Saad Reda S, Liu Yulin L, Han Helen, Landreneau Rodney J, Silverman Jan F
Department of Pathology, Allegheny General Hospital/Drexel University College of Medicine, Pittsburgh, PA, USA.
Hum Pathol. 2004 Jan;35(1):3-7. doi: 10.1016/j.humpath.2003.08.011.
Thyroid transcription factor 1 (TTF-1) is a diagnostic immunohistochemical marker for primary pulmonary neoplasms, but its utility as a prognostic marker is not well established. Surgical specimens from 100 cases of pulmonary adenocarcinoma were retrieved from the hospital computer system, including 50 cases of conventional adenocarcinoma (CA) and 50 cases of bronchioloalveolar adenocarcinoma (BAC) (32 nonmucinous type and 18 mucinous type). Representative sections were immunostained for TTF-1. Positive immunohistochemical study was correlated with other prognostic parameters. In the CA group, strong or moderate TTF-1 expression was seen in 30 of 50 (60%) patients and was associated with significantly better survival compared with those patients having weak staining (7 cases; 14%) or negative staining (13 cases; 26%) (P <0.01; log-rank test). Spearman and Pearson's correlation showed no significant correlation between TTF-1 expression and tumor grade, size, recurrence, or vascular invasion; therefore, TTF-1 was considered an independent predictor of survival. In the BAC group, TTF-1 was strongly expressed in 34 of 50 cases (68%) and was negative in 16 of 50 cases (32%), including 14 mucinous BACs. Although TTF-1 immunoreactivity was not statistically associated with good survival in BAC patients, those patients with strong immunohistochemical expression showed a trend toward longer survival. Our results indicate that TTF-1 positivity is an independent predictor of better survival, especially in patients with CA. Mucinous and nonmucinous BACs exhibit disparate staining patterns with TTF-1, with nonmucinous BAC demonstrating greater positivity. Although nonmucinous BAC patients showing strong positive staining had longer survival, the difference was not statistically significant, which is probably related to the overall good survival of patients with early-stage BAC.
甲状腺转录因子1（TTF-1）是原发性肺肿瘤的一种诊断性免疫组织化学标志物，但其作为预后标志物的作用尚未得到充分证实。从医院计算机系统中检索出100例肺腺癌手术标本，其中包括50例传统腺癌（CA）和50例细支气管肺泡腺癌（BAC）（32例非黏液型和18例黏液型）。对代表性切片进行TTF-1免疫染色。免疫组织化学阳性研究与其他预后参数相关。在CA组中，50例患者中有30例（60%）出现TTF-1强阳性或中度阳性表达，与染色弱阳性（7例；14%）或阴性（13例；26%）的患者相比，其生存率显著更高（P<0.01；对数秩检验）。Spearman和Pearson相关性分析显示TTF-1表达与肿瘤分级、大小、复发或血管侵犯之间无显著相关性；因此，TTF-1被认为是生存的独立预测因子。在BAC组中；50例患者中有34例（68%）TTF-1呈强阳性表达，50例中有16例（32%）呈阴性表达，其中包括14例黏液型BAC。尽管TTF-1免疫反应性在BAC患者中与良好生存无统计学关联，但免疫组织化学强阳性表达的患者有生存时间延长的趋势。我们的结果表明，TTF-1阳性是生存较好的独立预测因子；尤其是在CA患者中。黏液型和非黏液型BAC与TTF-1表现出不同的染色模式，非黏液型BAC的阳性率更高。尽管非黏液型BAC强阳性染色的患者生存时间更长，但差异无统计学意义，这可能与早期BAC患者总体生存良好有关。
