Expression and clinical significance of TTF-1 and p63 in NSCLC.

Abstract

To detect the expressions of thyroid transcription factor-1 (TTF-1) and p63 in non-small cell lung cancer (NSCLC) and to evaluate their clinical significance. The expression of TTF-1 and p63 from 404 NSCLC and 28 benign pulmonary disease (BPD) tissue specimens were detected by immunohistochemical EnVision two-step method, together with their clinicopathologic data. The positive rate of TTF-1 and p63 protein in NSCLC tissues was 51.7% (209/404) and 37.9% (153/404), respectively, while negative in the BPD group. There was overexpression of TTF-1 in female gender and non-smoking history (P<0.001) and asymptomatic patients (P=0.015). It was more frequently in adenocarcinoma (AdC) with sensitivity of 84.1% and specificity of 89.8%, especially in well or moderately differentiated AdC (P<0.001). The positive rate of p63 was closely related with male gender and smoking history (P<0.001). Its sensitivity and specificity to squamous cell carcinoma (SCC) was 95.5% and 98.8%, respectively, which was positively correlated with differentiation of SCC (P=0.008), but negatively with tumor stage (P=0.002). Logistic multivariate analysis showed smoking history and histological type were significantly associated with TTF-1 and p63 expression. 93.1% of those represent TTF-1(+)/p63(-) were AdC, while 98.6% of TTF-1(-)/p63(+) were SCC. p63 expression was negatively correlated with TTF-1 (P<0.001). TTF-1 and p63 might be effective bio-markers for AdC and SCC in NSCLC. They may be a useful marker panel for the identification and differential of lung cancer.