Akciğerin Primer ve Metastatik Adenokarsinomlarının Ayrımında Tiroid Transkripsiyon Faktör-1 TTF-1 'in Yeri.

GİRİŞ ve AMAÇ: Akciğer AC kanseri insidansı gün geçtikçe artmakta olup günümüzde kanserden ölümlerin başlıca nedenleri arasındadır. Malignitenin primer akciğer AC kaynaklı ya da metastatik olduğunun belirlenmesi klinikte sıkça karşılaşılan sorunlardandır. Tiroid transkripsiyon faktör-1 TTF-1 daha çok bronşiyal epitel hücrelerinden kaynaklanan adenokarsinomalarda ve adenoskuamöz karsinomalarda tespit edilmektedir. Diğer organların adenokarsinomalarmda TTF-1 büyük çoğunlukla negatiftir. Çalışmamızın amacı, AC'in primer ve metastatik adenokarsinomalarında TTF-1 immunhistokimyasal belirtecinin kullanımının ayırıcı tanıya katkısını belirlemektir.YÖNTEM ve GEREÇLER: Çalışmamıza 30 primer ve 20 metastatik olmak üzere toplam 50 AC kanseri hastası değerlendirildi. TTF-1 sunumunu belirlemek amacıyla TTF-1 Ab-1 8 G7G3/1, Neomarkers, USA kullanıma hazır mouse monoklonal antikoru ile immunhistokimyasal boyama prosedürü uygulandı.BULGULAR: Toplam 50 primer ve metastatik AC adenokarsinoma vakasının 11 tanesinde nükleer TTF-bir pozitifliği görüldü. Bu vakaların klinikleri değerlendirildiğinde hepsinin primer AC adenokarsinoma vakaları olduğu görüldü 11/30, %36,67 . Metastatik AC adenokarsinoma vakalarının hiç biri TTF-1 ile pozitif boyanma göstermediTARTIŞMA ve SONUÇ: Çalışmamızda TTF-1 pozitifliğinin tiroid kaynaklı AC metastazlar dışlandığında, primer pulmoner orijini işaret ettiği ancak TTF-1 ile negatif boyanmanın pulmoner orijini ekarte edemediği görülmüştür. Ayrıca bildirilen en yüksek pozitiflik oranının %76 olduğu göz önüne alınırsa tanı aşamasında TTF-1’in tek başına değil, bir antikor paneli içerisinde kullanılmasının uygun olacağı görüşüne varılmıştır.

Anahtar Kelimeler:

Akciğer kanseri, metastatik, primer, Tiroid Transkripsiyon Faktör-1.

The Discriminating Role of Thyroid Transcripsion Factor-1 TTF-1 in the Primary and Methastatic Cansers of the Lung.

INTRODUCTION: Lung cancer incidence is increasing and becoming the first cause of death due to cancer.One of the most frequent clinical problem is to determine whether the malignity is primary due to lung cancer or metastatic lung cancer. Thyroid Transcription Factor-1 TTF- 1 is a nuclear protein which is expressed in adenocarcinomas or adenosquamos carcinomas by bronchiolar epithelium cells.TTF-1 is almost negative in the other carcinomas of organs. We aimed to analyze the discriminating role of TTF-1 in the primary and metastatic cancers of the lung.METHODS: We analyzed 50 lung cancer patients, 30 patients had primary pulmonary cancers and 20 patients had metastatic pulmonary carcinomas. Immunohistochemical dyeing study was performed on the specimens using mouse monoclonal antibody against TTF-1 8 G7G3/1, Neomarkers, USA .RESULTS: We analyzed 50 lung cancer patients, 30 patients had primary pulmonary cancers and 20 patients had metastatic pulmonary carcinomas. Immunohistochemical dyeing study was performed on the specimens using mouse monoclonal antibody against TTF-1 8 G7G3/1, Neomarkers, USA .DISCUSSION AND CONCLUSION: In this study it is found that positive TTF-1 results indicate primary pulmonary cancer when thyroid-originated metastatic lung cancers were excluded, but the negative results for TTF-1 could not exclude the pulmonary origin. Also, considering the highest positivity rate is 76 % for TTF-1, the results suggest that not only using TTF-1 alone but using it within an antibody panel may be more useful for discriminating the primary adenocarcinomas from metastatic adenocarcinomas.

Keywords:

Lung Cancer, metastatic, primary, Thyroid Transcription Factor-1,

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