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Thyroid transcription factor‐1 expression is an independent predictor of recurrence and correlates with the IASLC/ATS/ERS histologic classification in patients with stage I lung adenocarcinoma
Author(s) -
Kadota Kyuichi,
Nitadori Junichi,
Sarkaria Inderpal S.,
Sima Camelia S.,
Jia Xiaoyu,
Yoshizawa Akihiko,
Rusch Valerie W.,
Travis William D.,
Adusumilli Prasad S.
Publication year - 2012
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.27863
Subject(s) - medicine , thyroid transcription factor 1 , adenocarcinoma , thyroid , stage (stratigraphy) , lung , oncology , pathology , lung cancer , transcription factor , cancer , gene , biology , paleontology , biochemistry
BACKGROUND: In the current study, the authors investigated whether thyroid transcription factor‐1 (TTF‐1) expression is correlated with the International Association for the Study of Lung Cancer (IASLC)/American Thoracic Society (ATS)/European Respiratory Society (ERS) classification and whether it stratifies patients with stage I lung adenocarcinoma with respect to disease recurrence. METHODS: Patients with stage I lung adenocarcinoma were classified according to the IASLC/ATS/ERS classification. Tissue microarrays were constructed and immunostaining for TTF‐1 was performed. A total of 452 cases were available for analysis. Tumors were dichotomized based on the intensity of nuclear TTF‐1 expression as negative (score of 0) or positive (score of 1–3). The cumulative incidence of recurrence (CIR) was used to estimate disease recurrence probabilities. RESULTS: TTF‐1 expression was identified in 92% of patients, including 100% of patients with minimally invasive or lepidic‐predominant adenocarcinoma, 94% of patients with acinar‐predominant adenocarcinoma, 98% of patients with papillary‐predominant adenocarcinoma, 93% of patients with micropapillary‐predominant adenocarcinoma, 86% of patients with solid‐predominant adenocarcinoma, 67% of patients with colloid‐predominant adenocarcinoma, and 47% of patients with invasive mucinous carcinoma. The CIR for patients with negative TTF‐1 expression (n = 34 patients; 5‐year CIR, 40%) was significantly higher than that for patients with positive TTF‐1 expression (n = 418 patients; 5‐year CIR, 15%) ( P < .001). Among the patients with intermediate‐grade tumors, the CIR for patients with negative TTF‐1 expression (n = 16 patients; 5‐year CIR, 45%) was significantly higher than that for patients with positive TTF‐1 expression (n = 313 patients; 5‐year CIR, 14%) ( P < .001). On multivariate analysis, negative TTF‐1 expression was found to be significantly correlated with an increased risk of disease recurrence (hazards ratio, 2.55; P = .009). CONCLUSIONS: TTF‐1 expression was found to be an independent predictor of disease recurrence, stratifying intermediate‐grade tumors into 2 prognostic subsets, and it correlates with the IASLC/ATS/ERS classification. Cancer 2013. © 2012 American Cancer Society.