Novel marker D240, combined with calretinin, CEA, and TTF-1 - An optimal set of immunodiagnostic markers for pleural mesothelioma
Novel marker D240, combined with calretinin, CEA, and TTF-1 - An optimal set of immunodiagnostic markers for pleural mesothelioma
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DOI：
10.1002/cncr.22477
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发表时间：
2007-03-01
期刊：
影响因子：
6.2
通讯作者：
Okada, Morihito
中科院分区：
文献类型：
--
作者：
Mimura, Takeshi;Ito, Akihiko;Okada, Morihito
背景恶性胸膜间皮瘤是一个具有挑战性的疾病方面的诊断和治疗;早期和准确的诊断将导致适当的治疗策略，包括胸膜外全肺切除术免疫组化已被证明是最常见的上皮样间皮瘤的诊断价值，虽然它往往是难以区分它与肺或转移性腺癌与绝对的把握，如果一个单一的抗体。目前的研究旨在确定胸膜间皮瘤的免疫诊断面板。本文对66例胸膜间皮瘤和66例肺腺癌的大手术标本在相同条件下进行了化学分析。检测的抗体针对新的间皮细胞标记物D2-40，以及钙视网膜蛋白、CEA和TTF-1。D2-40和calretinin对间皮瘤的敏感性分别为84.8%和87.9%，特异性均为95.5%。CEA和TTF-1对腺癌的敏感性分别为95.5%和92.4%，特异性均为100%。在间皮瘤上皮样分化的大部分区域观察到D2-40和钙视黄蛋白的免疫反应性。免疫印迹法也显示D2-40抗原在上皮样间皮瘤侵袭的胸膜中的表达水平高于正常胸膜。这些数据有力地表明，D240和钙视网膜蛋白作为阳性标志物，CEA和TTF-1作为阴性标志物，胸膜间皮瘤的显着有用性。4抗体免疫组化组化显示高敏感性和特异性方面的分化上皮样间皮瘤肺腺癌。
BACKGROUND. Malignant pleural mesothelioma is a challenging disease with regard to diagnosis and treatment; early and accurate diagnosis would lead to appropriate therapeutic strategies, including extrapleural pneumonectomy Immunohistochemistry has proven valuable for the diagnosis of the most common epithelioid mesothelioma, although it is often difficult to differentiate it from pulmonary or metastatic adenocarcinoma with absolute certainty if a single antibody is employed. The current study was designed to identify an immunodiagnostic panel for pleural mesothelioma.METHODS. Large surgical specimens from 66 cases with pleural mesothelioma and 66 with lung adenocarcinoma were immunohistochemically reevaluated under uniform conditions. The antibodies examined were directed against the novel mesothelial marker D2-40, as well as calretinin, CEA, and TTF-1.RESULTS. For mesothelioma the sensitivities of D2-40 and calretinin were 84.8% and 87.9%, respectively, and their specificities were both 95.5%. For adenocarcinoma, the sensitivities of CEA and TTF-1 were 95.5% and 92.4%, respectively, and their specificities were both 100%. Immunoreactivity to D2-40 and calretinin was observed in most areas of epithelioid differentiation in mesothelioma. Western blots also showed higher levels of D2-40 antigen in pleura invaded by epithelioid mesothelioma as compared with unaffected pleura.CONCLUSIONS. These data strongly suggest the significant usefulness of D240 and calretinin as positive markers, and of CEA and TTF-1 as negative markers, for pleural mesothelioma. The 4-antibody immunohistochemical panel showed high sensitivity and specificity with regard to differentiation of epithelioid mesothelioma from lung adenocarcinoma.