The diagnostic utility of immunohistochemistry in distinguishing between epithelioid mesotheliomas and squamous carcinomas of the lung:: a comparative study
The diagnostic utility of immunohistochemistry in distinguishing between epithelioid mesotheliomas and squamous carcinomas of the lung:: a comparative study
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DOI：
10.1038/modpathol.3800544
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发表时间：
2006-03-01
期刊：
影响因子：
7.5
通讯作者：
Ordóñez, NG
中科院分区：
文献类型：
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作者：
Ordóñez, NG
由于间皮瘤和鳞状癌都可以呈现各种各样的形态模式，它们有时会被混淆。最近，一些研究小组提请注意，有时在区分这些恶性肿瘤方面存在困难，需要确定一组标志物，以帮助达到正确的诊断。本研究的目的是比较目前可用于诊断间皮瘤和肺鳞状癌的各种免疫组织化学标志物的价值。研究了30例呈实性或主要实性形态的上皮样胸膜间皮瘤和30例非角化性肺鳞状癌中以下标志物的表达情况：podoplanin、calretinin、mesothelin、WT1、角蛋白5/6、角蛋白7、p63、癌胚抗原（CEA）、MOC-31、Ber-EP4、B72.3、BG-8 （Lewisy）、leu-M1 （CD15）和甲状腺转录因子-1 （TTF-1）。所有30例间皮瘤（100%）对calretinin、间皮素和角蛋白7有反应，对podoplanin、WT1和角蛋白5/6有反应的各为93%，对Ber-EP4有反应的各为13%，对p63、MOC-31和BG- 8有反应的各为7%，对B72.3、CEA、leu-M1和TTF-1有反应的各为0%。所有30例（100%）鳞状癌p63和角蛋白5/6阳性，MOC-31阳性97%，Ber-EP4阳性87%，BG- 8阳性80%，CEA阳性77%，角蛋白7阳性57%，calretinin和B72.3阳性40%，leu-M1阳性30%，间皮素阳性27%，podoplanin阳性15%，WT 1和TTF-1阳性0%。在分析结果后，我们得出结论，从实际的角度来看，将两种阳性间皮瘤标志物（WT1和calretinin或mesothelin）与两种阴性间皮瘤标志物（p63和MOC-31）结合起来，几乎可以在所有病例中建立上皮样间皮瘤和肺鳞状癌的鉴别诊断。
As both mesotheliomas and squamous carcinomas can present a wide variety of morphological patterns, they can on occasion be confused. Recently, some groups of investigators have called attention to the difficulties that sometimes exist in distinguishing between these malignancies and the need to define a panel of markers that can assist in reaching the correct diagnosis. The aim of the present study is to compare the value of the various immunohistochemical markers currently available for the diagnosis of mesothelioma and squamous carcinoma of the lung. A total of 30 epithelioid pleural mesotheliomas exhibiting a solid or predominantly solid pattern, and 30 nonkeratinizing squamous carcinomas of the lung were investigated for the expression of the following markers: podoplanin, calretinin, mesothelin, WT1, keratin 5/6, keratin 7, p63, carcinoembryonic antigen (CEA), MOC-31, Ber-EP4, B72.3, BG-8 (Lewisy), leu-M1 (CD15), and thyroid transcription factor-1 (TTF-1). All 30 (100%) of the mesotheliomas reacted for calretinin, mesothelin and keratin 7, 93% each for podoplanin, WT1 and keratin 5/6, 13% for Ber-EP4, 7% each for p63, MOC-31 and BG- 8, and 0% for B72.3, CEA, leu-M1 and TTF-1. All 30 (100%) of the squamous carcinomas were positive for p63 and keratin 5/6, 97% for MOC-31, 87% for Ber-EP4, 80% for BG- 8, 77% for CEA, 57% for keratin 7, 40% for calretinin and B72.3, 30% for leu-M1, 27% for mesothelin, 15% for podoplanin, and 0% for WT 1 and TTF-1. After analyzing the results, it is concluded that from a practical point-of-view, a combination of two positive mesothelioma markers (WT1 and calretinin or mesothelin) with two negative mesothelioma markers (p63 and MOC-31) would allow the differential diagnosis to be established between epithelioid mesotheliomas and squamous carcinomas of the lung in nearly all instances.