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Immunohistochemistry in the
Distinction Between Malignant Mesothelioma and
Pulmonary
Adenocarcinoma: a Critical Evaluation of New Antibodies
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J Clin Pathol 2002 Sep;55(9):662-8 (ISSN: 0021-9746) Abutaily AS;
Addis BJ; Roche WR
Respiratory Cell and Molecular Biology, University of Southampton, University of
Southampton, Southampton General Hospital, UK. AIM:
The value of immunohistochemical staining in differentiating between
malignant mesothelioma and pulmonary adenocarcinoma was re-examined using newly available
commercial antibodies, with the aim of increasing the sensitivity and specificity of
diagnosis, and simplifying the antibody panel required.
METHODS: Forty one malignant mesotheliomas and 35
lung adenocarcinomas were studied. Commercial antibodies to calretinin, E-cadherin,
N-cadherin, surfactant apoprotein A (SP-A), thyroid transcription factor 1 (TTF-1),
thrombomodulin, and cytokeratin 5/6 were applied using the streptavidin-biotin-peroxidase
complex procedure on formalin fixed, paraffin wax embedded tissue.
RESULTS: E-cadherin was expressed in all
adenocarcinomas and in 22% of the mesotheliomas. TTF-1 expression was detected in 69% of
the adenocarcinomas and none of the mesotheliomas. Positive staining with polyclonal
anticalretinin was detected in 80% of the mesotheliomas and 6% of the adenocarcinomas.
N-cadherin was expressed in 78% of mesotheliomas and 26% of adenocarcinomas.
Thrombomodulin was expressed in 6% of the adenocarcinomas and in 53% of the mesotheliomas.
Cytokeratin 5/6 expression was detected in 6% of the adenocarcinomas and 63% of the
mesotheliomas. The results were compared with the standard laboratory panel for
mesothelioma diagnosis: anticarcinoembryonic antigen (anti-CEA), LeuM1, BerEP4, and
HBME-1.
CONCLUSION: Of the antibodies used in this study,
E-cadherin was 100% sensitive for pulmonary adenocarcinoma and TTF-1 was 100% specific for
pulmonary adenocarcinoma. The application of these two antibodies alone was adequate for
the diagnosis of 69% of adenocarcinomas and 78% of mesotheliomas. Where TTF-1 is negative
and E-cadherin is positive, a secondary panel of antibodies, including BerEP4 and LeuM1
(CD15) and antibodies directed against CEA, calretinin, cytokeratin 5/6, thrombomodulin,
and N-cadherin, is required for differentiation between malignant mesothelioma and
pulmonary adenocarcinoma.
Major
Subject Heading(s) |
Minor
Subject Heading(s) |
CAS
Registry / EC Numbers |
| Adenocarcinoma [diagnosis]
Lung Neoplasms [diagnosis] Mesothelioma [diagnosis] Tumor Markers, Biological [metabolism]
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Adenocarcinoma [metabolism]
Antibodies, Monoclonal [immunology] Cadherins [metabolism] Diagnosis, Differential
Immunoenzyme Techniques Lung Neoplasms [metabolism] Mesothelioma [metabolism] Neoplasm
Proteins [metabolism] Nuclear Proteins [metabolism] Sensitivity and Specificity
Transcription Factors [metabolism] |
0 (Antibodies, Monoclonal) 0
(Cadherins) 0 (Neoplasm Proteins) 0 (Nuclear Proteins) 0 (Transcription Factors) 0 (Tumor
Markers, Biological) 0 (thyroid nuclear factor 1) |
*** POSTED OCTOBER 14, 2002 *** |
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