The predominant expression of hepatocyte nuclear factor 4α (HNF4α) in thyroid transcription factor‐1 (TTF‐1)‐negative pulmonary adenocarcinoma

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Kunii R, Jiang S, Hasegawa G, Yamamoto T, Umezu H, Watanabe T, Tsuchida M, Hashimoto T, Hamakubo T, Kodama T, Sasai K & Naito M (2011) Histopathology58, 467–476 The predominant expression of hepatocyte nuclear factor 4α (HNF4α) in thyroid transcription factor‐1 (TTF‐1)‐negative pulmonary adenocarcinoma Aims: To investigate TTF‐1‐negative pulmonary adenocarcinoma, focusing upon mucin production and the expression of hepatocyte nuclear factor‐4α (HNF4α). Materials and methods: Two hundred and sixty‐two cases of pulmonary adenocarcinoma were examined histologically and immunohistochemically; TTF‐1 was expressed in 222 cases (84.7%), and 40 cases (15.3%) were negative. Among TTF‐1‐negative cases there were 31 mucinous‐type tumours, and HNF4α, MUC5AC and MUC2 were expressed in 34 cases (85%), 29 cases (72.5%) and four cases (10%), respectively. In contrast, their expression was rare in TTF‐1‐positive tumours. A statistically inverse correlation was confirmed between the expression of TTF‐1 and that of HNF4α and MUC5AC. Conclusion: Most TTF‐1‐negative pulmonary adenocarcinomas are mucinous lesions with the predominant expressionof HNF4α and MUC5AC.