TTF-1 and surfactant-B as co-adjuvants in the diagnosis of lung adenocarcinoma and pleural mesothelioma

Ann Diagn Pathol. 2004 Dec;8(6):337-41. doi: 10.1053/j.anndiagpath.2004.08.003.


Primary lung adenocarcinomas and metastatic adenocarcinomas may show a great morphologic resemblance to malignant mesothelioma. There are numerous immunohistochemical markers being used, but none of them were proved to be effective enough to reach a certain diagnosis. The current study was performed to evaluate the utility of thyroid transcription factor-1 (TTF-1) and surfactant protein-B (SP-B) expression in the differential diagnosis between lung adenocarcinomas and pleural mesotheliomas. In this retrospective study, TTF-1 and SP-B were applied to 30 cases with adenocarcinoma and 15 cases with pleural mesothelioma, immunohistochemically, using an avidin-biotin detection system. Twenty percent of adenocarcinomas and 13.3% of pleural mesothelioma stained positive for SP-B. TTF-1 stained 24 of the 30 adenocarcinomas (80%) and none of the 15 mesotheliomas (0%). TTF-1 positivity in adenocarcinomas was found to be statistically significant, while SP-B had no important practical value either used alone or in combination with TTF-1. There was no statistically significant correlation between the differentiation level of adenocarcinomas and TTF-1 staining pattern. In conclusion, we believe that TTF-1 may be helpful in distinguishing lung adenocarcinoma from pleural mesothelioma.

Publication types

  • Evaluation Study

MeSH terms

  • Adenocarcinoma / diagnosis*
  • Adenocarcinoma / metabolism
  • Biomarkers, Tumor / metabolism
  • Diagnosis, Differential
  • Humans
  • Lung Neoplasms / diagnosis*
  • Lung Neoplasms / metabolism
  • Mesothelioma / diagnosis*
  • Mesothelioma / metabolism
  • Nuclear Proteins / metabolism*
  • Pleural Neoplasms / diagnosis*
  • Pleural Neoplasms / metabolism
  • Pulmonary Surfactant-Associated Protein B / metabolism*
  • Reproducibility of Results
  • Retrospective Studies
  • Thyroid Nuclear Factor 1
  • Transcription Factors / metabolism*


  • Biomarkers, Tumor
  • NKX2-1 protein, human
  • Nuclear Proteins
  • Pulmonary Surfactant-Associated Protein B
  • Thyroid Nuclear Factor 1
  • Transcription Factors