The role of Thyroid Transcription Factor-1 and Tumor differentiation in Resected Lung Adenocarcinoma

Huang, Tsai-Wang; Lin, Ke Feng; Lee, Chien-Hsing; Chang, Hung Chi; Shieh, Yi‐Shing

doi:10.1038/s41598-017-14651-y

Cited by 17 publications

(12 citation statements)

References 26 publications

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“…This feature is contrary to the conclusions of Zhang et al, Stenhouse et al, Zhou et al, and Yaman et al [10,11,14,15] In the present study, necrosis was a predominant feature of the TTF-1-negative group and was present in 55.66% cases while 94.33% of cases were either moderately or poorly differentiated tumors. A reciprocal correlation between tumor differentiation and TTF-1 expression has been described by Huang et al [16] Yaman et al concluded from their study that poorly differentiated tumors were generally TTF-1 negative. [15] The staining pattern of TTF-1 is largely uniform in the adenocarcinomas in spite of histologic and microenvironmental multiplicity in individual tumors.…”

Section: Discussionsupporting

confidence: 55%

Thyroid Transcription Factor-1 Expression in Adenocarcinoma Lung and Its Association with Histomorphological Features

Shukla

Husain

Kant

et al. 2019

Indian Journal of Medical and Paediatric Oncology

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Objectives: Thyroid transcription factor-1 (TTF-1) expression is frequently associated with adenocarcinoma lung. This study was undertaken with the objectives to assess the expression of TTF-1 in non-small cell lung carcinoma (NSCLC) with adenocarcinoma phenotype and to evaluate the TTF-1 expression with clinicopathological and histomorphological features. Materials and Methods: This was a tertiary care hospital-based case series that included 250 cases of NSCLC. TTF-1 immunostaining along with a basic panel of immunohistochemistry markers was performed. The histomorphological analysis was done to compare the morphological features of TTF-1-positive versus TTF-1-negative cases. Results: TTF-1 was positive in 144 cases (57.6%), while 106 cases were negative for TTF-1. The M: F ratio in the TTF-1-positive group was 1:2, and the mean age of the cases that expressed TTF-1 was 48.5 years. The most common pattern in the TTF-1-positive group was loose clusters or singly dispersed cells (77.78%), followed by the acinar (54.86%) and solid pattern (42.36%). In the TTF-1-negative group, 86.79% of cases had singly dispersed cells or loose cohesive clusters, followed by a solid pattern in 50.94% cases. Conclusion: TTF-1 is a useful and reliable marker for pulmonary adenocarcinoma. TTF-1 expression does not have any association with the patterns and degree of differentiation evident in the tumor.

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Section: Discussionsupporting

confidence: 55%

Thyroid Transcription Factor-1 Expression in Adenocarcinoma Lung and Its Association with Histomorphological Features

Shukla

Husain

Kant

et al. 2019

Indian Journal of Medical and Paediatric Oncology

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“…Therefore, patients with multi-N2 station metastasis may not benefit from the surgery because of the higher LNR although surgeons believed that each lymph node could be removed. It is undisputed that the T stage and tumor grade are significant independent predictive factors (30,31). Besides these, we found that histology also affects prognosis.…”

Section: Discussionmentioning

confidence: 60%

“…It is undisputed that the T stage and tumor grade are significant independent predictive factors ( 30 , 31 ). Besides these, we found that histology also affects prognosis.…”

Section: Discussionmentioning

confidence: 99%

Identification of Resectable N2 in NSCLC: A Single Center Experience and Review of the SEER Database

