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Immunohistochemical double staining with TTF-1 and aldehyde fuchsin with CT scan enhances the detection of visceral pleural invasion in lung cancer
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L. Wu   , Q. Lin , Y. Chen , N. Qiu , J. Huang |
| Department of Pathology, Fuzhou Pulmonary Hospital of Fujian, Fuzhou 350008, Fujian Province, China , wlpwcx1@163.com |
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Abstract: (6 Views) |
Background: Accurate assessment of visceral pleural invasion (VPI) is important for lung cancer staging and prognosis, but distinguishing PL0 from PL1 can be difficult on conventional histology. We evaluated whether combined thyroid transcription factor-1 (TTF-1) immunohistochemistry and aldehyde fuchsin elastic staining, interpreted with preoperative computed tomography (CT), facilitates VPI assessment in lung adenocarcinoma. Materials and Methods: This retrospective study included 76 patients with surgically resected lung adenocarcinoma. Clinicopathological characteristics, immunohistochemical findings, pathological stage, VPI status, CT features, and recurrence outcomes were reviewed. Selected sections underwent combined TTF-1/aldehyde fuchsin double staining. Principal component analysis (PCA) and Mahalanobis distance analysis were performed as exploratory analyses. Results: The mean age was 62.0 ± 8.8 years; 58.4% were female and 31.2% had a smoking history. EGFR mutations were detected in 58.4% of tumors. VPI was identified in 75 of 76 evaluable cases (98.7%). Double staining demonstrated the relationship of TTF-1-positive tumor cells to the visceral pleural elastic lamina, distinguishing the single PL0 case from PL1 lesions. Three patients (3.9%) developed recurrence 14–19 months after surgery. The first three principal components explained 64.5% of total variance; the PL0 case had the greatest Mahalanobis distance, whereas recurrent cases were not multivariate outliers. Conclusion: Combined TTF-1 and aldehyde fuchsin staining permits simultaneous visualization of tumor cells and the pleural elastic layer and may serve as a practical adjunct for distinguishing PL0 from PL1 in lung adenocarcinoma. CT may provide complementary information in integrated VPI assessment. |
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| Keywords: Adenocarcinoma of lung, neoplasm invasiveness, immunohistochemistry, thyroid nuclear factor 1, tomography, X-ray computed. |
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Full-Text [PDF 1450 kb]
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Type of Study: Original Research |
Subject:
Radiation Biology
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