Napsin A and thyroid transcription factor-1 expression in carcinomas of the lung, breast, pancreas, colon, kidney, thyroid, and malignant mesothelioma

Bishop, Justin A.; Sharma, Rajni; Illei, Peter B.

doi:10.1016/j.humpath.2009.06.014

Cited by 302 publications

(302 citation statements)

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“…Intense staining in the cytoplasm was observed in clear cell adenocarcinoma tumor cells (Figures 1a and b) but not in a typical serous adenocarcinoma (Figures 1c and d). Positive (16,20) staining was also observed in the cytoplasm of clear cell adenofibroma (Figures 1e and f). However, five cases (three serous adenocarcinoma and two endometrioid adenocarcinoma) contained clear cell-or hob-nail-like change resembling clear cell adenocarcinoma (Figure 2a), and focal immunostaining of napsin A was observed in two of the five cases ( Figure 2b).…”

Section: Resultsmentioning

confidence: 87%

“…In this study, Recent studies have shown that napsin A is expressed in various tumors other than lung adenocarcinomas, including pulmonary sclerosing hemangioma, renal and thyroid carcinomas, and adrenal cortical neoplasms. 16,17,[44][45][46] Renal papillary carcinomas are known to exhibit Met amplification, and renal clear cell carcinomas are known to exhibit vHL mutations leading to overexpression. 47 Thus, we consider that clear cell adenocarcinomas of the ovary and kidney have many common characteristics, including clear cell or papillary morphology, and gene mutation and expression.…”

Section: Discussionmentioning

confidence: 99%

“…15 In neoplasms other than lung cancer, napsin A expression is most frequently observed in papillary renal carcinoma (79%), followed by other subtypes of renal cell carcinoma and thyroid carcinoma. 16,17 No expression was observed in breast, pancreatic, or colon carcinomas or mesotheliomas. 16 It remains unclear whether napsin A exhibits some relationship with ovarian cancer.…”

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confidence: 99%

“…16,17 No expression was observed in breast, pancreatic, or colon carcinomas or mesotheliomas. 16 It remains unclear whether napsin A exhibits some relationship with ovarian cancer.…”

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confidence: 99%

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Napsin A is a specific marker for ovarian clear cell adenocarcinoma

et al. 2015

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Ovarian clear cell adenocarcinoma has a relatively poor prognosis among the ovarian cancer subtypes because of its high chemoresistance. Differential diagnosis of clear cell adenocarcinoma from other ovarian surface epithelial tumors is important for its treatment. Napsin A is a known diagnostic marker for lung adenocarcinoma, and expression of napsin A is reported in a certain portion of thyroid and renal carcinomas. However, napsin A expression in ovarian surface epithelial tumors has not previously been examined. In this study, immunohistochemical analysis revealed that in 71 of 86 ovarian clear cell adenocarcinoma patients (83%) and all of the 13 patients with ovarian clear cell adenofibroma, positive napsin A staining was evident. No expression was observed in 30 serous adenocarcinomas, 11 serous adenomas or borderline tumors, 19 endometrioid adenocarcinomas, 22 mucinous adenomas or borderline tumors, 10 mucinous adenocarcinomas, or 3 yolk sac tumors of the ovary. Furthermore, expression of napsin A was not observed in the normal surface epithelium of the ovary, epithelia of the fallopian tubes, squamous epithelium, endocervical epithelium, or the endometrium of the uterus. Therefore, we propose that napsin A is another sensitive and specific marker for distinguishing ovarian clear cell tumors (especially adenocarcinomas) from other ovarian tumors.

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Section: Resultsmentioning

confidence: 87%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

“…16,17 No expression was observed in breast, pancreatic, or colon carcinomas or mesotheliomas. 16 It remains unclear whether napsin A exhibits some relationship with ovarian cancer.…”

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confidence: 99%

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Napsin A is a specific marker for ovarian clear cell adenocarcinoma

et al. 2015

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“…7,[24][25][26] The documented expression of TTF-1 in typical and atypical carcinoids of lung origin has been very variable ranging from 0 to 94% and 0 to 100%, respectively. 7,[14][15][16][17][18][19][20][21][22][23][27][28][29][30][31] This corresponds to an average expression rate of 34.3% for carcinoid tumors and 37.3% for atypical carcinoid tumors. This contrasts with neuroendocrine carcinomas of non-pulmonary origin, the majority which are reportedly negative for this marker, 15,16,18,19,23 although isolated cases of low grade gastrointestinal neuroendocrine carcinoma may show some reactivity with TTF-1.…”

