Surfactant proteins

Pulmonary surfactant contains a number of proteins including the 10 kD Clara cell protein and surfactant proteins A, B, C and D. As markers of primary pulmonary adenocarcinoma, they are inferior to TTF-1.

Surfactant apoprotein A appears to be a major constituent of giant lamellar bodies.

PE-10 is a monoclonal antibody against components of human surfactant proteins⁴.

Immunoreactivity

Sp-A

S-B

TTF-1

primary lung tumours

adenocarcinoma

25/46¹

29/46¹

35/46¹

squamous cell carcinoma

2/10¹

0/10¹

0/10¹

adenosquamous carcinoma

1/1¹

1/1¹

1/1¹

pleomorphic carcinoma

19/55 (these 55 cases all included an epithelial component, which was positive in 19 cases: the sarcomatous component was only positive in three cases. 20 further cases lacking an epithelial component were all negative)²

primary breast carcinoma

4/51¹

0/51¹

0/51¹

breast carcinoma metastatic to lung

6/13¹

6/13¹

0/13¹

It appears that breast tumour cells metastatic to the lung incorporate pulmonary surfactant proteins, which are therefore of little value if differentiating metastatic breast carcinoma form primary pulmonary adenocarcinoma.

The pattern of staining is different in primary pulmonary adenocarcinoma and mesothelioma, but there are many more informative antibodies.

adenocarcinoma

mesothelioma

Abutaily³

35/35 (9 membranous, 26 cytoplasmic)

40/41 (33 membranous, 7 cytoplasmic)

References

¹ Bejarano, P. A., Baughman, R. P., Biddinger, P. W. Surfactant proteins and thyroid transcription factor-1 in pulmonary and breast carcinomas. Mod Pathol 1996;9:445-452.

² Rossi, G., Cavazza, A., Sturm, N., Migaldi, M., Facciolongo, N., Longo, L., Maiorana, A. and Brambilla, E. Pulmonary carcinomas with pleomorphic, sarcomatoid, or sarcomatous elements: a clinicopathologic and immunohistochemical study of 75 cases. Am J Surg Pathol 2003;27:311-24.

³ Abutaily, A.S., Addis, B.J. and Roche, W.R. Immunohistochemistry in the distinction between malignant mesothelioma and pulmonary adenocarcinoma: a critical evaluation of new antibodies. J Clin Pathol 2002;55:662-8.

⁴ Chhieng DC, Cangiarella JF, Zakowski MF, et al. Use of thyroid transcription factor 1, PE-10, and cytokeratins 7 and 20 in discriminating between primary lung carcinomas and metastatic lesions in fine-needle aspiration biopsy specimens. Cancer 2001; 93:330-6

This page last revised 13.6.2005.

		Sp-A	S-B	TTF-1
primary lung tumours	adenocarcinoma	25/46¹	29/46¹	35/46¹
	squamous cell carcinoma	2/10¹	0/10¹	0/10¹
	adenosquamous carcinoma	1/1¹	1/1¹	1/1¹
	pleomorphic carcinoma	19/55 (these 55 cases all included an epithelial component, which was positive in 19 cases: the sarcomatous component was only positive in three cases. 20 further cases lacking an epithelial component were all negative)²
primary breast carcinoma		4/51¹	0/51¹	0/51¹
breast carcinoma metastatic to lung		6/13¹	6/13¹	0/13¹

	adenocarcinoma	mesothelioma
Abutaily³	35/35 (9 membranous, 26 cytoplasmic)	40/41 (33 membranous, 7 cytoplasmic)