Skip to main content
Log in

TTF1 expression in normal lung neuroendocrine cells and related tumors: immunohistochemical study comparing two different monoclonal antibodies

  • Original Article
  • Published:
Virchows Archiv Aims and scope Submit manuscript

Abstract

Thyroid transcription factor-1 (TTF1) regulates lung morphogenesis and differentiation, and its immunohistochemical expression is used for identifying lung neoplasms. The 8G7G3/1 antibody has been used in previous studies, but a different and more sensitive anti-TTF1 antibody, named SPT24, has become commercially available. Since the immunohistochemical expression of TTF1 in normal lung neuroendocrine (NE) cells has not been previously investigated and its utility in the diagnosis of lung NE tumors is a controversial issue, we studied the TTF1 expression in normal adult and fetal lungs, in 83 pulmonary NE neoplasms, in 131 non-lung NE tumors and in 36 metastases from these neoplasms using these two antibodies. A TTF1 immunoreactivity was demonstrated in normal fetal and adult NE cells when using the SPT24 clone. Conversely, using the 8G7G3/1 antibody, only rare fetal neuroendocrine cells were TTF1 positive while adult NE cells were negative. The SPT24 clone identified TTF1 expression in more carcinoids, most of them peripherally located, and poorly differentiated NE carcinomas than the 8G7G3/1 clone. Non-pulmonary well-differentiated NE tumors were negative for both antibodies. Among the 45 non-pulmonary poorly differentiated NE carcinomas 11% were positive for 8G7G3/1 and 18% for SPT24. TTF1 expression in metastases perfectly reflected that detected in the related primary tumors. Our results indicate that the SPT24 antibody is more sensitive than the 8G7G3/1 clone for labeling lung carcinoids and it appears particularly useful in detecting peripheral neoplasms. In addition, the expression of TTF1 in normal NE cells suggests a possible role for the transcription factor in their development and differentiation.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Lau SK, Luthringer DJ, Eisen RN (2002) Thyroid transcription factor-1: review. Appl Immunohistochem Mol Morphol 10:97–102

    Article  CAS  PubMed  Google Scholar 

  2. Katoh R, Kawaoi A, Miyagi E, Li X, Suzuki K, Nakamura Y, Kakudo K (2000) Thyroid transcription factor-1 in normal, hyperplastic, and neoplastic follicular thyroid cells examined by immunohistochemistry and nonradioactive in situ hybridization. Mod Pathol 13:570–576

    Article  CAS  PubMed  Google Scholar 

  3. Lee EB, Tihan T, Scheithauer BW, Zhang PJ, Gonatas NK (2009) Thyroid transcription factor 1 expression in sellar tumors: a histogenetic marker? J Neuropathol Exp Neurol 68:482–488

    Article  CAS  PubMed  Google Scholar 

  4. Miettinen M, Franssila KO (2000) Variable expression of keratins and nearly uniform lack of thyroid transcription factor 1 in thyroid anaplastic carcinoma. Hum Pathol 31:1139–1145

    Article  CAS  PubMed  Google Scholar 

  5. Chang YL, Lee YC, Liao WY, Wu CT (2004) The utility and limitation of thyroid transcription factor-1 protein in primary and metastatic pulmonary neoplasms. Lung Cancer 44:149–157

    Article  PubMed  Google Scholar 

  6. Maeda Y, Davé V, Whitsett JA (2007) Transcriptional control of lung morphogenesis. Physiol Rev 87:219–244

    Article  CAS  PubMed  Google Scholar 

  7. Agoff SN, Lamps LW, Philip AT, Amin MB, Schmidt RA, True LD, Folpe AL (2000) Thyroid transcription factor-1 is expressed in extrapulmonary small cell carcinomas but not in other extrapulmonary neuroendocrine tumors. Mod Pathol 13:238–242

    Article  CAS  PubMed  Google Scholar 

  8. Ordonez NG (2000) Value of thyroid transcription factor-1 immunostaining in distinguishing small cell lung carcinomas from other small cell carcinomas. Am J Surg Pathol 24:1217–1223

    Article  CAS  PubMed  Google Scholar 

  9. Cheuk W, Kwan MY, Suster S, Chan JK (2001) Immunostaining for thyroid transcription factor 1 and cytokeratin 20 aids the distinction of small cell carcinoma from Merkel cell carcinoma, but not pulmonary from extrapulmonary small cell carcinomas. Arch Pathol Lab Med 125:228–231

