Immunohistochemistry in the differential diagnostics of primary lung cancer: an investigation within the Southern Swedish Lung Cancer Study

Am J Clin Pathol. 2013 Jul;140(1):37-46. doi: 10.1309/AJCP50RDXSCSBTBO.

Abstract

Objectives: To assess immunohistochemical (IHC) stains differentially expressed between different types of lung cancer.

Methods: We evaluated 16 different IHC stains in 209 prospectively included, surgically treated primary lung cancers, including 121 adenocarcinomas, 65 squamous cell carcinomas, 15 large-cell carcinomas, 5 adenosquamous carcinomas, 2 sarcomatoid carcinomas, and 1 small-cell carcinoma, using the tissue microarray technique.

Results: Cytokeratin 5 (CK5) and P63 were both positive in 10% or more of the cells in 97% of the squamous cell carcinomas, with the former being positive (<10% of the cells) in only 2 non-squamous cell carcinomas. Thyroid transcription factor 1 (TTF1) and napsin A were positive in 10% or more of the cells in 88% and 87% of the adenocarcinomas, respectively, with 94% of the adenocarcinomas being positive in at least 1 marker. Fifteen percent of the adenocarcinomas were positive for estrogen receptor.

Conclusions: CK5, TTF1, and napsin A are sensitive markers for squamous cell carcinoma and adenocarcinoma of the lung.

Keywords: Adenocarcinoma; CK5; Cytokeratin; Estrogen receptor; Large-cell carcinoma; Napsin A; Neuroendocrine; P63; Squamous cell carcinoma; TTF-1.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adenocarcinoma / classification
  • Adenocarcinoma / pathology*
  • Adenocarcinoma / surgery
  • Aged
  • Aspartic Acid Endopeptidases / metabolism
  • Biomarkers, Tumor / metabolism*
  • Carcinoma, Adenosquamous / classification
  • Carcinoma, Adenosquamous / pathology*
  • Carcinoma, Adenosquamous / surgery
  • Carcinoma, Large Cell / classification
  • Carcinoma, Large Cell / pathology*
  • Carcinoma, Large Cell / surgery
  • Carcinoma, Squamous Cell / classification
  • Carcinoma, Squamous Cell / pathology*
  • Carcinoma, Squamous Cell / surgery
  • Diagnosis, Differential
  • Estrogen Receptor alpha / metabolism
  • Female
  • Humans
  • Immunohistochemistry
  • Keratin-5 / metabolism
  • Lung / pathology
  • Lung Neoplasms / classification
  • Lung Neoplasms / pathology*
  • Lung Neoplasms / surgery
  • Male
  • Membrane Proteins / metabolism
  • Middle Aged
  • Nuclear Proteins / metabolism
  • Prospective Studies
  • Receptors, Estrogen / metabolism
  • Small Cell Lung Carcinoma / classification
  • Small Cell Lung Carcinoma / pathology
  • Small Cell Lung Carcinoma / surgery
  • Sweden
  • Thyroid Nuclear Factor 1
  • Tissue Array Analysis
  • Transcription Factors / metabolism

Substances

  • Biomarkers, Tumor
  • CKAP4 protein, human
  • ESR1 protein, human
  • Estrogen Receptor alpha
  • Keratin-5
  • Membrane Proteins
  • NKX2-1 protein, human
  • Nuclear Proteins
  • Receptors, Estrogen
  • Thyroid Nuclear Factor 1
  • Transcription Factors
  • Aspartic Acid Endopeptidases
  • NAPSA protein, human