D. NART, B. SARSIK, B DOĞANAVŞARGİL, M. SEZAK, B. YAMAN, M. ÇİRİŞ, A. VERAL

Primer ve metastatik akciğer tümörlerinin ayırıcı tanısında tiroid transkripsiyon faktör-1 ekspresyonunun önemi ve güvenilirliği

Giriş: Tiroid transkripsiyon faktör-1 (TTF-1), gelişmekte olan tiroid, akciğer ve beyinin erken diferansiyasyon ve morfogenezinde önemli rol oynar. TTF-1 ekspresyonu, akciğer ve tiroid kanserlerinde yüksek oranlarda görülmektedir. TTF-1'in immunohistokimyasal (İHK) uygulaması, akciğer kökenli adenokarsinomların identifikasyonunda oldukça yaygın olarak kullanılmaktadır. Bu çalışmada primer akciğer kanserlerinin farklı tiplerinde ve farklı organlardan akciğere metastaz yapmış kanserlerde TTF-1 immunoreaktivitesi incelenerek TTF-1'in primer- metastaz ayırıcı tanısındaki yeri ve güvenilirliği irdelendi. Gereç ve Yöntem: Primer akciğer tümörü tanısı alan 111 olgu ve metastatik akciğer tümörü tanısı alan 23 olgu çalışmamıza dahil edildi. Primer akciğer tümörlerine genel olarak bakıldığında toplam 111 olgunun 78'inde yani %70'inde TTF-1 ekspresyonu saptandı. Özellikle küçük hücreli karsinom (%100) ve adenokarsinomlarda (%89) bu oran oldukça yüksekti. Metastatik akciğer tümörlerinde ise tiroid karsinom metastazında beklendiği gibi diffüz bir pozitiflik izlenirken, diğer tümör metastazlarının hiçbirinde TTF-1 ekspresyonu izlenmedi. Sonuç ve Tartışma: Bizim sonuçlarımız da göstermektedir ki, TTF-1 ekspresyonu primer akciğer tümörlerinin metastatik tümörlerinden ayırıcı tanısında oldukça değerli bir belirleyicidir ve İHK olarak rutin işleyişte kullanabileceğimiz sensitif (%70) ve oldukça spesifik (%100) bir metoddur.

The importance and reliability of thyroid transcription factor-1 expression to differential diagnosis in primary and metastatic lung cancers

Introduction: Thyroid transcription factor-1 (TTF-1) has an important role in the morphogenesis and early differantiation of the fetal tyhroid, brain and lung. Tyhroid and lung carcinomas express TTF-1 in a high proportion. TTF-1 immunostaining is commonly used in the diagnosis of lung adenocarcinomas. In this study , TTF-1 immunreactivity has been examined in different types of primary lung carcinomas and lung metastases from different sites. The reliability of TTF-1 has been studied in the diagnosis of primary and metastatic lung carcinomas. Materials and Methods: One hundred eleven primary lung carcinomas and 23 metastatic lung carcinomas have been included. TTF-1 was positive in 78 of 111 primary lung carcinomas (%70). This ratio was very high especially in small cell carcinomas(%100) and adenocarcinomas(%83). In the metastatic group, diffuse TTF-1 immunoreactivity was seen in thyroid cancer metastasis, as expected and TTF-1 expression was not seen in other metastatic carcinomas. Results and Discussion: Our study shows that TTF-1 has a great value in differential diagnosis of primary and metastatic lung carcinomas, and it's a sensitive (%70) and spesific (%100) immunohistochemical method in routine studies.

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