Immunohistochemical distinction of malignant mesothelioma from pulmonary adenocarcinoma with anti-surfactant apoprotein, anti-Lewisa, and anti-Tn antibodies

Our plain-English summary of Immunohistochemical distinction of malignant mesothelioma from pulmonary adenocarcinoma with anti-surfactant apoprotein, anti-Lewisa, and anti-Tn antibodies, by M. Noguchi, T. Nakajima, S. Hirohashi, et al (Human Pathology, 1989).

The study

• Authors: M. Noguchi, T. Nakajima, S. Hirohashi, T. Akiba, Y. Shimosato
• Journal: Human Pathology
• Published: 1989;20(1):53-7
• Cited by: 63 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Nine cases of malignant mesothelioma of pure epithelial and biphasic types (five pleural, three peritoneal, and one pericardial mesotheliomas), seven cases of benign adenomatoid tumor of the uterus, and 21 cases of peripheral pulmonary adenocarcinoma of non-mucus-producing type were examined immunohistochemically for expression of keratin, vimentin, carcinoembryonic antigen (CEA), surfactant apoprotein, Lewis blood group antigens, and Tn antigen. The majority (78%) of the malignant mesotheliomas expressed keratin, but CEA and surfactant apoprotein were not detected in any mesotheliomas. On the other hand, pulmonary adenocarcinomas expressed not only keratin (100%), but also CEA (62%) and surfactant apoprotein (62%). The expression of Lewisa blood group antigen and Tn antigen was detected in 76% and 62% of the pulmonary adenocarcinomas, respectively, but only one mesothelioma was stained for Lewisa antigen. This study reveals that the majority of malignant mesotheliomas can be distinguished from pulmonary adenocarcinomas by immunohistochemcial staining for CEA, surfactant apoprotein, Lewisa antigen, and Tn antigen. Immunohistochemically, adenomatoid tumors behaved similarly to malignant mesotheliomas.

In plain English

This Tokyo laboratory study tested whether tissue stains could tell malignant mesothelioma apart from peripheral pulmonary adenocarcinoma, a lung cancer that can look similar. The authors stained stored tissue, from hospital files from 1962 to 1987, from nine malignant mesotheliomas of epithelial and biphasic types (five pleural, three peritoneal, one pericardial), seven benign uterine adenomatoid tumors, and 21 non-mucus-producing lung adenocarcinomas. Keratin was found in 78% of mesotheliomas and all adenocarcinomas. CEA and surfactant apoprotein were each found in 13 of 21 adenocarcinomas but in no mesotheliomas. Tn antigen was found in 13 of 21 adenocarcinomas and no mesotheliomas. Lewis a antigen was found in 16 of 21 adenocarcinomas and one unusual pleural mesothelioma. The tables mark the CEA, surfactant apoprotein, Lewis a and Tn differences as statistically significant. The adenomatoid tumors stained like the mesotheliomas. A history of definite asbestos exposure was not obtained for any mesothelioma patient. The study concerned diagnosis, not causes. The authors concluded that most malignant mesotheliomas can be distinguished from pulmonary adenocarcinomas by staining for CEA, surfactant apoprotein, Lewis a antigen and Tn antigen.

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 (immunohistochemical) study of archived tumor tissue from surgical and autopsy files
• Who was studied: Tumor tissue from the National Cancer Center Hospital, Tokyo, 1962 to 1987: 9 malignant mesotheliomas of epithelial and biphasic types (5 pleural, 3 peritoneal, 1 pericardial), 7 benign adenomatoid tumors of the uterus, and 21 non-mucus-producing pulmonary adenocarcinomas
• Exposure: The study was about diagnostic tissue stains (keratin, vimentin, CEA, surfactant apoprotein, Lewis blood group antigens, Tn antigen), not asbestos. The authors reported that a history of definite asbestos exposure was not obtained in any mesothelioma case.
• Main results:
  • Keratin was present in 78% of the 9 malignant mesotheliomas and in all 21 pulmonary adenocarcinomas
  • CEA was present in 13 of 21 pulmonary adenocarcinomas (62%) and in none of the mesotheliomas or adenomatoid tumors
  • Surfactant apoprotein was present in 13 of 21 pulmonary adenocarcinomas (62%) and in none of the mesotheliomas or adenomatoid tumors
  • Lewis a antigen was present in 16 of 21 pulmonary adenocarcinomas (76%) and Tn antigen in 13 of 21 (62%)
  • No mesothelioma was positive for Tn antigen, and only 1 of 9 (11%) was positive for Lewis a antigen
  • The single Lewis a-positive mesothelioma was an unusual pleural epithelial mesothelioma with trophoblastic differentiation (hCG-producing)
  • The tables mark the mesothelioma versus adenocarcinoma differences for CEA, surfactant apoprotein, Lewis a and Tn as statistically significant (P less than .01, Fisher's exact test). Keratin is not marked.
  • The benign adenomatoid tumors of the uterus, like most malignant mesotheliomas, did not express Lewis blood group antigens or Tn antigen
  • Vimentin stained some biphasic mesotheliomas and some adenocarcinomas focally, and the authors did not regard it as a useful marker for mesothelioma
• The authors' conclusion: The authors concluded that most malignant mesotheliomas can be distinguished from pulmonary adenocarcinomas by staining for CEA, surfactant apoprotein, Lewis a antigen and Tn antigen. They also concluded that benign and malignant mesothelial cells do not express Tn antigen or Lewis a antigen, with rare exceptions.

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: Malignant Mesothelioma, Adenocarcinoma, Biphasic Mesothelioma, Pericardial Mesothelioma, Adenomatoid Tumor, Carcinoembryonic Antigen (CEA), Mesothelioma.

Related studies

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• Distinction between pleural mesothelioma and pulmonary adenocarcinoma using MOC31 in an asbestos sprayer — P.J. Ryan, J.L. Oates, et al. (1997)
• Immunohistochemistry in the distinction between malignant mesothelioma and pulmonary adenocarcinoma: a critical evaluation of new antibodies — A.S. Abutaily, B.J. Addis, et al. (2002)
• 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)
• Distinguishing malignant mesothelioma from pulmonary adenocarcinoma: an immuno-histochemical approach using a panel of monoclonal antibodies — S.E. Tuttle, J.G. Lucas, et al. (1990)
• Calretinin, thrombomodulin, CEA, and CD15: a useful combination of immunohistochemical markers for differentiating pleural epithelial mesothelioma from peripheral pulmonary adenocarcinoma — C.E. Comin, L. Novelli, et al. (2001)

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