Correlation between TTF-1 expression and EGFR mutations in moroccan lung adenocarcinoma: A prospective six-year study.

OBJECTIVE

Lung cancer is the second most common malignancy worldwide and remains a leading cause of cancer-related mortality. Identifying predictive biomarkers is essential to improve personalized treatment. This prospective six-year study investigated the correlation between thyroid transcription factor-1 (TTF-1) expression and epidermal growth factor receptor (EGFR) mutations in Moroccan patients with lung adenocarcinoma.

MATERIALS AND

METHODS

Between 2017 and 2022, 234 patients with histologically confirmed lung adenocarcinoma were prospectively enrolled. TTF-1 expression was assessed by immunohistochemistry, and EGFR mutations were evaluated using molecular testing. Statistical analyses examined associations with clinicopathological parameters and overall survival.

RESULTS

TTF-1 expression was detected in 83.8 % of cases and was more frequent among females (85.5 %) and never-smokers (88.2 %). EGFR mutations were identified in 21.36 % of patients, with exon 19 deletions (15.38 %) and exon 21 mutations (4.27 %) being the most common. A strong association was observed between TTF-1 expression and EGFR mutations (p < 0.001), particularly exon 19 deletions (p = 0.009). No significant correlation was found with exon 21 mutations or rare/dual variants. Combined exon 19 and 21 mutations were also significantly associated with TTF-1 positivity (p = 0.001).

CONCLUSION

This study demonstrates a strong correlation between TTF-1 expression and common EGFR mutations, especially exon 19 deletions, in Moroccan patients with advanced lung adenocarcinoma. The association was most evident in never-smokers, supporting the role of TTF-1 and EGFR as complementary biomarkers in guiding diagnosis and treatment. Larger multicenter studies are warranted to further explore their prognostic value.