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Peroperative frozen section analysis of TTF-1 antigen expression

Service d’Anatomie Pathologique et Unité de Chirurgie Thoracique, Hotel-Dieu, 1, Place Du Parvis Notre Dame, Cedex 75181, Paris, France

Correspondence to:
Dr S P Camilleri-Broet
Service d’Anatomie Pathologique, Hotel-Dieu, 1, Place Du Parvis Notre Dame, Cedex 75181, Paris, France; sophie.camilleri-broet{at}htd.ap-hop-paris.fr
ABSTRACT
Background: The assessment of thyroid transcription factor 1 (TTF-1) expression is a useful way to investigate the origin of lung adenocarcinomas or large cell carcinomas when dealing with a solitary lung nodule in a patient with a history of extrathoracic cancer. However, if immunohistological analysis has not been performed before surgery, a peroperative frozen section may be insufficient to distinguish between a primary pulmonary tumour and a metastatic tumour.

Aims: To develop a technique for the rapid assessment of TTF-1 expression that could improve the ability of frozen section peroperative histological diagnosis to answer such questions.

Methods: A rapid immunohistochemical technique (lasting 30 minutes) to assess the expression of TTF-1 was developed and tested.

Results: Among the 45 interpretable cases, results of frozen section immunohistochemistry were similar to those found by the standard immunohistochemical technique for the expression of TTF-1.

Conclusions: This technique enables TTF-1 to be analysed peroperatively, but further prospective studies are needed to assess its usefulness in routine practice.

Keywords: thyroid transcription factor 1; frozen section; immunohistochemistry; lung metastasis

Abbreviations: SABC, streptavidin–biotin–peroxidase; TTF-1, thyroid transcription factor 1