• All IHC stains will include a positive control tissue

• 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

Submit a formalin-fixed, paraffin embedded tissue block

Formalin-fixed, paraffin embedded (FFPE) tissue block

FFPE tissue section mounted on a charged, unstained slide

Ambient (preferred)

• Unlabeled/mislabeled block
• Insufficient tissue
• Slides broken beyond repair

Immunohistochemical staining and microscopic examination

If requested, an interpretive report will be provided

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

Staining pattern

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

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.