Journal of the Formosan Medical Association
Volume 105, Issue 9 , Pages 695-700, 2006

Utility of Thyroid Transcription Factor-1 Expression in the Differential Diagnosis of Metastatic Adenocarcinoma of Serous Effusion Specimens Prepared Using the Cell Transfer Technique

  • I-Shiow Jan

      Affiliations

    • Department of Laboratory Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan
  • ,
  • Ping-Fung Chung

      Affiliations

    • Department of Laboratory Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan
  • ,
  • Ming-Hsiang Weng

      Affiliations

    • Department of Laboratory Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan
  • ,
  • Min-Se Huang

      Affiliations

    • Department of Laboratory Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan
  • ,
  • Ya-Ting Lee

      Affiliations

    • Department of Laboratory Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan
  • ,
  • Sow-Hsong Kuo

      Affiliations

    • Department of Laboratory Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan
    • Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan
    • Corresponding Author InformationCorrespondence to: Dr Sow-Hsong Kuo, Department of Laboratory Medicine, National Taiwan University Hospital, 7 Chung-Shan South Road, Taipei 100, Taiwan

Received 4 November 2005; received in revised form 14 December 2005; accepted 7 February 2006.

Article Outline

Background/Purpose

Pulmonary adenocarcinoma is a common malignancy of the pleural cavity. The cell transfer technique can be used to create multiple slides from a single smear. The goal of this study was to investigate the pulmonary origin of metastatic adenocarcinoma by evaluating the immunocytochemi-cal reactivity to thyroid transcription factor-1 (TTF-1) of slides of serous effusion specimens prepared by the cell transfer technique.

Methods

In 2001, a total of 76 archived serous effusion specimens containing adenocarcinoma from patients were used in this study. The primary site of metastatic adenocarcinoma was determined by a review of the medical records. The cell transfer technique was used to create multiple slides from a single Papanicolaou-stained smear. If more than 10% of the target cells reacted with perceptible intensity, nuclear staining was considered to indicate a positive TTF-1 result.

Results

Positive rates of TTF-1 for body fluids collected from patients with lung, stomach, ovarian, breast, colorectal and liver carcinomas were 41/50, 0/11, 0/6, 0/5, 0/2 and 0/1, respectively. Lung adenocarci-noma showed TTF-1 positivity in 82% of specimens, and all other adenocarcinomas had negative TTF-1 staining results.

Conclusion

This study demonstrated that TTF-1 immunostaining in serous effusion specimens prepared using the cell transfer technique is a sensitive and highly specific marker for metastatic lung adenocarci-noma.

Key Words:  body fluid , cytology , immunocytochemistry , thyroid transcription factor-1