Section: Discussionmentioning

confidence: 99%

Comparative immunohistochemical analysis of pulmonary and thymic neuroendocrine carcinomas using PAX8 and TTF-1

et al. 2013

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PAX8 is expressed in thymic epithelial neoplasms and a subset of neuroendocrine carcinomas of gastrointestinal origin but not pulmonary neuroendocrine carcinomas. Thyroid transcription factor 1 (TTF-1) is known to be positive in pulmonary neuroendocrine carcinomas, but studies investigating its expression in thymic neuroendocrine carcinomas are lacking. To date, there are no comprehensive studies focusing on the comparative expression of PAX8 or TTF-1 in pulmonary and thymic neuroendocrine carcinoma. Twenty-five cases of low and intermediate grade neuroendocrine carcinomas of pulmonary and thymic origin, respectively, were selected for immunohistochemical studies using antibodies directed against PAX8 and TTF-1. The percentage of positive tumor cells as well as the intensity of staining were evaluated and scored. Twenty-one of the pulmonary neuroendocrine carcinomas were classified as low grade (typical carcinoid) and 4 as intermediate grade (atypical carcinoid) tumors; the thymic tumors consisted of 8 low grade and 17 intermediate grade neuroendocrine carcinomas. Only 2 (8%) of the pulmonary tumors showed nuclear expression of PAX8 while 19 (76%) expressed TTF-1. Of the thymic tumors, 8 (32%) were positive for PAX8 and 2 (8%) showed TTF-1 positivity. Primary neuroendocrine carcinomas of the thymus are rare neoplasms that display a more aggressive clinical course than pulmonary neuroendocrine carcinomas, highlighting the importance of the separation of these tumors. To date, there are no specific immunomarkers to distinguish between neuroendocrine carcinomas of pulmonary and thymic origin. The differential expression of PAX8 and TTF-1 may prove useful in this context as a PAX8 þ /TTF-1 À immunophenotype appears to be more common in thymic neuroendocrine carcinomas, whereas the reverse (PAX8 À /TTF-1 þ ) is true for most pulmonary neuroendocrine carcinomas.

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The utility of napsin‐A in the identification of primary and metastatic lung adenocarcinoma among cytologically poorly differentiated carcinomas

Stoll

Johnson

Gabrielson

et al. 2010

Cancer Cytopathology

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BACKGROUND: New developments in the treatment of lung cancer have necessitated the further histologic and cytologic subtyping of nonsmall cell lung carcinomas. Thyroid transcription factor‐1 (TTF‐1) long has served as the predominant marker for demonstrating lung origin. However, it is also expressed in a variety of other tumors, particularly neuroendocrine neoplasms and, to a much lesser degree, squamous cell carcinoma of the lung. Napsin‐A, which is expressed in lung tissue, is a relatively new marker for lung adenocarcinoma. In this study, the authors examined the utility of napsin‐A compared with TTF‐1 in cytologic specimens of primary and metastatic, poorly differentiated lung adenocarcinomas. METHODS: The archives of the Department of Pathology at The Johns Hopkins Hospital were searched for cytologic cases of poorly differentiated lung adenocarcinoma that were histologically confirmed. In total, 75 patients (cases) along with 95 controls were included, each of whom had adequate cell block material for TTF‐1 and napsin‐A staining. Tissue microarrays of lung adenocarcinoma also were examined. RESULTS: TTF‐1 and napsin‐A were detected in 61 of 75 cases (81.3%) and in 49 of 75 cases (65.3%), respectively. The sensitivity and specificity of TTF‐1 were 81% each; and napsin‐A had a greater specificity of 96%, and sensitivity of 65%. Napsin‐A was not detected in small cell carcinomas or in other carcinomas of nonlung origin except for renal cell carcinoma. CONCLUSIONS: Although TTF‐1 had a higher sensitivity, napsin‐A was useful as a surrogate marker when encountering a poorly differentiated lung adenocarcinoma or an unknown primary tumor, particularly in cytologic specimens and difficult cases. The current results indicate that the dual use of both markers may be necessary to improve diagnostic accuracy. Cancer (Cancer Cytopathol) 2010. © 2010 American Cancer Society.

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Napsin A and thyroid transcription factor-1 expression in carcinomas of the lung, breast, pancreas, colon, kidney, thyroid, and malignant mesothelioma

Cited by 302 publications

References 23 publications

Napsin A is a specific marker for ovarian clear cell adenocarcinoma

Napsin A is a specific marker for ovarian clear cell adenocarcinoma

Comparative immunohistochemical analysis of pulmonary and thymic neuroendocrine carcinomas using PAX8 and TTF-1

The utility of napsin‐A in the identification of primary and metastatic lung adenocarcinoma among cytologically poorly differentiated carcinomas

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