Immunohistochemical study of 158 lung carcinomas

Our plain-English summary of Immunohistochemical study of 158 lung carcinomas, by L. Johansson, C. Andersson, M. Albin (APMIS, 1992).

The study

• Authors: L. Johansson, C. Andersson, M. Albin
• Journal: APMIS
• Published: 1992;100(10):914-21
• Cited by: 3 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Lung carcinomas were studied immunohistochemically and the results were related to type of tissue sample (bronchoscopic biopsies, surgical specimens, autopsies). All cytokeratins (CAM 5.2, PKK-1, AE1/AE3) reacted with virtually all adenocarcinomas, most squamous, and 65% of the large cell carcinomas, while CAM 5.2 was most efficient with the small cell carcinomas. CEA stained 33% and 60% of the small and large cell carcinomas, respectively, most adenocarcinomas, and 84% of the squamous cell carcinomas, among which staining decreased with dedifferentiation and was often focal. EMA reacted with 90%, and NSE with 20% of all histological types. There was no staining for NF. All antibodies, except EMA, were more efficient with surgical specimens. Our study implies that the cytokeratins we used work better with surgical material, but are generally comparable to monospecific cytokeratin antibodies. Also, EMA is a reliable marker for epithelial differentiation with all types of tissue samples. Moreover, CEA negativity in several poorly differentiated lung carcinomas might have implications in the differential diagnosis against pleural mesothelioma.

In plain English

This laboratory pathology study, from Lund, Sweden, examined 158 lung cancer tissue samples (50 bronchoscopic biopsies, 21 surgical specimens and 87 autopsy samples) from 156 patients. The material included 29 asbestos cement workers and 87 matched non-exposed controls, but the article did not report its staining results by asbestos exposure, and no mesothelioma tissue was examined. The authors tested how seven antibodies stained these tumours. All adenocarcinomas reacted with at least two of three cytokeratin antibodies. At least one cytokeratin antibody stained 98% of squamous cell carcinomas, 57% of small cell carcinomas and 81% of large cell carcinomas. The marker CEA stained only 33% of small cell and 60% of large cell carcinomas, and eight (26%) poorly differentiated squamous cell carcinomas showed no reaction. EMA stained about 90% of all four tumour groups. NF stained none. Most antibodies, but not EMA, worked better on surgical specimens. The authors concluded that CEA negativity in poorly differentiated lung carcinomas might have implications in telling them apart from pleural mesothelioma. They noted that too few surgically removed tumours were available to draw some conclusions.

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 (tissue staining) study of lung carcinoma samples, with results compared by type of tissue sample
• Who was studied: 158 tissue samples (50 bronchoscopic biopsies, 21 surgical specimens, 87 autopsies) from 156 patients with lung carcinoma (144 males, 12 females), University Hospital, Lund, Sweden; dates not given
• Exposure: Not an exposure study. The material included 29 asbestos cement workers and 87 individually matched non-exposed controls. No fiber type is stated, and staining results are not given by exposure group. The study tested seven antibodies: three cytokeratin antibodies (CAM 5.2, PKK-1, AE1/AE3), CEA, EMA, NSE and NF.
• Main results:
  • Tumour types: 30 (19%) adenocarcinomas, four of them adenosquamous; 63 (40%) squamous cell carcinomas; 47 (30%) small cell carcinomas; 18 (11%) large cell carcinomas
  • All (100%) adenocarcinomas were positive with at least two cytokeratin antibodies
  • 98% of squamous cell carcinomas were positive with at least one cytokeratin antibody
  • Among small cell carcinomas, CAM 5.2 stained 50%, and 57% were positive with at least one cytokeratin antibody
  • Each of the three cytokeratin antibodies stained about 65% of large cell carcinomas, and 81% were positive with at least one
  • CEA: eight (26%) of the poorly differentiated squamous cell carcinomas showed no reaction; only 33% of small cell and 60% of large cell carcinomas were positive
  • EMA stained about 90% of all four tumour groups
  • NSE stained about 20% of tumours in each group, always weakly
  • No tumour stained for NF
  • The cytokeratin antibodies, CEA and NSE generally gave better results on surgical specimens; EMA was not affected by type of tissue sample
• The authors' conclusion: The authors concluded that CEA is negative in a substantial part of the poorly differentiated squamous cell and large cell carcinomas, which might have implications in distinguishing them from pleural mesothelioma
• Limitations the authors state:
  • Too few surgically removed small cell carcinomas were available to draw conclusions about tissue sample type
  • The number of surgically removed large cell carcinomas was small
  • The cytokeratin results for small cell carcinoma may be due partly to crush artifacts and the cells' high nucleus-to-cytoplasm ratio

Topics

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

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

Related studies

• 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)
• Immunohistochemical analysis still has a limited role in the diagnosis of malignant mesothelioma. A study of thirteen antibodies — F. Roberts, C.M. Harper, et al. (2001)
• 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)
• Immunohistochemical staining in malignant mesotheliomas — J.G. Strickler, B.G. Herndier, et al. (1987)
• 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)
• Peritoneal cystic mesothelioma: an electron microscopic and immunohistochemical study of two male patients — I.K. Sienkowski, A.J. Russell, et al. (1986)

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