Allina Health Laboratory a part of Abbott Northwestern Hospital



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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
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
Processing Details:

  • 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

Staining pattern:
  • Positive TTF-1 staining: Brown nuclear staining
  • Positive P40 staining: Red nuclear staining
  • 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
  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