    CAS  PubMed  Google Scholar 

  10. Oliveira AM, Tazelaar HD, Myers JL, Erickson LA, Lloyd RV (2001) Thyroid transcription factor-1 distinguishes metastatic pulmonary from well-differentiated neuroendocrine tumors of other sites. Am J Surg Pathol 25:815–819

    Article  CAS  PubMed  Google Scholar 

  11. Sturm N, Rossi G, Lantuejoul S, Papotti M, Frachon S, Claraz C, Brichon PY, Brambilla C, Brambilla E (2002) Expression of thyroid transcription factor-1 in the spectrum of neuroendocrine cell lung proliferation with special interest in carcinoids. Hum Pathol 33:175–182

    Article  PubMed  Google Scholar 

  12. Zamecnik J, Kodet R (2002) Value of thyroid transcription factor-1 and surfactant apoprotein A in the differential diagnosis of pulmonary carcinomas: a study of 109 cases. Virchows Arch 440:353–361

    Article  CAS  PubMed  Google Scholar 

  13. Hiroshima K, Iyoda A, Shida T, Shibuya K, Iizasa T, Kishi H, Tanizawa T, Fujisawa T, Nakatani Y (2006) Distinction of pulmonary large cell neuroendocrine carcinoma from small cell lung carcinoma: a morphological, immunohistochemical, and molecular analysis. Mod Pathol 19:1358–1368

    Article  CAS  PubMed  Google Scholar 

  14. Folpe AL, Gown AM, Lamps LW, Garcia R, Dail DH, Zarbo RJ, Schmidt RA (1999) Thyroid transcription factor-1: immunohistochemical evaluation in pulmonary neuroendocrine tumors. Mod Pathol 12:5–8

    CAS  PubMed  Google Scholar 

  15. Kaufmann O, Dietel M (2000) Expression of thyroid transcription factor-1 in pulmonary and extrapulmonary small cell carcinomas and other neuroendocrine carcinomas of various primary sites. Histopathology 36:415–420

    Article  CAS  PubMed  Google Scholar 

  16. Du EZ, Goldstraw P, Zacharias J, Tiffet O, Craig PJ, Nicholson AG, Weidner N, Yi ES (2004) TTF-1 expression is specific for lung primary in typical and atypical carcinoids: TTF1-positive carcinoids are predominantly in peripheral location. Hum Pathol 35:825–831

    Article  CAS  PubMed  Google Scholar 

  17. Saqi A, Alexis D, Remotti F, Bhagat G (2005) Usefulness of CDX2 and TTF-1 in differentiating gastrointestinal from pulmonary carcinoids. Am J Clin Pathol 123:394–404

    Article  PubMed  Google Scholar 

  18. Lin X, Saad RS, Luckasevic TM, Silverman JF, Liu Y (2007) Diagnostic values of CDX2 and TTF-1 expressions in separating metastatic neuroendocrine neoplasms of unknown origin. Appl Immunohistochem Mol Morphol 15:407–414

    Article  CAS  PubMed  Google Scholar 

  19. Cai YC, Banner B, Glickman J, Odze RD (2001) Cytokeratin 7 and 20 and thyroid transcription factor 1 can help distinguish pulmonary from gastrointestinal carcinoid and pancreatic endocrine tumors. Hum Pathol 32:1087–1093

    Article  CAS  PubMed  Google Scholar 

  20. Matoso A, Singh K, Jacob R, Greaves WO, Tavares R, Noble L, Resnick MB, DeLellis RA, Wang LJ (2010) Comparison of thyroid transcription factor-1 expression by 2 monoclonal antibodies in pulmonary and nonpulmonary primary tumors. Appl Immunohistochem Mol Morphol 18:142–149

    Article  CAS  PubMed  Google Scholar 

  21. Schmitt AM, Riniker F, Anlauf M, Schmid S, Soltermann A, Moch H, Heitz PU, Klöppel G, Komminoth P, Perren A (2008) Islet 1 (Isl1) expression is a reliable marker for pancreatic endocrine tumors and their metastases. Am J Surg Pathol 32:420–425

    Article  PubMed  Google Scholar 

  22. Compérat E, Zhang F, Perrotin C, Molina T, Magdeleinat P, Marmey B, Régnard JF, Audouin J, Camilleri-Broet S (2005) Variable sensitivity and specificity of TTF-1 antibodies in lung metastatic adenocarcinoma of colorectal origin. Mod Pathol 18:1371–1376

