Usefulness of TA02 (napsin A) to distinguish primary lung adenocarcinoma from metastatic lung adenocarcinoma

Hirano, Takashi; Gong, Yunbo; Yoshida, Kôichi; Kato, Yasufumi; Yashima, Koich; Maeda, Masahiro; Nakagawa, Ayako; Fujioka, Kaoru; Ohira, Tetsuya; Ikeda, Norihiko; Ebihara, Yoshiro; Auer, Gert; Kato, Harubumi

doi:10.1016/s0169-5002(03)00194-6

Cited by 84 publications

(87 citation statements)

References 20 publications

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“…Two studies reported Napsin A expression in 84.3 and 90.7% of lung adenocarcinomas whereas squamous cell carcinoma was completely negative. 46,47 These two studies also examined a total of 14 mammary carcinomas and none of the cases expressed Napsin A. 46,47 None of the 115 mammary carcinomas in our study expressed this marker, either.…”

Section: Discussionmentioning

confidence: 63%

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A study of immunohistochemical differential expression in pulmonary and mammary carcinomas

2010

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The risk of developing a second primary cancer is increased in patients with breast cancer, and the lung is one of the major sites involved. Moreover, the lung is the major metastatic site for breast cancers. A distinction between metastatic breast cancer and primary lung cancer can be histologically difficult, and both show an overlapping CK7 þ /CK20À immunoprofile in a majority of cases. The degree of difficulty increases with poorly differentiated tumors. We investigated differential expressions of TTF-1, Napsin A, surfactant apoprotein A, estrogen receptor, GATA-3, mammaglobin, and GCDFP-15 immunostains in 197 pulmonary carcinomas (158 adenocarcinomas, 39 squamous) and 115 invasive mammary carcinomas (91 ductal, 24 lobular type). In mammary carcinomas, estrogen receptor, GATA-3, mammaglobin, and GCDFP-15 were expressed in 74, 72, 64, and 62%, respectively, whereas TTF-1, Napsin A, and surfactant apoprotein A were all negative. The expressions were diffuse in estrogen receptor and GATA-3, and variable in mammaglobin and GCDFP-15. For a combination of estrogen receptor/mammaglobin or GATA-3/mammaglobin, 83% of mammary carcinomas were positive, and the detection rate was not improved by using all three markers. All lung squamous cell carcinomas were negative for all markers studied. TTF-1, Napsin A, and surfactant apoprotein A were positive in 80, 77, and 45% of pulmonary adenocarcinomas. None of the TTF-1-negative tumors expressed surfactant apoprotein A. GCDFP-15 was focally expressed in 2.5% of pulmonary adenocarcinomas, and estrogen receptor was focally expressed in one case (1.2%) of pulmonary adenocarcinoma. When metastasis from breast cancer is suspected in the lung, a combination of either estrogen receptor/mammaglobin or GATA-3/mammaglobin as breast markers, and a combination of TTF-1 and Napsin A as lung markers may be helpful for differentiating between the two. Caution should be taken in the interpretation of GCDFP-15 due to its occasional expression in pulmonary adenocarcinomas.

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Section: Discussionmentioning

confidence: 63%

“…46,47 These two studies also examined a total of 14 mammary carcinomas and none of the cases expressed Napsin A. 46,47 None of the 115 mammary carcinomas in our study expressed this marker, either. Our results indicate that the sensitivity of Napsin A in pulmonary adenocarcinoma is comparable to that of TTF-1.…”

Section: Discussionmentioning

confidence: 63%

A study of immunohistochemical differential expression in pulmonary and mammary carcinomas

2010

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“…Napsin A is a recently available lung adenocarcinoma marker that, similar to TTF-1, has also been reported to be frequently expressed in these tumors (B60-90%). 51,53,[58][59][60] All four of the signet-ring cell adenocarcinomas of the lung that were stained for napsin A in the present study exhibited strong positivity for this marker. To my knowledge, this is the first study on napsin A expression in signet-ring cell adenocarcinomas of the lung.…”

