Puglisi F, Barbone F, Damante G, Bruckbauer M, Di Lauro V, Beltrami C A, Di Loreto C
Department of Medical and Morphological Researches, Institute of Anatomic Pathology, Udine, Italy.
Mod Pathol. 1999 Mar;12(3):318-24.
Thyroid transcription factor-1 (TTF-1) is a 38-kDa nuclear protein expressed in thyroid follicular cells, in human fetal lung, and, after birth, in Type II epithelial cells of alveoli and in a subset of bronchial cells. Expression of TTF-1 was documented in neoplasms arising from cells that normally produce this transcription factor. In the present study, a series of surgically resected non-small cell lung carcinomas (NSCLCs) was evaluated for the expression of TTF-1 protein, and the correlation between TTF-1 expression and patient survival was retrospectively tested. Ninety-six patients with primary NSCLC underwent surgical resection between 1987 and 1992. All of the tissue specimens from these patients were examined for TTF-1 protein expression by immunohistochemical analysis. Tumor immunoreactivity for TTF-1 was categorized into three groups (-, +, and ++), according to the percentage of reactive cells. The relationship between TTF-1 expression and postsurgical survival was analyzed for 88 patients [60 squamous cell carcinomas (SCCs) and 28 adenocarcinomas (ACs)]. TTF-1 stain was always limited to nuclei. Of the 96 specimens of NSCLC, 59 (61%) were scored as -, 20 (21%) as +, and 17 (18%) as ++. TTF-1 expression was significantly higher in ACs than in SCCs (P < .0001). Survival curves among the -, +, and ++ groups were significantly different (log rank test, P = .04). Multivariate analysis showed that NSCLCs in the ++ group were associated with a poor prognosis (P = .009), independent of node (P = .01) or stage status (P = .0006). When subsets of patients with SCC and with AC were separately analyzed, TTF-1 was found to have an independent prognostic value only in patients with SCC (P = .04). The results of this study suggest that immunoreactivity for TTF-1 in NSCLC closely relates to clinical outcome, especially in patients with SCC.
甲状腺转录因子-1（TTF-1）是一种38 kDa的核蛋白，在甲状腺滤泡细胞、人胎儿肺中表达，出生后在肺泡Ⅱ型上皮细胞和一部分支气管细胞中表达。在通常产生这种转录因子的细胞来源的肿瘤中也记录到了TTF-1的表达。在本研究中，对一系列手术切除的非小细胞肺癌（NSCLC）进行了TTF-1蛋白表达评估，并对TTF-1表达与患者生存率之间的相关性进行了回顾性检验。1987年至1992年间，96例原发性NSCLC患者接受了手术切除。通过免疫组化分析对这些患者的所有组织标本进行TTF-1蛋白表达检测。根据反应性细胞的百分比，将肿瘤对TTF-1的免疫反应性分为三组（-、+和++）。对88例患者[60例鳞状细胞癌（SCC）和28例腺癌（AC）]分析了TTF-1表达与术后生存率之间的关系。TTF-1染色始终局限于细胞核。在96例NSCLC标本中，59例（61%）评分为-，20例（21%）评分为+，17例（18%）评分为++。AC中TTF-1表达显著高于SCC（P <.0001）。-、+和++组之间的生存曲线有显著差异（对数秩检验，P =.04）。多因素分析显示，++组的NSCLC与预后不良相关（P =.009），与淋巴结状态（P =.01）或分期状态（P =.0006）无关。当分别分析SCC和AC患者亚组时，发现TTF-1仅在SCC患者中具有独立的预后价值（P =.04）。本研究结果表明，NSCLC中TTF-1的免疫反应性与临床结局密切相关，尤其是在SCC患者中。