    Article  PubMed  Google Scholar 

  23. Travis WD, Brambilla E, Muller-Hermelink HK, Harris CC (2004) World Health Organization classification of tumours. Pathology and genetics of tumours of the lung, pleura, thymus and heart. IARC Press, Lyon

    Google Scholar 

  24. Lan HY, Mu W, Nikolic-Paterson DJ, Atkins RC (1995) A novel, simple, reliable, and sensitive method for multiple immunoenzyme staining: use of microwave oven heating to block antibody crossreactivity and retrieve antigens. J Histochem Cytochem 43:97–102

    CAS  PubMed  Google Scholar 

  25. Holzinger A, Dingle S, Bejarano PA, Miller M, Weaver TE, Di Lauro R, Whitsett JA (1996) Monoclonal antibody to thyroid transcription factor-1: production, characterization, and usefulness in tumor diagnosis. Hybridoma 15:49–53

    Article  CAS  PubMed  Google Scholar 

  26. Bejarano PA, Mousavi F (2003) Incidence and significance of cytoplasmic thyroid transcription factor-1 immunoreactivity. Arch Pathol Lab Med 127:193–195

    PubMed  Google Scholar 

  27. Byrd-Gloster AL, Khoor A, Glass LF, Messina JL, Whitsett JA, Livingston SK, Cagle PT (2000) Differential expression of thyroid transcription factor 1 in small cell lung carcinoma and Merkel cell tumor. Hum Pathol 31:58–62

    Article  CAS  PubMed  Google Scholar 

  28. La Rosa S, Rigoli E, Uccella S, Chiaravalli AM, Capella C (2004) CDX2 as a marker of intestinal EC-cells and related well-differentiated endocrine tumors. Virchows Arch 445:248–254

    Article  CAS  PubMed  Google Scholar 

  29. La Rosa S, Franzi F, Marchet S, Finzi G, Clerici M, Vigetti G, Chiaravalli AM, Sessa F, Capella C (2009) The monoclonal anti-BCL10 antibody (clone 331.1) is a sensitive and specific marker of pancreatic acinar cell carcinoma and pancreatic metaplasia. Virchows Arch 454:133–142

    Article  PubMed  Google Scholar 

  30. Fabbro D, Di Loreto C, Stamerra O, Beltrami A, Lonigro R, Damante G (1996) TTF-1 gene expression in human lung tumours. Eur J Cancer 32A:512–517

    Article  CAS  PubMed  Google Scholar 

  31. Di Loreto C, Di Lauro V, Puglisi F, Damante G, Fabbro D, Beltrami CA (1997) Immunocytochemical expression of tissue specific transcription factor-1 in lung carcinoma. J Clin Pathol 50:30–32

    Article  PubMed  Google Scholar 

  32. Harlamert HA, Mira J, Bejarano PA, Baughman RP, Miller MA, Whitsett JA, Yassin R (1998) Thyroid transcription factor-1 and cytokeratins 7 and 20 in pulmonary breast carcinoma. Acta Cytol 42:1382–1388

    CAS  PubMed  Google Scholar 

  33. Carlson JW, Nucci MR, Brodsky J, Crum CP, Hirsch MS (2007) Biomarker-assisted diagnosis of ovarian, cervical and pulmonary small cell carcinomas: the role of TTF-1, WT-1 and HPV analysis. Histopathology 51:305–312

    Article  CAS  PubMed  Google Scholar 

  34. Hanly AJ, Elgart GW, Jorda M, Smith J, Nadji M (2000) Analysis of thyroid transcription factor-1 and cytokeratin 20 separates Merkel cell carcinoma from small cell carcinoma of the lung. J Cutan Pathol 27:118–120

    Article  CAS  PubMed  Google Scholar 

  35. Myong N (2003) Thyroid transcription factor-1 (TTF-1) expression in human lung carcinomas: its prognostic implication and relationship with expression of p53 and Ki67 proteins. J Korean Med Sci 18:494–500

    CAS  PubMed  Google Scholar 

  36. Nakamura N, Miyagi E, Murata S, Kawaoi A, Katoh R (2002) Expression of thyroid transcription factor-1 in normal and neoplastic lung tissues. Mod Pathol 15:1058–1067