et al. 2021

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BackgroundNon-small cell lung carcinoma (NSCLC) with ipsilateral and/or subcarinal mediastinal lymphatic spread (N2) is a heterogeneous disease. The role of surgical resection in patients with N2 NSCLC remains controversial and no survival-based definition of “resectable N2” exists. The purpose of this study is to evaluate the factors that potentially affect the survival of N2 NSCLC patients who receive surgical resection and to define “resectable N2” based on the survival benefits.MethodsData from the open Surveillance, Epidemiology, and End Results (SEER) database from the National Cancer Institute in the United States were used to construct a nomogram. Patients who received surgery between 2010 and 2015 for N2 NSCLC were included. Independent prognostic factors for survival identified through Cox regression analysis were used to create the nomogram. The C-index, receiver operating characteristics (ROC) analyses, calibration curves, and risk stratification were used to evaluate the nomogram. The nomogram was also validated using data from 222 patients from Peking Union Medical College Hospital (PUMCH). Furthermore, lung cancer–related deaths were compared using competitive risk analysis.ResultsIn total, 4267 patients were included in the SEER cohort. Male gender, old age, high T stage and grade, adenosquamous and squamous cell carcinoma, lower lobe and overlapping lesions, extended lobe or bilobectomy and pneumonectomy, no chemotherapy, radiation before and after surgery, positive number of lymph nodes, and lymph node ratio (LNR) were identified as independent risk factors for higher mortality. The nomogram was created using these parameters. The C-index was 0.665 (95% confidence interval (CI), 0.651-0.679) and 0.722 (95% CI, 0.620-0.824) in the SEER and PUMCH cohorts, respectively. The calibration curves showed satisfactory consistency between the predicted and actual survival status in both the SEER and PUMCH cohorts. Competitive risk analysis confirmed that the variables in the nomogram, except radiation, are risk factors for prognosis.Conclusions“Resectable N2” should be assessed by a multidisciplinary team. The novel nomogram developed in this study may help with clinical decision-making for this patient population.

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“…2). Previous studies had reported several TTF-1-negative patients with MIA in their cohorts (18,56). The exact expression profile of TTF-1 and the associated significance requires further investigation in patients with MIA.…”

Section: Discussionmentioning

confidence: 95%

Significance of the epidermal growth factor receptor mutation status and differences among molecular subgroups in surgically resected lung microinvasive adenocarcinoma

et al. 2018

Oncol Lett

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Lung microinvasive adenocarcinoma (MIA) is a newly-defined subtype of early stage non-small cell lung cancer (NSCLC). However, its epidermal growth factor receptor (EGFR) mutation status and clinical significance remain unclear. The present study aimed to determine EGFR mutation characteristics and identify their significance in patients with resected lung MIA. The present study also analyzed clinicopathological differences between EGFR molecular subgroups defined as 19Del and L858R. The present study examined EGFR mutations in 79 consecutive lung MIA resection specimens and compared the differences in clinicopathological features between the EGFR wild-type and mutation groups, as well as between the 19Del and L858R subgroups. EGFR mutations were detected in 60 (75.95%) tumors. The most common mutations were 19Del (28 cases; 35.44%) and L858R (30 cases; 37.97%). Two patients harbored rare mutations and one of them had a concomitant double mutation. EGFR mutations were significantly associated with microinvasion component, thyroid transcription factor 1 (TTF-1) expression, intratumoral fibrosis and inflammatory cell infiltration. Subgroup evaluation indicated that there was a significant association between 19Del and tumor size, maximum diameter of microinvasion, presence of intratumoral fibrosis and inflammatory cell infiltration. Similar associations were observed for the L858R subgroup, and L858R was associated with TTF-1 expression. In particular, 19Del occurred more frequently in MIA with a smaller size, with a smaller microinvasive area, without TTF-1 expression, and lacking intratumoral fibrosis and inflammatory cell infiltration. By contrast, L858R was detected more frequently in MIA with entirely different tumor features. In conclusion, the results of the present study indicated that surgically resected MIA cases harboring different EGFR gene statuses exhibit distinct clinicopathological features. Significant differences in pathological features associated with the tumor microenvironment were identified in MIA with 19Del or L858R mutations. Therefore, the present study proposed that MIA should be classified into molecular subgroups based on EGFR mutation subtypes. The molecular sub-classification should be taken into account for prognostic evaluation and clinical management of MIA.

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The role of Thyroid Transcription Factor-1 and Tumor differentiation in Resected Lung Adenocarcinoma

Cited by 17 publications

References 26 publications

Thyroid Transcription Factor-1 Expression in Adenocarcinoma Lung and Its Association with Histomorphological Features

Thyroid Transcription Factor-1 Expression in Adenocarcinoma Lung and Its Association with Histomorphological Features

Identification of Resectable N2 in NSCLC: A Single Center Experience and Review of the SEER Database

Significance of the epidermal growth factor receptor mutation status and differences among molecular subgroups in surgically resected lung microinvasive adenocarcinoma

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