Utility of surfactant protein B precursor and thyroid transcription factor 1 in differentiating adenocarcinoma of the lung from malignant mesothelioma.

Differentiation of malignant mesothelioma from adenocarcinoma, particularly from a lung primary, remains a difficult diagnostic problem. Surfactant protein B precursor (pro-SP-B) and thyroid transcription factor 1 (ITF-1) are expressed selectively in the normal respiratory epithelium and in adenocarcinomas of the lung. In this study, we evaluated the utility of pro-SP-B and ITF-1 in distinguishing pulmonary adenocarcinomas and malignant mesotheliomas. Immunoreactivity for pro-SP-B and TTF-1 was examined in paraffin sections of 370 primary lung carcinomas (208 adenocarcinomas, 101 squamous cell carcinomas, and 61 large cell carcinomas) and 95 malignant mesotheliomas, using a pro-SP-B antiserum and a monoclonal TTF-1 antibody with a biotin-streptavidin detection system. Immunostaining for pro-SP-B was detected in 57% of adenocarcinomas, and 20% of large cell carcinomas. Immunoreactivity for TTF-1 was shown in 76% of adenocarcinomas and 26% of large cell carcinomas. Malignant mesotheliomas and squamous cell carcinomas did not stain with either antibody. The expression of pro-SP-B and TTF-1 in adenocarcinomas of the lung but not in malignant mesotheliomas shows that pro-SP-B and TTF-1 staining is useful in differentiating these neoplasms.

[1]  J. Whitsett,et al.  Developmental expression of SP-A and SP-A mRNA in the proximal and distal respiratory epithelium in the human fetus and newborn. , 1993, The journal of histochemistry and cytochemistry : official journal of the Histochemistry Society.

[2]  J. Whitsett,et al.  Lung Cell-specific Expression of the Murine Surfactant Protein A (SP-A) Gene Is Mediated by Interactions between the SP-A Promoter and Thyroid Transcription Factor-1 (*) , 1995, The Journal of Biological Chemistry.

[3]  S. Sternberg,et al.  Diagnostic surgical pathology , 1994 .

[4]  Essentials of biostatistics , 1988 .

[5]  W. Travis,et al.  Pseudomesotheliomatous adenocarcinoma: a reappraisal. , 1992, Seminars in diagnostic pathology.

[6]  R. Lauro,et al.  The transcription factor TTF-1 is expressed at the onset of thyroid and lung morphogenesis and in restricted regions of the foetal brain. , 1991, Development.

[7]  J. Whitsett,et al.  Expression of thyroid transcription factor-1(TTF-1) in fetal and neonatal human lung. , 1996, The journal of histochemistry and cytochemistry : official journal of the Histochemistry Society.

[8]  B. Scheithauer,et al.  The pathobiologic features of carcinomas of type II pneumocytes. An immunocytologic study , 1986, Cancer.

[9]  F. Puglisi,et al.  TTF-1 protein expression in pleural malignant mesotheliomas and adenocarcinomas of the lung. , 1998, Cancer letters.

[10]  J. Minna,et al.  Expression of surfactant associated protein-A and Clara cell 10 kilodalton mRNA in neoplastic and non-neoplastic human lung tissue as detected by in situ hybridization. , 1992, Laboratory investigation; a journal of technical methods and pathology.

[11]  S. Mills,et al.  Malignant epithelioid pleural mesothelioma versus peripheral pulmonary adenocarcinoma: a histochemical, ultrastructural, and immunohistologic study of 103 cases. , 1990, Human pathology.

[12]  H. Geuze,et al.  Intracellular processing of pulmonary surfactant protein B in an endosomal/lysosomal compartment. , 1992, The American journal of physiology.

[13]  S. Katyal,et al.  Identification, cellular localization, isolation, and characterization of human Clara cell-specific 10 KD protein. , 1988, The journal of histochemistry and cytochemistry : official journal of the Histochemistry Society.

[14]  A. Gazdar,et al.  Peripheral airway cell differentiation in human lung cancer cell lines. , 1990, Cancer research.

