CD90 is a diagnostic marker to differentiate between malignant pleural mesothelioma and lung carcinoma with immunohistochemistry

Our plain-English summary of CD90 is a diagnostic marker to differentiate between malignant pleural mesothelioma and lung carcinoma with immunohistochemistry, by K. Kawamura, K. Hiroshima, T. Suzuki, et al (American Journal of Clinical Pathology, 2013).

The study

• Authors: K. Kawamura, K. Hiroshima, T. Suzuki, K. Chai, N. Yamaguchi, M. Shingyoji, T. Yusa, Y. Tada, Y. Takiguchi, K. Tatsumi, H. Shimada, M. Tagawa
• Journal: American Journal of Clinical Pathology
• Published: 2013;140(4):544-9
• Cited by: 14 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Objectives: To pathologically distinguish mesothelioma from lung carcinoma, particularly adenocarcinoma.

Methods: We conducted immunohistochemical analyses on clinical specimens, including 26 cases of mesothelioma, 28 cases of lung adenocarcinoma, and 33 cases of lung squamous cell carcinoma.

Results: We found that CD90 expression was useful in making a differential diagnosis between epithelioid mesothelioma and lung adenocarcinoma, whereas sarcomatoid mesothelioma and lung carcinoma specimens, irrespective of the histologic types, were negative in general. The sensitivity and specificity of CD90 expression in epithelioid mesothelioma and lung adenocarcinoma were comparable to those of well-established markers used for the differential diagnosis.

Conclusions: These data collectively indicate that CD90 is a novel diagnostic marker that contributes to a diagnosis of epithelioid mesothelioma.

In plain English

This laboratory study from Chiba, Japan, tested whether a protein called CD90 can help pathologists tell mesothelioma apart from lung cancer. The authors described that distinction as often difficult. The study did not examine asbestos exposure. Using flow cytometry, the authors found CD90 on all 5 mesothelioma cell lines tested and on none of 6 lung carcinoma cell lines. They then stained tissue samples from 26 mesotheliomas (15 epithelioid, 7 sarcomatoid, 4 biphasic), 28 lung adenocarcinomas and 33 lung squamous cell carcinomas. CD90 was positive in 14 of 15 epithelioid, 1 of 7 sarcomatoid and 4 of 4 biphasic mesotheliomas. It was positive in 5 of 28 adenocarcinomas and 10 of 33 squamous cell carcinomas. For epithelioid mesothelioma versus adenocarcinoma, sensitivity was 93% and specificity 82%. Against squamous cell carcinoma the figures were 93% and 70%. In data not shown, 3 of 5 reactive mesothelial hyperplasia samples also stained for CD90. The authors concluded that CD90 is a novel marker comparable to established ones. They noted that their sample was smaller than earlier studies' and that more specimens are needed.

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: Laboratory diagnostic study: flow cytometry on cell lines plus immunohistochemical staining of archived clinical tumor specimens
• Who was studied: Five human mesothelioma cell lines, one immortalized mesothelium-derived line (Met-5A) and 6 lung carcinoma cell lines. Clinical specimens: 26 mesotheliomas (15 epithelioid, 7 sarcomatoid, 4 biphasic) collected 2000 to 2008 at Chiba University Hospital, Chiba Rosai Hospital or Chiba East Hospital, Japan. Also 28 lung adenocarcinomas and 33 lung squamous cell carcinomas surgically resected at Chiba University Hospital, 2002 to 2004.
• Exposure: No asbestos exposure was studied or reported for the patients. The factor examined was staining for the protein CD90; a specimen counted as positive when more than 10% of tumor cells stained.
• Main results:
  • Cell lines: all 5 mesothelioma cell lines were CD90 positive and all 6 lung carcinoma cell lines were negative. The immortalized mesothelium-derived Met-5A cells were also negative.
  • Tissue specimens: 19 of 26 mesotheliomas were CD90 positive, compared with 5 of 28 lung adenocarcinomas and 10 of 33 lung squamous cell carcinomas (mesothelioma vs each lung cancer type, P < .01). Adenocarcinoma and squamous cell carcinoma did not differ (P = .26).
  • By mesothelioma type: 14 of 15 epithelioid specimens were CD90 positive and 1 of 7 sarcomatoid specimens. All 4 biphasic specimens were positive in both components; the authors noted the biphasic numbers were limited.
  • Epithelioid mesothelioma versus lung adenocarcinoma: sensitivity 93%, specificity 82%.
  • Epithelioid mesothelioma versus lung squamous cell carcinoma: sensitivity 93%, specificity 70%.
  • In 14 mesothelioma samples also tested with conventional markers, positive rates were calretinin 71%, D2-40 77%, WT-1 71% and CD90 71%. Of 7 cases negative for calretinin, WT-1 or D2-40, 4 were CD90 positive.
  • In data not shown, 3 of 5 reactive mesothelial hyperplasia specimens expressed CD90, while 6 normal mesothelium samples were negative.
• The authors' conclusion: The authors concluded that CD90 is a novel marker for mesothelioma diagnosis. In their view it has ability comparable to conventional markers to differentiate epithelioid mesothelioma from lung carcinoma, particularly adenocarcinoma, and could be added to antibody marker panels.
• Limitations the authors state:
  • The number of specimens was smaller than in previous studies of mesothelioma markers.
  • The number of biphasic mesothelioma samples was limited.
  • The authors said further investigation with more clinical specimens is needed to confirm CD90 reactivity, particularly the difference between sarcomatoid and biphasic mesothelioma.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Lung cancer, Mesothelioma.

Medical terms in this study, explained in our Lexicon: Pleural Mesothelioma, Carcinoma, Immunohistochemistry, Mesothelioma, Adenocarcinoma, Lung Adenocarcinoma, Squamous Cell Carcinoma, Differential Diagnosis.

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