TTF‐1 and napsin A on cell blocks and supernatants of pleural fluids for labeling malignant effusions

Abstract

In this retrospective study of 80 pleural effusions, the combination of thyroid transcription factor 1 (TTF-1) and napsin A immunostaining on fluid cell blocks was positive in 80% of lung adenocarcinomas. Although measuring TTF-1 pleural fluid concentrations was of no value, quantification of napsin A levels allowed the identification of one third of the double-negative stained lung adenocarcinomas, with an overall accuracy similar to classical tumour markers for malignant-benign discrimination (sensitivity 40%, specificity 100%).

Malignant pleural effusions because of lung cancer

“…The concentrations of TTF-1 and napsin-A were concomitantly measured in fluid supernatants by enzyme-linked immunosorbent assays. Although TTF-1 levels were useless, napsin-A concentrations greater than 3.32 mg/ml (the 100% specific cutoff point set for malignancy) were observed in one-third of the double-negative stained lung adenocarcinomas [8]. These preliminary results suggest a possible complementary clinical value of pleural fluid napsin-A levels to the cytological immunostainings, but further confirmation is needed.…”

“…One example is thyroid transcription factor-1 (TTF-1) and napsin-A, which are considered robust immunocytochemical markers of lung adenocarcinoma. In one study, immunoreactivity for TTF-1 and napsin-A on pleural fluid cell blocks of 58 malignant effusions and 22 benign conditions was examined [8]. Of 30 lung adenocarcinomas, 21 (70%), 20 (67%), and 24 (80%) stained positive for TTF-1, napsin-A, or either, respectively.…”

Pleural fluid cytology samples in cases of suspected lung cancer: An experience from a tertiary care centre

“…Although nuclear TTF‐1 is usually taken as a specific marker for pulmonary and thyroid neoplasms, it has been reported to be positive in a minority of colorectal cancers, esophageal and uterine cancers. About 70% of lung adenocarcinomas express TTF 1 on cell blocks prepared from with >98% specificity . Therefore, we selected TTF1 as the primary immunomarker to identify pulmonary origin in pleural effusion samples.…”

“…In addition, in cases of endobronchial growth with collapse of the adjacent lung parenchyma where detection of the mass is difficult by radiology, the presence of an effusion might help diagnose the lesion. There are only a few studies on the diagnosis and subtyping of lung carcinomas in the pleural fluid material . Immunohistochemistry (IHC) can be performed on effusion samples on direct fixed or liquid‐based cytology (LBC) smears or on the sections obtained from cell block.…”

ALK gene expression status in pleural effusion predicts tumor responsiveness to crizotinib in Chinese patients with lung adenocarcinoma

“…The diagnosis of lung adenocarcinoma in MPE has been discussed in the literature (23,24). MPE samples are now commonly used for diagnosis and molecular testing of NSCLC patients at stage IV.…”