CD147 immunohistochemistry discriminates between reactive mesothelial cells and malignant mesothelioma: an expanded analysis of the data

Our plain-English summary of CD147 immunohistochemistry discriminates between reactive mesothelial cells and malignant mesothelioma: an expanded analysis of the data, by S.J. Geyer (Diagnostic Cytopathology, 2014).

The study

• Author: S.J. Geyer
• Journal: Diagnostic Cytopathology
• Published: 2014;42(8):734
• Type of article: Letter, Comment
• Cited by: 1 article, as counted by NIH iCite
• Read it: PubMed · Publisher

In plain English

This is a letter to the editor, not an original study. The author re-examined published results from an earlier study by Pinheiro and colleagues, which tested whether a stain for the protein CD147 could tell reactive (non-cancerous) mesothelial cells apart from malignant mesothelioma (MM). Asbestos exposure was not discussed. In that study's text, CD147 was positive in 8 MM cases and negative in 1, and negative in 10 reactive cases and positive in 1. The author noted that one of its tables showed only nine negative reactive cases. Using the study's case mix, a positive result was correct 89% of the time and a negative result 91%. Because the study had nearly equal numbers of MM and reactive cases, the author recalculated assuming MM made up 10% of cases, closer to routine cytopathology practice. A positive result was then correct 53% of the time and a negative result 99%. The author concluded that a negative CD147 result effectively rules out MM while a positive result has little diagnostic value. This challenged the original authors' conclusion that CD147 is a reliable marker of MM.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Letter to the editor re-analysing the published data of another study (Pinheiro et al.); no new patients were studied
• Who was studied: No new population. The letter re-uses the case counts reported in the text of Pinheiro et al.: 9 cases of malignant mesothelioma and 11 cases of reactive mesothelial cells. It also uses a hypothetical group of 100 patients with a pleural effusion, 90 with reactive mesothelial cells and 10 with MM.
• Exposure: Not applicable: the letter concerns a laboratory test (CD147 immunohistochemistry), not asbestos or any other exposure
• Main results:
  • In the original study's text, CD147 was positive in 8 MM cases and negative in 1 MM case. It was negative in 10 reactive cases and positive in 1 reactive case.
  • The author noted a discrepancy: Table I of the original study showed only nine (not 10) reactive cases without CD147 staining.
  • At the original study's case mix, the author calculated a predictive value of 89% for a positive test and 91% for a negative test.
  • The author stated that the original study population over-represented MM compared with the prevalence in routine cytopathology practice.
  • Assuming MM in 10% of cases and the reported sensitivity (89%) and specificity (91%), the predictive value of a positive test became 53% and of a negative test 99%.
  • In the hypothetical 100 patients, this meant 9 true positives and 1 false negative among the 10 with MM. Among the 90 with reactive cells, it meant 82 true negatives and 8 false positives.
• The authors' conclusion: The author concluded that, at a representative prevalence, a positive CD147 result is about as predictive as a coin toss and has little diagnostic value for MM. A negative result effectively rules out MM. The author said this challenges the original authors' conclusion that CD147 is a reliable marker of MM.

Topics

Medical terms in this study, explained in our Lexicon: Immunohistochemistry, Reactive Mesothelial Cells, Malignant Mesothelioma.

Related studies

• CD147 immunohistochemistry discriminates between reactive mesothelial cells and malignant mesothelioma — C. Pinheiro, A. Longatto-Filho, et al. (2012)
• Diagnostic value of BRCA1-associated protein-1, glucose transporter-1 and desmin expression in the discrimination between reactive mesothelial proliferation and malignant mesothelioma in tissues and effusions — S. Önder, E. Özogul, et al. (2019)
• Immunocytochemistry of CD146 is useful to discriminate between malignant pleural mesothelioma and reactive mesothelium — A. Sato, I. Torii, et al. (2010)
• Utility of Methylthioadenosine Phosphorylase Compared With BAP1 Immunohistochemistry, and CDKN2A and NF2 Fluorescence In Situ Hybridization in Separating Reactive Mesothelial Proliferations From Epithelioid Malignant Mesotheliomas — K.B. Berg, S. Dacic, et al. (2018)
• Challenges and controversies in the diagnosis of mesothelioma: Part 1. Cytology-only diagnosis, biopsies, immunohistochemistry, discrimination between mesothelioma and reactive mesothelial hyperplasia, and biomarkers — D.W. Henderson, G. Reid, et al. (2013)
• Highly expressed EZH2 in combination with BAP1 and MTAP loss, as detected by immunohistochemistry, is useful for differentiating malignant pleural mesothelioma from reactive mesothelial hyperplasia — M. Yoshimura, Y. Kinoshita, et al. (2019)

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