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References 

  1. Smith GP , Kjeldsberg CR . Cerebrospinal, synovial, and serous body fluids . In:  Henry JB editors. Clinical Diagnosis and Management by Laboratory Methods . 20th edition. Philadelphia: Saunders; 2001;p. 403–424
  2. DiBonito L , Falconieri G , Colautti I , et al.   The positive peritoneal effusion. A retrospective study of cytopathologic diagnoses with autopsy confirmation . Acta Cytol . 1993;37:483–488
  3. DiBonito L , Falconieri G , Colautti I , et al.   The positive pleural effusion. A retrospective study of cytopathologic diagnoses with autopsy confirmation . Acta Cytol . 1992;36:329–332
  4. Lazzaro D , Price M , de Felice M , et al.   The transcription factor TTF-1 is expressed at the onset of thyroid and lung morphogenesis and in restricted regions of the foetal brain . Development . 1991;113:1093–1104
  5. Bingle CD . Thyroid transcription factor-1 . Int J Biochem Cell Biol . 1997;29:1471–1473
  6. Kelly SE , Bachurski CJ , Burnhans MS , et al.   Transcription of the lung-specific surfactant protein C gene is mediated by thyroid transcription factor-1 . J Biol Chem . 1996;271:6881–6888
  7. Holzinger A , Dingle S , Bejarano PA , et al.   Monoclonal antibody to thyroid transcription factor-1: production, characterization, and usefulness in tumor diagnosis . Hybridoma . 1996;15:49–53
  8. Comperat E , Zhang F , Perrotin C , et al.   Variable sensitivity and specificity of TTF-1 antibodies in lung metastatic adenocarcinoma of colorectal origin . Mod Pathol . 2005;18:1371–1376
  9. Tan D , Li Q , Deeb G , et al.   Thyroid transcription factor-1 expression prevalence and its clinical implications in non-small cell lung cancer: a high-throughput tissue microarray and immunohistochemistry study . Hum Pathol . 2003;34:597–604
  10. Stenhouse G , Fyfe N , King G , et al.   Thyroid transcription factor 1 in pulmonary adenocarcinoma . J Clin Pathol . 2004;57:383–387
  11. Saad RS , Liu YL , Han H , et al.   Prognostic significance of thyroid transcription factor-1 expression in both early-stage conventional adenocarcinoma and bronchioloalveo-lar carcinoma of the lung . Hum Pathol . 2004;35:3–7
  12. Chang YL , Lee YC , Liao WY , et al.   The utility and limitation of thyroid transcription factor-1 protein in primary and metastatic pulmonary neoplasms . Lung Cancer . 2004;44:149–157
  13. Romeike BF , Feiden W . Diagnostic value of the monoclonal antibody to thyroid transcription factor-1 (TTF-1) in CNS metastases. An immunohistochemical study of 65 cases . Pathologe . 2002;23:292–296 [In German]
  14. Srodon M , Westra WH . Immunohistochemical staining for thyroid transcription factor-1: a helpful aid in discerning primary site of tumor origin in patients with brain metastases . Hum Pathol . 2002;33:642–645
  15. Bohinski RJ , Bejarano PA , Balko G , et al.   Determination of lung as the primary site of cerebral metastatic adenocarci-nomas using monoclonal antibody to thyroid transcription factor-1 . J Neurooncol . 1998;40:227–231
  16. Roh MS , Hong SH . Utility of thyroid transcription factor-1 and cytokeratin 20 in identifying the origin of metastatic carcinomas of cervical lymph nodes . J Korean Med Sci . 2002;17:512–517
  17. Gomez-Fernandez C , Jorda M , Delgado PI , et al.   Thyroid transcription factor 1: a marker for lung adenocarcinoma in body cavity fluids . Cancer . 2002;96:289–293
  18. Afify AM , al-Khafaji BM . Diagnostic utility of thyroid transcription factor-1 expression in adenocarcinomas presenting in serous fluids . Acta Cytol . 2002;46:675–678
  19. Ng WK , Chow JC , Ng PK . Thyroid transcription factor-1 is highly sensitive and specific in differentiating metastatic pulmonary from extrapulmonary adenocarcinoma in effusion fluid cytology specimens . Cancer . 2002;96:43–48
  20. Jang KY , Kang MJ , Lee DG , et al.   Utility of thyroid transcription factor-1 and cytokeratin 7 and 20 immunostaining in the identification of origin in malignant effusions . Anal Quant Cytol Histol . 2001;23:400–404
  21. Hecht JL , Pinkus JL , Weinstein LJ , et al.   The value of thyroid transcription factor-1 in cytologic preparations as a marker for metastatic adenocarcinoma of lung origin . Am J Clin Pathol . 2001;116:483–488
  22. Harlamert HA , Mira J , Bejarano PA , et al.   Thyroid transcription factor-1 and cytokeratins 7 and 20 in pulmonary and breast carcinoma . Acta Cytol . 1998;42:1382–1388
  23. Khoor A , Whitsett JA , Stahlman MT , et al.   Utility of surfactant protein B precursor and thyroid transcription factor 1 in differentiating adenocarcinoma of the lung from malignant mesothelioma . Hum Pathol . 1999;30:695–700
  24. Byrd-Gloster AL , Khoor A , Glass LF , et al.   Differential expression of thyroid transcription factor 1 in small cell lung carcinoma and Merkel cell tumor . Hum Pathol . 2000;31:58–62
  25. Cheuk W , Kwan MY , Suster S , et al.   Immunostaining for thyroid transcription factor 1 and cytokeratin 20 aids the distinction of small cell carcinoma from Merkel cell carcinoma, but not pulmonary from extrapulmonary small cell carcinomas . Arch Pathol Lab Med . 2001;125:228–231
  26. Liu J , Farhood A . Immunostaining for thyroid transcription factor-1 on fine-needle aspiration specimens of lung tumors-a comparison of direct smears and cell block preparations . Cancer . 2004;102:109–114
  27. Chhieng DC , Cangiarella JF , Zakowski MF , et al.   Use of thyroid transcription factor 1, PE-10, and cytokeratins 7 and 20 in discriminating between primary lung carcinomas and metastatic lesions in fine-needle aspiration biopsy specimens . Cancer . 2001;93:330–336
  28. Gong Y , Joseph T , Sneige N . Validation of commonly used immunostains on cell-transferred cytologic specimens . Cancer . 2005;105:158–164
  29. Brown GG , Tao LC . Restoration of broken cytology slides and creation of multiple slides from a single smear preparation . Acta Cytol . 1992;36:259–263
  30. Sherman ME , Jimenez-Joseph D , Gangi MD , et al.   Immunostaining of small cytologic specimens facilitation with cell transfer . Acta Cytol . 1994;38:18–22
  31. Hsu SM , Raine L , Fanger H . Use of avidin-biotin-peroxidase complex (ABC) in immunoperoxidase techniques: a comparison between ABC and unlabeled antibody (PAP) procedures . J Histochem Cytochem . 1981;29:577–580
  32. Elston RC , Johnson WD . In: Essentials of Biostatistics . 2nd edition. Philadelphia: Davis; 1994;p. 34–63

PII: S0929-6646(09)60196-0

doi:10.1016/S0929-6646(09)60196-0

Journal of the Formosan Medical Association
Volume 105, Issue 9 , Pages 695-700, 2006