Volume 36, Issue 4 pp. 408-417

ORIGINAL ARTICLE

The Diagnostic Role of TFF1, TFF3, FOXA1, CA XII and TRPS1 in Serous Effusions

Ben Davidson,

Corresponding Author

Ben Davidson

[email protected]

orcid.org/0000-0003-3332-8427

Department of Pathology, Oslo University Hospital, Norwegian Radium Hospital, Oslo, Norway

Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway

Correspondence:

Ben Davidson ([email protected])

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Arild Holth,

Arild Holth

Department of Pathology, Oslo University Hospital, Norwegian Radium Hospital, Oslo, Norway

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Jeremias Wohlschlaeger,

Jeremias Wohlschlaeger

Institute of Pathology, Academic Teaching Hospitals Flensburg, DIAKO Hospital gGmbH, Flensburg, Germany

Department of Pathology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany

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Maurizio Pinamonti,

Maurizio Pinamonti

Department of Pathology, University Hospital Cattinara, Trieste, Italy

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Binnur Önal,

Binnur Önal

orcid.org/0000-0001-8406-9491

Central Pathology Laboratory, Acıbadem Healthcare Group, Acıbadem University, Istanbul, Turkey

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Ben Davidson,

Corresponding Author

Ben Davidson

[email protected]

orcid.org/0000-0003-3332-8427

Department of Pathology, Oslo University Hospital, Norwegian Radium Hospital, Oslo, Norway

Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway

Correspondence:

Ben Davidson ([email protected])

Search for more papers by this author

Arild Holth,

Arild Holth

Department of Pathology, Oslo University Hospital, Norwegian Radium Hospital, Oslo, Norway

Search for more papers by this author

Jeremias Wohlschlaeger,

Jeremias Wohlschlaeger

Institute of Pathology, Academic Teaching Hospitals Flensburg, DIAKO Hospital gGmbH, Flensburg, Germany

Department of Pathology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany

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Maurizio Pinamonti,

Maurizio Pinamonti

Department of Pathology, University Hospital Cattinara, Trieste, Italy

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Binnur Önal,

Binnur Önal

orcid.org/0000-0001-8406-9491

Central Pathology Laboratory, Acıbadem Healthcare Group, Acıbadem University, Istanbul, Turkey

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First published: 01 April 2025

https://doi.org/10.1111/cyt.13489

Citations: 1

Funding: The authors did not receive any specific funding for this study.

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ABSTRACT

Objective

To analyse the diagnostic role of trefoil factor-1 and -3 (TFF1, TFF3), forkhead box protein A1 (FOXA1), carbonic anhydrase XII (CA XII) and trichorhinophalangeal syndrome type 1 (TRPS1) in serous effusions. The prognostic role of these markers in breast carcinoma was additionally studied.

Methods

Protein expression by immunohistochemistry was analysed in 247 effusions, consisting of 60 breast carcinomas, 54 tubo-ovarian carcinomas, 47 mesotheliomas, 44 lung carcinomas, 20 uterine corpus and cervical carcinomas, 17 gastrointestinal carcinomas and 5 cancers of other origin.

Results

TFF1, TFF3, FOXA1, CA XII and TRPS1 expression was found in 67%, 70%, 88%, 82% and 83% of breast carcinomas, respectively. Expression of all markers was seen in some carcinomas of other origin, most commonly in GI metastases, but was least frequent for TRPS1. CA XII expression was additionally seen in mesotheliomas and reactive mesothelial cells. All 5 markers were significantly overexpressed in breast compared to tubo-ovarian carcinoma (all p < 0.001) and lung carcinoma (all p < 0.001 except for FOXA1, p = 0.023). TFF1 (p = 0.003), TFF3 (p = 0.008) and FOXA1 (p = 0.017) expression was significantly higher in receptor-positive compared to receptor-negative primary breast carcinomas. In survival analysis for 44 breast carcinoma patients with clinical data, TFF1 expression was associated with a trend for longer overall (p = 0.096) and disease-free (p = 0.06) survival.

Conclusion

TFF1, TFF3, FOXA1, CA XII and TRPS1 are sensitive breast carcinoma markers, with FOXA1 performing best in terms of sensitivity and TRPS1 being the most specific. Whether the expression of these markers in breast carcinoma effusions is informative of survival merits further research.

Graphical Abstract

TFF1, TFF3, FOXA1, CA XII and TRPS1 are sensitive breast carcinoma markers. FOXA1 is the most sensitive, and TRPS1 is the most specific of these 5 markers. The expression of TFF1 in breast carcinoma effusions may be informative of survival.

Conflicts of Interest

The authors declare no conflicts of interest.

Open Research

Data Availability Statement

The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.

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Citing Literature

Volume36, Issue4

Special Issue: Interventional Cytopathology

July 2025

Pages 408-417