Section: Markermentioning

confidence: 87%

Mesothelioma with signet-ring cell features: report of 23 cases

Ordóñez

2013

Modern Pathology

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Signet-ring cell mesothelioma is uncommon and only two case reports have been published on this mesothelioma variant, both of which were initially misdiagnosed as signet-ring cell carcinoma. Herein are reported 23 signet-ring cell mesotheliomas that were investigated by immunohistochemistry, 12 of which were also studied by electron microscopy. Twenty-one of the cases originated in the pleura and two in the peritoneum. For comparison purposes and in order to determine the value of these techniques in the differential diagnosis of these tumors, seven cases of signet-ring cell lung adenocarcinoma were also studied. All signetring cell mesotheliomas were positive for calretinin, keratin 5/6, keratin 7, and mesothelin, 93% for podoplanin, and 91% for WT1; whereas, none reacted for MOC-31, CEA, TAG-72, CD15, TTF-1, napsin A, or CDX2. Among signet-ring cell lung adenocarcinomas, 100% were positive for keratin 7, CEA, and napsin A, 86% each for TTF-1 and TAG-72, 71% for CD15, and 14% for mesothelin, while all were negative for calretinin, keratin 5/6, WT1, podoplanin, and CDX2. After analyzing the results, it is concluded that the panels of markers used in the differential diagnosis of this mesothelioma variant should include those markers that are usually expressed in mesotheliomas (eg, calretinin, keratin 5/6, WT1, and podoplanin), broad-spectrum carcinoma markers that are frequently expressed in adenocarcinomas regardless of their site of origin (eg, MOC-31 and CEA), and organ-associated markers (eg, TTF-1 and napsin A for lung), which allow the site of origin of a metastatic adenocarcinoma to be established. Electron microscopy can be very useful as it permits the identification of characteristic ultrastructural mesothelioma and adenocarcinoma markers, and it also allows a better understanding of the morphologic features seen on routine light microscopy. Pathologists should be aware of this mesothelioma subtype as it can potentially be confused with other tumors that exhibit signet-ring features. Modern Pathology (2013) 26, 370-384; doi:10.1038/modpathol.2012.172; published online 5 October 2012Keywords: electron microscopy; immunohistochemistry; signet-ring cell carcinoma; signet-ring cell mesotheliomaThe finding of occasional vacuolated cells exhibiting signet-ring-like morphology is not rare in mesotheliomas; however, epithelioid mesotheliomas having a large number of such cells are relatively uncommon and have been subclassified as signet-ring cell mesotheliomas. 1 Signet-ring cell carcinomas can arise in a wide variety of organs, including lung, 2-6 stomach, 7,8 colon, 8-10 breast, 8,11,12 urinary bladder, 13-17 pancreas, 18 salivary glands, 19 and prostate. [20][21][22][23][24][25][26][27][28] The signet-ring configuration seen in adenocarcinomas has traditionally been associated with the accumulation of large amounts of intracytoplasmic mucin. It can also occur as a result of the formation of a true intracytoplasmic lumen with displacement of the nucleus toward the periphery of the cell, in which case, spe...

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“…Thus, we consider napsin A to be another suitable marker to specifically distinguish clear cell adenocarcinoma from other ovarian tumors with a relatively high sensitivity. Furthermore, because napsin A is an established marker for lung adenocarcinomas, [7][8][9][10][11][12][13] we assume that napsin A immunostaining will be easily applied to routine surgical pathology specimens in laboratories. In this study, we determined the criteria for positive napsin A immunostaining as 410% tumor area for differential diagnosis between histological subtypes of ovarian adenocarcinomas, and given that focal positivity is observed in those other than clear cell adenocarcinoma, careful interpretation is required when applying this method on small biopsy specimen.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3][4] Napsin A has a role in processing pulmonary surfactant B protein produced by alveolar type II pneumocytes; 5,6 thus, it has been reported to be a good diagnostic marker for the confirmation of primary lung adenocarcinoma together with thyroid transcription factor 1 (TTF-1). [7][8][9][10][11][12][13] Expression of napsin A is also observed in the fetal kidney 14 and proximal tubules of the adult kidney, where it is most likely involved in protein catabolism. 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.…”

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confidence: 99%

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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Usefulness of TA02 (napsin A) to distinguish primary lung adenocarcinoma from metastatic lung adenocarcinoma

Cited by 84 publications

References 20 publications

A study of immunohistochemical differential expression in pulmonary and mammary carcinomas

A study of immunohistochemical differential expression in pulmonary and mammary carcinomas

Mesothelioma with signet-ring cell features: report of 23 cases

Napsin A is a specific marker for ovarian clear cell adenocarcinoma

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