Immunohistological staining of reactive mesothelium, mesothelioma, and lung carcinoma with a panel of monoclonal antibodies

Our plain-English summary of Immunohistological staining of reactive mesothelium, mesothelioma, and lung carcinoma with a panel of monoclonal antibodies, by A.K. Ghosh, K.C. Gatter, M.S. Dunnill, et al (Journal of Clinical Pathology, 1987).

The study

• Authors: A.K. Ghosh, K.C. Gatter, M.S. Dunnill, D.Y. Mason
• Journal: Journal of Clinical Pathology
• Published: 1987;40(1):19-25
• Cited by: 73 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

A panel of seven monoclonal antiepithelial antibodies of different specificities, including anticytokeratin, human milk fat globule membrane, C, and carcinoembryonic antigen (CEA) were used with the alkaline phosphatase-antialkaline phosphatase (APAAP) immunostaining technique to determine their value in the differentiation between benign and malignant mesothelial cells and lung carcinoma in histological preparations. The anticytokeratin antibody reacted strongly with all cases of reactive mesothelium, mesothelioma, and lung carcinoma. Antibodies to human milk fat globule membrane and the Ca antigen stained mesothelioma and carcinoma and 43% of cases of reactive mesothelium. Staining for carcinoembryonic antigen was not detected in reactive mesothelium or mesothelioma, but was present in most of the lung carcinomas. CEA seemed to be the single most useful marker in distinguishing carcinoma from mesothelioma in that a positive reaction for CEA would indicate carcinoma rather than mesothelioma.

In plain English

This laboratory study tested whether seven monoclonal antibodies could help pathologists tell apart three kinds of tissue that can look alike: reactive (benign) mesothelium, pleural mesothelioma, and lung carcinoma. The authors stained stored tissue samples from John Radcliffe Hospital, Oxford. These were seven pleural mesotheliomas, 15 primary lung tumours, and benign reactive mesothelial cells from seven cases of recurrent pneumothorax. Asbestos exposure was not examined. The anticytokeratin antibody stained all benign and mesothelioma samples and most of the lung tumours. Antibodies to epithelial membrane antigen and the Ca antigen stained the mesotheliomas, often weakly or patchily, but they also stained three of the seven benign cases. The carcinoembryonic antigen (CEA) antibody stained no benign or mesothelioma samples. It stained three of four adenocarcinomas, three of four squamous cell carcinomas and three of five oat cell carcinomas, and the two carcinoid tumours were negative. The authors concluded that a positive CEA reaction suggests carcinoma rather than mesothelioma. They also concluded that these antibodies could not reliably separate benign from malignant mesothelium in tissue sections, and that more specific markers were needed.

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: immunohistochemical staining (alkaline phosphatase-antialkaline phosphatase, APAAP, method) of archived formalin-fixed, paraffin-embedded tissue with a panel of seven monoclonal antibodies
• Who was studied: Tissue samples from John Radcliffe Hospital, Oxford: seven pleural mesotheliomas (most referred to and accepted by the Pneumoconiosis panel), 15 primary lung tumours (four squamous cell carcinomas, four adenocarcinomas, five oat cell carcinomas and two carcinoid tumours), and reactive mesothelial cells from seven cases of recurrent pneumothorax. Dates not given.
• Exposure: Not reported. The study did not examine asbestos or any other exposure; it compared antibody staining patterns in tissue samples.
• Main results:
  • The anticytokeratin antibody stained mesothelium in all seven benign (reactive) cases.
  • The anticytokeratin antibody stained all seven mesotheliomas.
  • Among oat cell carcinomas, the anticytokeratin and anti-epithelial membrane antigen antibodies stained four of five cases.
  • The epithelial membrane antigen antibodies (E29, HMFG2) and the three Ca antibodies stained three of the seven benign reactive mesothelium cases.
  • The epithelial membrane antigen antibodies reacted with all mesotheliomas, but in four cases the staining was patchy and weak on solid tumour areas. The Ca antibodies gave similar reactions.
  • The anti-CEA antibody did not stain any reactive mesothelial cells.
  • The anti-CEA antibody was negative on all seven mesotheliomas.
  • The anti-CEA antibody stained three of the four adenocarcinomas (one focally). In separate statements, the results report three of four squamous cell carcinomas and three of five oat cell carcinomas stained.
  • The carcinoid tumours were negative for epithelial membrane antigen, Ca and CEA.
• The authors' conclusion: The authors concluded that CEA staining is a useful marker for telling lung carcinoma from mesothelioma, since a positive reaction suggests carcinoma. They also concluded that the antibodies tested could not distinguish benign from malignant mesothelium in histological sections, and that more specific markers for mesothelioma are needed.

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: Mesothelium, Mesothelioma, Carcinoma, Monoclonal, Carcinoembryonic Antigen (CEA), Mesothelial Cells.

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)
• Immunocytological staining reactions of anti-carcinoembryonic antigen, Ca, and anti-human milk fat globule monoclonal antibodies on benign and malignant exfoliated mesothelial cells — A.K. Ghosh, E.B. Butler (1987)
• Distinct keratin patterns demonstrated by immunoperoxidase staining of adenocarcinomas, carcinoids, and mesotheliomas using polyclonal and monoclonal anti-keratin antibodies — H.J. Kahn, P.S. Thorner, et al. (1986)
• 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)
• 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 study of malignant diffuse mesotheliomas of the pleura — H. Loosli, J. Hurlimann (1984)

Browse more research in Journal of Clinical Pathology, or return to medical research.