[15]  A. Gazdar,et al.  Glucocorticoids regulate surfactant protein synthesis in a pulmonary adenocarcinoma cell line. , 1989, The American journal of physiology.

[16]  J. Whitsett,et al.  Transcriptional Control in the Developing Lung , 1997 .

[17]  V. Roggli,et al.  Diagnosis of diffuse malignant mesothelioma: experience of a US/Canadian Mesothelioma Panel. , 1991, Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc.

[18]  J. Whitsett,et al.  Expression of surfactant protein B precursor and surfactant protein B mRNA in adenocarcinoma of the lung. , 1997, Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc.

[19]  J. Whitsett,et al.  Temporal-spatial distribution of SP-B and SP-C proteins and mRNAs in developing respiratory epithelium of human lung. , 1994, The journal of histochemistry and cytochemistry : official journal of the Histochemistry Society.

[20]  S. Hirohashi,et al.  Immunohistochemical distinction of malignant mesothelioma from pulmonary adenocarcinoma with anti-surfactant apoprotein, anti-Lewisa, and anti-Tn antibodies. , 1989, Human pathology.

[21]  B. Stripp,et al.  Regulation of Clara cell secretory protein gene transcription by thyroid transcription factor-1. , 1997, Biochimica et biophysica acta.

[22]  J. Whitsett,et al.  Monoclonal antibody to thyroid transcription factor-1: production, characterization, and usefulness in tumor diagnosis. , 1996, Hybridoma.

[23]  N. Ordóñez.  The value of antibodies 44-3A6, SM3, HBME-1, and thrombomodulin in differentiating epithelial pleural mesothelioma from lung adenocarcinoma: a comparative study with other commonly used antibodies. , 1997, The American journal of surgical pathology.

[24]  T. Nakajima,et al.  Immunohistochemical localization of pulmonary surfactant apoproteins in various lung tumors: Special reference to nonmucus producing lung adenocarcinomas , 1988, Cancer.

[25]  J. Riera,et al.  The immunohistochemical diagnostic panel for epithelial mesothelioma: a reevaluation after heat-induced epitope retrieval. , 1997, The American journal of surgical pathology.

[26]  P. Cagle,et al.  Concurrent mesothelioma and adenocarcinoma of the lung in a patient with asbestosis. , 1993, Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc.

[27]  R. Lauro,et al.  Surfactant proteins and thyroid transcription factor-1 in pulmonary and breast carcinomas. , 1996, Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc.

[28]  M. Stahlman,et al.  Ontogeny of Clara cell-specific protein and its mRNA: their association with neuroepithelial bodies in human fetal lung and in bronchopulmonary dysplasia. , 1996, The journal of histochemistry and cytochemistry : official journal of the Histochemistry Society.

[29]  S. Steinberg,et al.  Peripheral airway cell marker expression in non-small cell lung carcinoma. Association with distinct clinicopathologic features. , 1992, American journal of clinical pathology.

[30]  B Terracini,et al.  Malignant mesothelioma of the pleura: interobserver variability. , 1995, Journal of clinical pathology.

[31]  R. Lauro,et al.  The lung-specific surfactant protein B gene promoter is a target for thyroid transcription factor 1 and hepatocyte nuclear factor 3, indicating common factors for organ-specific gene expression along the foregut axis , 1994, Molecular and cellular biology.

[32]  M. Wick.  Immunophenotyping of malignant mesothelioma. , 1997, The American journal of surgical pathology.

[33]  Taylor Murray,et al.  Cancer statistics, 1998 , 1998, CA: a cancer journal for clinicians.

[34]  N. Hooper,et al.  Function and regulation of expression of pulmonary surfactant-associated proteins. , 1991, The Biochemical journal.

[35]  C H Fox,et al.  The T/ebp null mouse: thyroid-specific enhancer-binding protein is essential for the organogenesis of the thyroid, lung, ventral forebrain, and pituitary. , 1996, Genes & development.