Abstract
Objectives: To distinguish primary lung adenocarcinoma (PLA) from metastatic adenocarcinoma/malignancy to optimize therapy. Methods: We investigated the utility of thyroid transcription factor 1 (TTF-1) and napsin A in distinguishing PLA from metastatic adenocarcinoma/malignancy and assessed the frequency of PLA in patients with extrapulmonary malignancy/adenocarcinoma (PLA-EPM/EPA). Results: TTF-1 and napsin A identified PLA in PLA-EPM/ EPA with a sensitivity of 89.4% and 93.3% and a specificity of 93.9% and 94.7%, respectively. PLA was confirmed in 47.4% of PLA-EPM and 40.2% of PLA-EPA. Overall, 38.5% of patients with PLA had EPM. The common organs for PLA-EPA were breast (35.8%), colon (13.2%), and others, whereas the common organs resulting in pulmonary metastasis were the colon (32.8%), breast (28.1%), and others. A patient with a smoking history and without EPM had a higher chance of having PLA. Multiple nodules are not a reliable indication of metastatic adenocarcinoma. Conclusions: Our results firmly support the role of TTF-1 and napsin A in identifying PLA-EPM/EPA. We reason that all new lung nodules in patients with a history of EPM should be screened using these techniques due to the high frequency of PLA-EPM, which will affect treatment and prognosis of patients with EPM/EPA.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 429-436 |
| Number of pages | 8 |
| Journal | American journal of clinical pathology |
| Volume | 141 |
| Issue number | 3 |
| DOIs | |
| State | Published - Mar 1 2014 |
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Keywords
- Extrapulmonary malignancy
- Frequency
- Immunohistochemistry
- Metastatic malignancy
- Primary lung adenocarcinoma
ASJC Scopus subject areas
- Pathology and Forensic Medicine
Cite this
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Warranting investigation of primary lung adenocarcinoma in patients with an extrapulmonary malignancy and lung nodules due to high frequency. / Zhu, Bing; Dalal, Shavari; Kamp, David W.; Lin, Xiaoqi.
In: American journal of clinical pathology, Vol. 141, No. 3, 01.03.2014, p. 429-436.Research output: Contribution to journal › Article
TY - JOUR
T1 - Warranting investigation of primary lung adenocarcinoma in patients with an extrapulmonary malignancy and lung nodules due to high frequency
AU - Zhu, Bing
AU - Dalal, Shavari
AU - Kamp, David W.
AU - Lin, Xiaoqi
PY - 2014/3/1
Y1 - 2014/3/1
N2 - Objectives: To distinguish primary lung adenocarcinoma (PLA) from metastatic adenocarcinoma/malignancy to optimize therapy. Methods: We investigated the utility of thyroid transcription factor 1 (TTF-1) and napsin A in distinguishing PLA from metastatic adenocarcinoma/malignancy and assessed the frequency of PLA in patients with extrapulmonary malignancy/adenocarcinoma (PLA-EPM/EPA). Results: TTF-1 and napsin A identified PLA in PLA-EPM/ EPA with a sensitivity of 89.4% and 93.3% and a specificity of 93.9% and 94.7%, respectively. PLA was confirmed in 47.4% of PLA-EPM and 40.2% of PLA-EPA. Overall, 38.5% of patients with PLA had EPM. The common organs for PLA-EPA were breast (35.8%), colon (13.2%), and others, whereas the common organs resulting in pulmonary metastasis were the colon (32.8%), breast (28.1%), and others. A patient with a smoking history and without EPM had a higher chance of having PLA. Multiple nodules are not a reliable indication of metastatic adenocarcinoma. Conclusions: Our results firmly support the role of TTF-1 and napsin A in identifying PLA-EPM/EPA. We reason that all new lung nodules in patients with a history of EPM should be screened using these techniques due to the high frequency of PLA-EPM, which will affect treatment and prognosis of patients with EPM/EPA.
AB - Objectives: To distinguish primary lung adenocarcinoma (PLA) from metastatic adenocarcinoma/malignancy to optimize therapy. Methods: We investigated the utility of thyroid transcription factor 1 (TTF-1) and napsin A in distinguishing PLA from metastatic adenocarcinoma/malignancy and assessed the frequency of PLA in patients with extrapulmonary malignancy/adenocarcinoma (PLA-EPM/EPA). Results: TTF-1 and napsin A identified PLA in PLA-EPM/ EPA with a sensitivity of 89.4% and 93.3% and a specificity of 93.9% and 94.7%, respectively. PLA was confirmed in 47.4% of PLA-EPM and 40.2% of PLA-EPA. Overall, 38.5% of patients with PLA had EPM. The common organs for PLA-EPA were breast (35.8%), colon (13.2%), and others, whereas the common organs resulting in pulmonary metastasis were the colon (32.8%), breast (28.1%), and others. A patient with a smoking history and without EPM had a higher chance of having PLA. Multiple nodules are not a reliable indication of metastatic adenocarcinoma. Conclusions: Our results firmly support the role of TTF-1 and napsin A in identifying PLA-EPM/EPA. We reason that all new lung nodules in patients with a history of EPM should be screened using these techniques due to the high frequency of PLA-EPM, which will affect treatment and prognosis of patients with EPM/EPA.
KW - Extrapulmonary malignancy
KW - Frequency
KW - Immunohistochemistry
KW - Metastatic malignancy
KW - Primary lung adenocarcinoma
UR - http://www.scopus.com/inward/record.url?scp=84897944083&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84897944083&partnerID=8YFLogxK
U2 - 10.1309/AJCP97FTJXWPFJXY
DO - 10.1309/AJCP97FTJXWPFJXY
M3 - Article
C2 - 24515772
AN - SCOPUS:84897944083
VL - 141
SP - 429
EP - 436
JO - American Journal of Clinical Pathology
JF - American Journal of Clinical Pathology
SN - 0002-9173
IS - 3
ER -