Immunocytological staining reactions of anti-carcinoembryonic antigen, Ca, and anti-human milk fat globule monoclonal antibodies on benign and malignant exfoliated mesothelial cells

Our plain-English summary of Immunocytological staining reactions of anti-carcinoembryonic antigen, Ca, and anti-human milk fat globule monoclonal antibodies on benign and malignant exfoliated mesothelial cells, by A.K. Ghosh, E.B. Butler (Journal of Clinical Pathology, 1987).

The study

• Authors: A.K. Ghosh, E.B. Butler
• Journal: Journal of Clinical Pathology
• Published: 1987;40(12):1424-7
• Cited by: 17 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

A panel of three monoclonal antibodies were used in an immunoalkaline phosphatase staining method on a series of serous effusion samples from cases of mesothelioma, lung carcinoma, and benign disease. The antibodies used were anti-carcinoembryonic (CEA) antigen, Ca, and anti-human milk fat globule membrane antigen. Antibodies to the Ca antigen and human milk fat globule membrane antigen stained 75% and 83% of mesothelioma and 75% of cases of lung carcinoma, respectively. The anti-CEA antibody stained most cases of lung carcinoma strongly but was negative on 11 of 12 cases of mesothelioma and showed weak staining on one case. Benign cases were negative with all three antibodies. These three antibodies may be useful in distinguishing benign and malignant mesothelial cells and lung carcinoma in serous effusions.

In plain English

This laboratory study tested whether three antibody stains could help tell mesothelioma apart from lung cancer and from benign conditions, using cells shed into body-cavity fluid (pleural or peritoneal effusions). The stains detected carcinoembryonic antigen (CEA), the Ca antigen, and human milk fat globule membrane antigen. Samples came from patients in Oxford and Manchester with mesothelioma, lung carcinoma, or benign disease. The article does not discuss asbestos exposure. Among mesothelioma cases, 75% stained for the Ca antigen and 83% for the milk fat globule antigen, and 11 of 12 were negative for CEA. One mesothelioma patient stayed negative with all three stains. Lung adenocarcinoma, squamous and undifferentiated carcinomas stained with all three. One oat cell carcinoma stained with CEA alone, and another stained with none. Benign effusions were negative with all three, apart from occasional plasma cells. The authors concluded that no single stain was specific for mesothelioma, but that the panel could aid diagnosis of problem cases. They also noted that the series included only a few benign cases.

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 (immunocytochemical staining of effusion samples from a small series of patients)
• Who was studied: Effusion samples from two groups. Group 1 was four pleural or peritoneal fluid specimens from the Churchill Hospital, Oxford, from patients with cytologically diagnosed mesothelioma (histologically confirmed in three). Group 2 was samples sent to St Mary's Hospital, Manchester, as possible mesothelioma cases, including mesothelioma, carcinoma and benign conditions. In all, 12 mesothelioma cases are reported. Dates are not given.
• Exposure: No asbestos or other environmental exposure was studied. The study tested three monoclonal antibody stains on cells in effusion fluid: anti-CEA, Ca antigen (Ca1/Ca2), and human milk fat globule membrane antigen (E29/HMFG2).
• Main results:
  • Mesothelioma cases overall: 75% were positive for the Ca antigen and 83% for human milk fat globule membrane antigen. 11 of 12 were negative for CEA.
  • Group 1 (four Oxford mesothelioma cases): the malignant cells stained strongly with the milk fat globule and Ca antibodies. One case showed very weak speckling with anti-CEA, and the others were CEA-negative.
  • Group 2 (eight mesothelioma patients): five were positive with both E29/HMFG2 and Ca1/Ca2, and two with E29/HMFG2 alone.
  • Group 2: one mesothelioma patient, from whom two samples were taken, was negative with all three antibodies, although the cells looked like mesothelioma.
  • Lung adenocarcinoma, squamous cell and undifferentiated lung carcinoma stained positive with all three antibodies.
  • Oat cell (small cell) lung carcinoma: one case was positive with CEA alone, and another was negative with all three.
  • Benign effusions were negative with all three antibodies, apart from occasional positive plasma cells.
• The authors' conclusion: The authors concluded that none of the antibodies is specific for mesothelioma, but that a panel of these stains could aid diagnosis of problem cases. A positive CEA reaction strongly suggests a tumour of bronchial epithelial origin.
• Limitations the authors state:
  • The series included only a few benign cases.
  • A staining pattern supporting mesothelioma does not rule out carcinoma, especially from sites outside the lung.
  • The oat cell carcinoma slides contained only a few carcinoma cells.
  • The authors' earlier study of tissue sections found these antibodies stained benign mesothelium, and the reason for the difference from shed cells is unclear.

Topics

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

Medical terms in this study, explained in our Lexicon: Carcinoembryonic Antigen (CEA), Monoclonal, Mesothelial Cells, Mesothelioma, Carcinoma.

Related studies

• Use of antibodies to carcinoembryonic antigen and human milk fat globule to distinguish carcinoma, mesothelioma, and reactive mesothelium — R.J. Marshall, A. Herbert, et al. (1984)
• Differential reactivities of carcinoembryonic antigen (CEA) and CEA-related monoclonal and polyclonal antibodies in common epithelial malignancies — K. Sheahan, M.J. O'Brien, et al. (1990)
• The distinction of adenocarcinoma from malignant mesothelioma in cell blocks of effusions: the role of routine mucin histochemistry and immunohistochemical assessment of carcinoembryonic antigen, keratin proteins, epithelial membrane antigen, and milk fat globule-derived antigen — E.S. Cibas, J.M. Corson, et al. (1987)
• The value of anticarcinoembryonic antigen, human milk factor globulin, and antikeratin antibodies in differentiating mesothelioma from lung carcinoma — V.M. Joglekar, D. Oliver, et al. (1991)
• Immunohistological staining of reactive mesothelium, mesothelioma, and lung carcinoma with a panel of monoclonal antibodies — A.K. Ghosh, K.C. Gatter, et al. (1987)
• Lung surfactant protein-A and carcinoembryonic antigen in pleural effusions due to lung adenocarcinoma and malignant mesothelioma — N. Shijubo, Y. Honda, et al. (1995)

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