TTF-1 is a highly sensitive but not fully specific marker for pulmonary and thyroidal cancer: a tissue microarray study evaluating more than 17,000 tumors from 152 different tumor entities
Thyroid transcription factor 1 (TTF-1) immunohistochemistry (IHC) is routinely used for the distinction of primary pulmonary adenocarcinomas. However, TTF-1 can also occur in other malignancies. A tissue microarray containing 17,772 samples from 152 different tumor types was analyzed. Napsin-A, CK20, SATB2, FABP1, and Villin-1 IHC data were available from previous studies. TTF-1 staining was seen in 82 of 152 tumor categories including thyroidal cancers (19-100%), adenocarcinomas (94%), neuroendocrine tumors (67%) of the lung, small cell neuroendocrine carcinomas (71-80%), mesenchymal tumors (up to 42%), and thymomas (39%). Comparative analysis of TTF-1 and Napsin-A revealed a sensitivity/specificity of 94%/86% (TTF-1), 87%/98% (Napsin-A), and 85%/99.1% (TTF-1 and Napsin-A) for the distinction of pulmonary adenocarcinomas. Combined analysis of TTF-1 and enteric markers revealed a positivity for TTF-1 and at least one enteric marker in 22% of pulmonary adenocarcinomas but also a TTF-1 positivity in 6% of colorectal, 2% of pancreatic, and 3% of gastric adenocarcinomas. TTF-1 is a marker of high sensitivity but insufficient specificity for pulmonary adenocarcinomas. A small fraction of TTF-1-positive gastrointestinal adenocarcinomas represents a pitfall mimicking enteric-type pulmonary adenocarcinoma. Combined analysis of TTF-1 and Napsin-A improves the specificity of pulmonary adenocarcinoma diagnosis.
Authors
- Katharina Möller (ORCID: https://orcid.org/0000-0002-9739-4274)
- Maximilian Lennartz (ORCID: https://orcid.org/0000-0002-1572-8200)
- Guido Sauter (ORCID: https://orcid.org/0000-0002-9024-4978)
- Nikolaj Frost (ORCID: https://orcid.org/0000-0001-7452-7129)
- Eike Burandt (ORCID: https://orcid.org/0000-0002-5705-9084)
- Andreas Marx (ORCID: https://orcid.org/0000-0002-6471-3689)
- Stefan Steurer (ORCID: https://orcid.org/0000-0002-7199-3615)
- Christoph Fraune (ORCID: https://orcid.org/0000-0002-0833-9549)
- Till Krech
- Martin Reck (ORCID: https://orcid.org/0000-0002-5336-9739)
- Claudia Hube‐Magg (ORCID: https://orcid.org/0000-0001-7542-4340)
- Simon Kind
- Patrick Lebok (ORCID: https://orcid.org/0000-0003-3652-532X)
- Frank Jacobsen (ORCID: https://orcid.org/0009-0009-8047-580X)
- Florian Viehweger
- Till Sebastian Clauditz (ORCID: https://orcid.org/0000-0002-4257-856X)
- Ahmed Abdulwahab Bawahab (ORCID: https://orcid.org/0000-0002-3657-9291)
- Christian Bernreuther (ORCID: https://orcid.org/0000-0003-3939-322X)
- Ronald Simon (ORCID: https://orcid.org/0000-0003-0158-4258)
- Andrea Hinsch (ORCID: https://orcid.org/0000-0001-5868-1185)
- Martina Kluth (ORCID: https://orcid.org/0000-0003-4782-4616)
- Tayyaba Gulzar
- Ria Schlichter
Institutions
- Universität Hamburg (DE)
- Osnabrück University (DE)
- Humboldt-Universität zu Berlin (DE)
- University of Jeddah (SA)
- University Medical Center Hamburg-Eppendorf (DE)
- LungenClinic Grosshansdorf (DE)
- Klinikum Fulda (DE)
- Freie Universität Berlin (DE)
- Charité - Universitätsmedizin Berlin (DE)
Publication Details
- Journal
- Archiv für Pathologische Anatomie und Physiologie und für Klinische Medicin
- Published
- 2024-10-08
- DOI
- https://doi.org/10.1007/s00428-024-03926-1
- Citations
- 13
- Primary Topic
- Lung Cancer Treatments and Mutations
- Type
- article
- Field-Weighted Citation Impact
- 5.45