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Test Name:p40-TTF1 cocktail by IHC
Test Number:12376 - Technical only; 12379 - Technical & Interpretation
Collect:Formalin-fixed, paraffin embedded (FFPE) tissue block
Container:FFPE tissue block
Processing:Submit processed tissue block or tissue section mounted on a charged, unstained slide
Transport/Stability:Ambient (preferred)
Alternate Names:Cocktail
p40
TTF-1
IHC
LAB12376
LAB12379
Performing Lab:AHL - Immunohistochemistry
Days Set Up:Mo - Fr
Expected TAT:1 - 2 days
Ref. Ranges:If requested, an interpretive report will be provided
All IHC stains will include a positive control tissue
Collection/
Processing Details:

Specifications:
  • TTF-1 reacts with a transcription factor expressed in thyroid (follicular cells), lung (type II cells, Clara cells), and diencephalon
  • P40 is one of 10 p63 isoforms which is highly specific for squamous differentiation




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Staining pattern:
  • Positive TTF-1 staining: Brown nuclear staining
  • Positive P40 staining: Red nuclear staining
Applications:
  • This cocktail is intended to be used to assist in differentiating lung adenocarcinomas and lung squamous cell carcinomas. This TTF-1/P40 cocktail has a reported sensitivity of 77% and a specificity of 100% for lung adenocarcinomas. This TTF-1/P40coktail has a reported sensitivity of 93% and a specificity of 92% for lung squamous cell carcinomas
  • Other tumors reported to be positive for TTF-1 include neuroendocrine tumors (pulmonary and non-pulmonary origin), thyroid neoplasms, a subset of endometrial and cervical neoplasms, papillary nasopharyngeal carcinomas, and colorectal adenocarcinoma. Tumors which have been reported to rarely stain for TTF-1 in a subset of tumor cells include: cholangiocarcinoma, ovarian, gastric/esophageal, pancreatic ductal, urothelial, hepatocellular, salivary gland neoplasms including adenoid cystic carcinoma, and adrenal cortical carcinoma
  • Other tumors reported to be positive for the P40 clone used in this cocktail include bladder, breast, and prostate
References:
  1. Brown AF, et al. Tissue preserving antibody cocktails to differentiate primary squamous cell carcinoma, adenocarcinoma, and small cell carcinoma of lung. Arch Pathol Lab Med. 2013 Sep;137(9):1274-81.
  2. Russel D, et al. Dual immunostaining TTF-1 and p40 for subcategorizing of nonsmall cell carcinoma of the lung in cytologic and surgical specimens.
Method:Immunohistochemical staining
Microscopic examination
CPT Codes:88342 - 1st stain
88341 - each additional stain
Date Created:01/02/2018
Revised Date:10/19/2018