Utility of Thyroid Transcription Factor-1 and Cytokeratin 20 in Identifying the Origin of Metastatic Carcinomas of Cervical Lymph Nodes.
10.3346/jkms.2002.17.4.512
- Author:
Mee Sook ROH
1
;
Sook Hee HONG
Author Information
1. Department of Pathology and Institute of Medical Science, Dong-A University College of Medicine, Busan, Korea. shhong@daunet.donga.ac.kr
- Publication Type:Original Article ; Research Support, Non-U.S. Gov't
- Keywords:
Thyroid Transcription Factors;
Cytokeratin 20;
Neoplasms Metastasis;
Lymph Nodes;
Cervical
- MeSH:
Adenocarcinoma/chemistry/pathology/secondary;
Carcinoma/chemistry/pathology/*secondary;
Gastrointestinal Neoplasms/chemistry/pathology;
Homeodomain Proteins/analysis;
Humans;
Intermediate Filament Proteins/*analysis/immunology;
Keratin-20;
Lung Neoplasms/chemistry/pathology;
Lymph Nodes/chemistry/pathology;
Lymphatic Metastasis/*diagnosis/pathology;
Neck;
Neoplasms, Unknown Primary/chemistry/pathology;
Nuclear Proteins/*analysis/immunology;
Sensitivity and Specificity;
Transcription Factors/*analysis/immunology;
Tumor Markers, Biological/analysis
- From:Journal of Korean Medical Science
2002;17(4):512-517
- CountryRepublic of Korea
- Language:English
-
Abstract:
The identification of primary location of a metastatic tumor is a difficult diagnostic problem and sometimes can be facilitated by the use of immunohistochemical markers. Thyroid transcription factor-1 (TTF-1) is a 38-kDa nuclear homeodomain transcription factor that is expressed specifically in lung or thyroid neoplasms. Cytokeratin 20 (CK20) is a 46-kDa low-molecular-weight cytokeratin that shows restricted expression in adenocarcinomas of the gastrointestinal tract (GIT) and transitional cell carcinomas of the urinary tract. We studied the immunohistochemical expression of TTF-1 and CK20 in 68 metastatic carcinomas in cervical lymph nodes. The primary sites were the lung in 29 cases, stomach in 13, colorectum in 3, and other sites in 23. TTF-1 expression was detected in 69.0% of metastatic lung carcinomas and none in metastatic GIT carcinomas, whereas CK20 expression was detected in 68.8% of metastatic GIT carcinomas and none of metastatic lung carcinomas. TTF-1 had a specificity of 0.95 and a sensitivity of 0.69 for metastatic lung carcinoma, whereas CK20 had a specificity of 1.00 and a sensitivity of 0.69 for metastatic GIT carcinoma. These results indicate that TTF-1 and CK20 should be the first choice as a component of antibody panel to prove or to exclude the lung and GIT origin, respectively, especially in patients presenting with metastatic carcinomas of unknown primary site.
