Differential expression of N-cadherin in pleural mesotheliomas and E-cadherin in lung adenocarcinomas in formalin-fixed, paraffin-embedded tissues

Our plain-English summary of Differential expression of N-cadherin in pleural mesotheliomas and E-cadherin in lung adenocarcinomas in formalin-fixed, paraffin-embedded tissues, by A.C. Han, A. Peralta-Soler, K.A. Knudsen, et al (Human Pathology, 1997).

The study

• Authors: A.C. Han, A. Peralta-Soler, K.A. Knudsen, M.J. Wheelock, K.R. Johnson, H. Salazar
• Journal: Human Pathology
• Published: 1997;28(6):641-5
• Cited by: 77 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

The differential diagnosis of pleural mesotheliomas and lung adenocarcinomas presents a continued challenge in the practice of surgical pathology. Paraffin immunohistochemistry (IHC) using different panels of antibodies can be helpful in some cases, but, as yet, no antigen is expressed specifically in mesotheliomas nor in adenocarcinomas. Using well characterized monoclonal antibodies (MAb) that recognized distinct mesenchymal and epithelial adhesion proteins, N-cadherin (13A9 MAb) and E-cadherin (E9 MAb), respectively, we found previously that in frozen-section IHC mesotheliomas and adenocarcinomas had distinct cadherin phenotypes: mesotheliomas were positive for N-cadherin, and lung adenocarcinomas were positive for E-cadherin. Using antigen-retrieval methods, we successfully extended our study to formalin-fixed, paraffin-embedded tissue sections. Tumors from 28 patients (14 originally diagnosed as mesotheliomas, and 14 diagnosed as adenocarcinomas) were stained with 13A9 MAb and E9 MAb. Review of hematoxylin-eosin sections excluded from analysis one case previously diagnosed as mesothelioma, which represented a hemangiopericytoma. Of the remaining 27 cases, 12 of 13 mesotheliomas were positive for N-cadherin and negative for E-cadherin. The exception was a multifocal microscopic papillary tumor of apparent mesothelial origin, which was negative for both N-cadherin and E-cadherin. Conversely, 13 of 14 adenocarcinomas were E-cadherin positive and N-cadherin negative except for one adenocarcinoma with focal N-cadherin expression. One case of a poorly differentiated adenocarcinoma invading skeletal muscle was negative for both 13A9 and E9. These studies confirmed the utility of the cadherin antibodies in distinguishing pleural mesotheliomas from lung adenocarcinomas. The reactivity of the cadherin-specific antibodies with antigens in paraffin sections make them powerful and reliable markers in the practice of diagnostic surgical pathology.

In plain English

This laboratory study tested whether two antibodies could help pathologists tell pleural mesothelioma apart from lung adenocarcinoma in routinely preserved (formalin-fixed, paraffin-embedded) tissue. One antibody detects N-cadherin and the other E-cadherin. Both are proteins that help cells stick together. The authors had earlier reported similar work on frozen tissue. They used cases from 1988 to 1996 at the Reading Hospital and Medical Center. One of 28 cases, originally called mesothelioma, proved to be a hemangiopericytoma and was excluded, leaving 13 mesotheliomas and 14 adenocarcinomas. Of the 27 tumors, 24 stained for only one of the two proteins. Twelve of 13 mesotheliomas were N-cadherin positive and E-cadherin negative, and 12 of 14 adenocarcinomas showed the reverse. One adenocarcinoma was mainly E-cadherin positive with a few N-cadherin-positive cells. One mesothelioma and one adenocarcinoma stained for neither, though both reacted with a broader (pan-cadherin) antibody. The authors recommended adding both antibodies to diagnostic panels. They noted that N-cadherin does not separate benign from malignant mesothelial growths. The article does not discuss asbestos exposure.

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: Diagnostic pathology study using immunohistochemistry (antibody staining) on archived formalin-fixed, paraffin-embedded tumor tissue
• Who was studied: 28 tumor cases from 1988 to 1996, from the Tumor Registry of the Reading Hospital and Medical Center (West Reading, PA). One case was excluded as a hemangiopericytoma, leaving 27 patients: 13 mesotheliomas and 14 lung adenocarcinomas.
• Exposure: Not studied. The article examines antibody staining of tumors and does not address asbestos or any other exposure.
• Main results:
  • 12 of 13 mesotheliomas were N-cadherin positive and E-cadherin negative. 12 of 14 lung adenocarcinomas were N-cadherin negative and E-cadherin positive.
  • One adenocarcinoma was mostly E-cadherin positive but had focal N-cadherin expression in a few cells.
  • One mesothelioma (micropapillary) and one adenocarcinoma (poorly differentiated, invading skeletal muscle) were negative for both cadherins. Both reacted with a pan-cadherin antibody.
  • In a biphasic mesothelioma, N-cadherin was found in both the epithelioid and spindle cell areas.
• The authors' conclusion: The authors recommended that antibodies to E-cadherin and N-cadherin be included in the diagnostic antibody panel for distinguishing pleural mesothelioma from lung adenocarcinoma.
• Limitations the authors state:
  • The authors had no data directly comparing how sensitive the staining is in frozen versus paraffin sections.
  • N-cadherin is also found in normal and reactive mesothelial cells, so it cannot tell benign from malignant mesothelial growths.

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, Lung Adenocarcinoma, Differential Diagnosis, Pathology, Immunohistochemistry, Mesothelioma, Adenocarcinoma, Monoclonal.

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