Warranting investigation of primary lung adenocarcinoma in patients with an extrapulmonary malignancy and lung nodules due to high frequency

Bing Zhu, Shavari Dalal, David William Kamp, Xiaoqi Lin*

*Corresponding author for this work

Research output: Contribution to journalArticle

3 Citations (Scopus)

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 languageEnglish (US)
Pages (from-to)429-436
Number of pages8
JournalAmerican Journal of Clinical Pathology
Volume141
Issue number3
DOIs
StatePublished - Mar 1 2014

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Lung
Neoplasms
Adenocarcinoma
Adenocarcinoma of lung
Colon
Breast
Smoking
History
Neoplasm Metastasis
Therapeutics

Keywords

  • Extrapulmonary malignancy
  • Frequency
  • Immunohistochemistry
  • Metastatic malignancy
  • Primary lung adenocarcinoma

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

Cite this

@article{f6c9688271554fb1878826e7f2234a1b,
title = "Warranting investigation of primary lung adenocarcinoma in patients with an extrapulmonary malignancy and lung nodules due to high frequency",
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.",
keywords = "Extrapulmonary malignancy, Frequency, Immunohistochemistry, Metastatic malignancy, Primary lung adenocarcinoma",
author = "Bing Zhu and Shavari Dalal and Kamp, {David William} and Xiaoqi Lin",
year = "2014",
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doi = "10.1309/AJCP97FTJXWPFJXY",
language = "English (US)",
volume = "141",
pages = "429--436",
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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 William

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

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