rate; D014157:Transcription Factors
chemical_list: D014408:Biomarkers, Tumor; D004268:DNA-Binding Proteins; C504003:TTF1 protein, human; D014157:Transcription Factors; C000626173:ALK protein, human; D000077548:Anaplastic Lymphoma Kinase; C512478:EGFR protein, human; D066246:ErbB Receptors; D020794:Receptor Protein-Tyrosine Kinases; C071447:ERCC1 protein, human; D004720:Endonucleases; D016282:Aspartic Acid Endopeptidases; C498549:NAPSA protein, human