Is PAX2 a reliable marker in differentiating diffuse malignant mesotheliomas of peritoneum from serous carcinomas of müllerian origin?

Our plain-English summary of Is PAX2 a reliable marker in differentiating diffuse malignant mesotheliomas of peritoneum from serous carcinomas of müllerian origin?, by F.F. Gao, A.M. Krasinskas, M. Chivukula (Applied Immunohistochemistry & Molecular Morphology, 2012).

The study

• Authors: F.F. Gao, A.M. Krasinskas, M. Chivukula
• Journal: Applied Immunohistochemistry & Molecular Morphology
• Published: 2012;20(3):272-6
• Cited by: 11 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Diffuse peritoneal malignant mesotheliomas (DPMM) are often disseminated in the peritoneal cavity as multiple nodules including localized masses in the ovaries that are clinically and histologically similar to serous adenocarcinomas of müllerian origin. It is imperative to differentiate these tumors given their diverse responses to chemotherapy and/or radiotherapy. PAX2 gene was recently demonstrated in benign epithelial cells of the female genital tract and in serous carcinomas (SC) of müllerian origin. The aim of our study was to determine if PAX2 can reliably be used in differentiating DPMM from SC. A total of 59 cases to include 25 cases of DPMM and 34 cases of SC were retrieved. All cases were stained with PAX2, Wilm tumor gene 1, calretinin and the results were compared. Our results demonstrate that PAX2 can be used reliably as a Müllerian marker in formulating an efficient panel to differentiate DPMM and SC.

In plain English

This laboratory study came from the pathology department of Magee-Women's Hospital in Pittsburgh. It asked whether a tissue stain called PAX2 can help pathologists tell diffuse malignant mesothelioma of the peritoneum (the lining of the abdomen) apart from serous carcinomas of müllerian origin. Those carcinomas arise from müllerian-lineage tissues such as the ovaries and peritoneum, and the two tumor types can look alike. The authors stained archived samples from 25 peritoneal mesotheliomas and 34 serous carcinomas (11 from the ovary, 23 from the peritoneum) for PAX2 and two other markers, WT-1 and calretinin. None of the 25 mesotheliomas stained for PAX2, while 21 of 34 serous carcinomas showed moderate to strong PAX2 staining. Calretinin stained 22 of 25 mesotheliomas and none of the 34 carcinomas. WT-1 stained most tumors of both kinds, and the authors judged it not helpful for telling them apart. The authors recommended adding PAX2 to the routine marker panel, noting that their number of cases was relatively small. The article does not discuss asbestos exposure. One calretinin figure for mesotheliomas in the text, 16% (7/25) with weak staining, does not match the article's own table.

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 (immunohistochemistry) study of archived pathology specimens comparing staining for PAX2, WT-1 and calretinin in two tumor types
• Who was studied: Tumor samples from 25 cases of diffuse peritoneal malignant mesothelioma and 34 cases of serous carcinoma of müllerian origin (11 ovary, 23 peritoneum), from the pathology archives of the Department of Pathology, Magee-Women's Hospital, University of Pittsburgh Medical Center, Pittsburgh. Dates of the cases are not given.
• Exposure: No asbestos or other exposure is reported. What the study examined was staining with the markers PAX2, WT-1 and calretinin.
• Main results:
  • PAX2: all 25 peritoneal mesotheliomas were negative (0%, 0/25).
  • PAX2: 61% (21/34) of serous carcinomas of müllerian origin showed moderate to strong expression.
  • WT-1: expression of any strength in 92% (23/25) of peritoneal mesotheliomas, of which 2/25 were weak, 10/25 moderate and 11/25 strong. The discussion's figure of 84% matches the moderate plus strong cases. Serous carcinomas showed 100% (34/34) expression.
  • Calretinin: expression in 88% (22/25) of peritoneal mesotheliomas.
  • Calretinin: no expression in any of the 34 serous carcinomas (0%, 0/34).
  • The authors stated that WT-1 was not helpful in distinguishing the two tumor types because both expressed it at high rates.
• The authors' conclusion: The authors recommended adding PAX2 to the panel of immunohistochemical markers used in routine clinical practice to differentiate diffuse peritoneal malignant mesothelioma from serous carcinomas of müllerian origin.
• Limitations the authors state:
  • The total number of cases was relatively small.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Mesothelioma, Ovarian cancer, Peritoneal mesothelioma.

Medical terms in this study, explained in our Lexicon: Malignant Mesothelioma, Peritoneum, Carcinoma, Peritoneal Cavity, Adenocarcinoma, Chemotherapy, Calretinin.

Related studies

• Value of mesothelial and epithelial antibodies in distinguishing diffuse peritoneal mesothelioma in females from serous papillary carcinoma of the ovary and peritoneum — R.L. Attanoos, R. Webb, et al. (2002)
• Rab25 is overexpressed in Müllerian serous carcinoma compared to malignant mesothelioma — K. Brusegard, H.T. Stavnes, et al. (2012)
• Value of PAX8, PAX2, claudin-4, and h-caldesmon immunostaining in distinguishing peritoneal epithelioid mesotheliomas from serous carcinomas — N.G. Ordóñez (2013)
• Hepatocyte nuclear factor-1β is not a specific marker of clear cell carcinoma in serous effusions — B. Davidson (2014)
• Claudin-4 as a marker for distinguishing malignant mesothelioma from lung carcinoma and serous adenocarcinoma — Y. Ohta, Y. Sasaki, et al. (2013)
• Expression of the Ets transcription factor EHF in serous ovarian carcinoma effusions is a marker of poor survival — K. Brenne, D.A. Nymoen, et al. (2012)

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