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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
Article first published online: 23 OCT 2012
Copyright © 2012 American Cancer Society
Volume 119, Issue 5, pages 931–938, 1 March 2013
How to Cite
Kadota, K., Nitadori, J.-i., Sarkaria, I. S., Sima, C. S., Jia, X., Yoshizawa, A., Rusch, V. W., Travis, W. D. and Adusumilli, P. S. (2013), 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. Cancer, 119: 931–938. doi: 10.1002/cncr.27863
- Issue published online: 19 FEB 2013
- Article first published online: 23 OCT 2012
- Manuscript Accepted: 19 SEP 2012
- Manuscript Revised: 17 SEP 2012
- Manuscript Received: 3 AUG 2012
- lung adenocarcinoma;
- thyroid transcription factor-1;
- histologic subtype;
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.
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.
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).
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.