    Article  PubMed  Google Scholar 

  37. Wang LJ, Greaves WO, Sabo E, Noble L, Tavares R, Ng T, DeLellis RA, Resnick MB (2009) GCDFP-15 positive and TTF-1 negative primary lung neoplasms. A tissue microarray study of 381 primary lung tumors. Appl Immunohistochem Mol Morphol 17:505–511

    Article  CAS  PubMed  Google Scholar 

  38. Yun J, Zhang M, Hou J, Tian Q, Fu J, Liang X, Wu Q, Rong T (2007) Primary small cell carcinoma of the esophagus: clinicopathological and immunohistochemical features of 21 cases. BMC Cancer 7:38

    Article  PubMed  Google Scholar 

  39. Leech SN, Kolar AJO, Barrett PD, Sinclair SA, Leonard N (2001) Merkel cell carcinoma can be distinguished from metastatic small cell carcinoma using antibodies to cytokeratin 20 and thyroid transcription factor 1. J Clin Pathol 54:727–729

    CAS  PubMed  Google Scholar 

  40. Yang DT, Holden JA, Florell SR (2004) CD117, CK20, TTF-1, and DNA topoisomerase II-α antigen expression in small cell tumors. J Cutan Pathol 31:254–261

    Article  PubMed  Google Scholar 

  41. Barbareschi M, Roldo C, Zamboni G, Capelli P, Cavazza A, Macri E, Cangi MG, Chilosi M, Doglioni C (2004) CDX-2 homeobox gene product expression in neuroendocrine tumors. Its role as a marker of intestinal neuroendocrine tumors. Am J Surg Pathol 28:1169–1176

    Article  PubMed  Google Scholar 

  42. Bobos M, Hytiroglou P, Kostopoulos I, Karkavelas G, Papadimitriou C (2006) Immunohistochemical distinction between Merkel cell carcinoma and small cell carcinoma of the lung. Am J Dermatopathol 28:99–104

    Article  PubMed  Google Scholar 

  43. La Rosa S, Bernasconi B, Micello D, Finzi G, Capella C (2009) Primary small cell neuroendocrine carcinoma of the kidney: morphological, immunohistochemical, ultrastructural, and cytogenetic study of a case and review of the literature. Endocr Pathol 20:24–34

    Article  PubMed  Google Scholar 

  44. Soriano P, Navarro S, Gil M, Llombart-Bosh A (2004) Small cell carcinoma of the urinary bladder. A clinico-pathological study of ten cases. Virchows Arch 445:292–297

    Article  CAS  PubMed  Google Scholar 

  45. Jones TD, Kernek KM, Yang XJ, Lopez-Beltran A, MacLennan GT, Eble JN, Lin H, Pan C, Tretiakova M, Baldrige LA, Cheng L (2005) Thyroid transcription factor 1 expression in small cell carcinoma of the urinary bladder: an immunohistochemical profile of 44 cases. Hum Pathol 36:718–723

    Article  CAS  PubMed  Google Scholar 

  46. Yao JL, Madeb R, Bourne P, Lei J, Yang X, Tickoo S, Liu Z, Tan D, Cheng L, Hatem F, Huang J, di Sant’Agnese PA (2006) Small cell carcinoma of the prostate: an immunohistochemical study. Am J Surg Pathol 30:705–712

    Article  PubMed  Google Scholar 

  47. Wang W, Epstein JA (2008) Small cell carcinoma of the prostate. A morphologic and immunohistochemical study of 95 cases. Am J Surg Pathol 32:65–71

    Article  PubMed  Google Scholar 

  48. Serrano FA, Sanchez-Mora N, Arranz JA, Hernandez C, Alvarez-Fernandez E (2007) Large cell and small cell neuroendocrine bladder carcinoma. Immunohistochemical and outcome study in a single institution. Am J Clin Pathol 128:733–739

    Article  Google Scholar 

Download references

Acknowledgments

This study was supported in part by a grant from the University of Insubria, Varese.

Conflict of interest statement

We declare that we have no conflict of interest.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Stefano La Rosa.

Rights and permissions

Reprints and permissions

About this article

Cite this article

La Rosa, S., Chiaravalli, A.M., Placidi, C. et al. TTF1 expression in normal lung neuroendocrine cells and related tumors: immunohistochemical study comparing two different monoclonal antibodies. Virchows Arch 457, 497–507 (2010). https://doi.org/10.1007/s00428-010-0954-0

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00428-010-0954-0

Keywords

Navigation