Comparison of antibodies to HBME-1 and calretinin for the detection of mesothelial cells in effusion cytology

Our plain-English summary of Comparison of antibodies to HBME-1 and calretinin for the detection of mesothelial cells in effusion cytology, by P.A. Fetsch, A. Simsir, A. Abati (Diagnostic Cytopathology, 2001).

The study

• Authors: P.A. Fetsch, A. Simsir, A. Abati
• Journal: Diagnostic Cytopathology
• Published: 2001;25(3):158-61
• Cited by: 32 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

The distinction of mesothelial cells in cytologic samples is often a diagnostic challenge. This is particularly true in potentially malignant effusions in which reactive mesothelial cells may simulate adenocarcinoma (ACA) cells, and in the differentiation of ACA vs. mesothelioma. We sought to determine the superior antibody for the positive identification of mesothelial cells in these circumstances. Cell block sections of 25 reactive and 8 malignant mesothelioma effusions were immunostained with an avidin-biotin procedure, using antibodies to HBME-1 and calretinin. No pretreatment of samples was necessary for the HBME-1-stained slides; microwave antigen retrieval was performed on all slides stained for calretinin. A negative control was performed on each sample. The staining intensity of tumor cells was scored on a scale of 0-3+, with the proportion of immunoreactive cells categorized as <25%, 25-50%, 50-75%, and >75%. The predominant staining pattern for HBME-1 was surface, with rare samples also exhibiting cytoplasmic staining as well. The calretinin-staining pattern was cytoplasmic, with peripheral condensation/prominence and accompanying nuclear staining. All samples were immunoreactive with both antibodies. Fifty-five percent (18/33) of samples showed significantly stronger immunoreactivity with calretinin than with HBME-1; 45% (15/33) of samples showed equivalent staining with the two markers. None of the samples in this study showed stronger immunoreactivity with HBME-1 than with calretinin. Sixty-one percent (20/33) of samples stained with HBME-1 at a moderate (2+) intensity. Fifty-five percent (18/33) of samples stained with calretinin at a strong (3+) intensity. While only 12% of samples showed >75% immunoreactivity for HBME-1, 58% of samples showed >75% of cells immunoreactive for calretinin. Calretinin is the preferred marker in identifying mesothelial cells in cytologic samples, showing the highest sensitivity for mesothelial cells, as evidenced by a more intense staining reaction in a higher percentage of cells than with HBME-1. Published 2001 Wiley-Liss, Inc.

In plain English

This laboratory study compared two antibody stains, HBME-1 and calretinin, for recognizing mesothelial cells in body-fluid samples (effusions). In these samples, benign mesothelial cells can resemble adenocarcinoma cells. The authors stained stored cell blocks from 25 reactive (benign) effusions and 8 malignant mesothelioma effusions. One pathologist scored the share of cells that stained and how strongly they stained. The study did not look at asbestos exposure. All samples stained with both antibodies. In 18 of 33 samples (55%), staining was what the authors called significantly stronger with calretinin. In 15 of 33 (45%) the two stains were equivalent, and no sample stained more strongly with HBME-1. Calretinin stained at strong (3+) intensity in 18 of 33 samples, while HBME-1 most often stained at moderate (2+) intensity (20 of 33). More than 75% of cells stained with calretinin in 58% of samples, compared with 4 of 33 (12%) with HBME-1. The authors concluded that calretinin is the superior antibody. They noted that neither marker can tell benign from malignant mesothelial cells.

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 comparison of two immunostains (antibodies to HBME-1 and calretinin) on archived cytology cell blocks
• Who was studied: cell blocks from 33 effusion samples (25 reactive/benign effusions and 8 malignant mesothelioma effusions) retrieved from the cytopathology files of the National Institutes of Health/National Cancer Institute
• Exposure: Not reported. The study compared two laboratory stains and did not examine asbestos or any other exposure.
• Main results:
  • Calretinin staining was described by the authors as significantly stronger than HBME-1 staining in 18 of 33 samples (55%)
  • Staining was equivalent with the two markers in 15 of 33 samples (45%)
  • No sample stained more strongly with HBME-1 than with calretinin
  • 20 of 33 samples (61%) stained with HBME-1 at moderate (2+) intensity
  • 18 of 33 samples (55%) stained with calretinin at strong (3+) intensity
  • More than 75% of cells stained with HBME-1 in only 4 of 33 samples (12%)
  • More than 75% of cells stained with calretinin in 58% of samples (19/33)
• The authors' conclusion: The authors concluded that calretinin is the superior antibody for identifying mesothelial cells in effusion samples, staining more intensely and in a greater proportion of cells than HBME-1
• Limitations the authors state:
  • The authors stated that neither HBME-1 nor calretinin can distinguish benign from malignant mesothelial cells in effusion cytology

Topics

The National Library of Medicine indexes this study under subjects our site covers: Pleural plaques and thickening.

Medical terms in this study, explained in our Lexicon: HBME-1, Calretinin, Mesothelial Cells, Cytology, Reactive Mesothelial Cells, Adenocarcinoma, Mesothelioma, Cell Block.

Related studies

• The value of anti-calretinin antibody in the differential diagnosis of normal and reactive mesothelia versus metastatic tumors in effusion cytology — H. Nagel, B. Hemmerlein, et al. (1998)
• Calretinin. A selective marker of normal and neoplastic mesothelial cells in serous effusions — M.C. Barberis, M. Faleri, et al. (1997)
• The diagnostic utility of D2-40, calretinin, CK5/6, desmin and MOC-31 in the differentiation of mesothelioma from adenocarcinoma in pleural effusion cytology — T.S. Hyun, M. Barnes, et al. (2012)
• Value of the mesothelium-associated antibodies thrombomodulin, cytokeratin 5/6, calretinin, and CD44H in distinguishing epithelioid pleural mesothelioma from adenocarcinoma metastatic to the pleura — P.M. Cury, D.N. Butcher, et al. (2000)
• Value of mesothelial and epithelial antibodies in distinguishing diffuse peritoneal mesothelioma in females from serous papillary carcinoma of the ovary and peritoneum — R.L. Attanoos, R. Webb, et al. (2002)
• Expression of calretinin, thrombomodulin, keratin 5, and mesothelin in lung carcinomas of different types: an immunohistochemical analysis of 596 tumors in comparison with epithelioid mesotheliomas of the pleura — M. Miettinen, M. Sarlomo-Rikala (2003)

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