Clinicopathological Features of Non-small Cell Lung Carcinoma with Coexpression of Thyroid Transcription Factor-1 and p40

CHEN Huiping; ZHANG Ruizhen; ZHANG Na; REN Jingli; FENG Yikun; HU Guiming

doi:10.3969/j.issn.1004-437X.2024.19.001

Abstract：Objective To explore the clinical and pathological characteristics of non-small cell lung carcinoma(NSCLC)patients with co-expressing thyroid transcription factor-1(TTF-1)and p40.Methods Seven cases of NSCLC co-expressing TTF-1 and p40 were collected.A retrospective analysis of their clinical features,pathological morphology,immunophenotype,and molecular characteristics was conducted,along with a review of relevant literature.Results The patients with a median age of 58 years old,common in males or people who had a history of smoking.Imaging showed peripheral masses in all cases.Tumor cells exhibited a solid nest-like arrangement,round,oval,or polygonal,with transparent or acidophilic cytoplasm;the mitotic figures were＞10/10 high-power fields(HPF).Vascular tumor emboli were observed in 3 cases.The same group of tumor cells expressed TTF-1 and p40 simultaneously;CK7,p63,CK5/6 and napsinA showed focal or diffuse expression,and the Ki-67 proliferative index was positive in 10％to 90％.According to g ARMS-PCR,two cases were found to have epidermal growth factor receptor(EGFR)exon 18 G719A/S/C mutations and exon 21 L858R mutations,while using next-generation sequencing,one case showed TPM3-ROS1 fusion mutation and ROS1(G2032R)mutation.After 1 to 46 months of followed-up,two patients died after 22 and 38 months,respectively.Three patients developed cervical lymph node or brain metastasis.Conclusion NSCLC co-expressing TTF-1 and p40 exhibits unique clinical and pathological features,characterized by rapid clinical progression and poor prognosis,suggesting it may represent a novel tumor entity.