Lectin binding properties of cells from serous effusion and peritoneal washing specimens

Our plain-English summary of Lectin binding properties of cells from serous effusion and peritoneal washing specimens, by P.W. Shield (Journal of Clinical Pathology, 1989).

The study

• Author: P.W. Shield
• Journal: Journal of Clinical Pathology
• Published: 1989;42(11):1178-83
• Cited by: 5 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

The diagnostic value of staining cells from serous effusion and peritoneal washing specimens with a panel of four lectins was investigated and the results compared with those achieved with polyclonal anti-carcinoembryonic antigen (anti-CEA) sera. Cell blocks from 42 pleural effusions, 25 peritoneal effusions, and 14 peritoneal washing specimens were stained with Con A (D-mannosyl, D-glucosyl), WGA (n-acetyl glucosamine), UEA-1 (L-fucose), SBA (n-acetyl galactosamine) and anti-CEA. Con A and WGA were not useful in discriminating mesothelial cells from adenocarcinomas. In contrast, UEA-1 and SBA binding was present in 30 of 46 (65%) and in 31 of 46 (67%), respectively, of adenocarcinomas tested, but negative in 21 cases with reactive mesothelial cells, 10 cases with benign mesothelial cells, and one case of mesothelioma. All mesothelial cells were also negative for CEA, but 24 of 46 (52%) of adenocarcinomas were positive. All three cases of lymphoma were negative with UEA-1, SBA, and anti-CEA. UEA-1 and SBA lectins identified a higher proportion of metastatic adenocarcinomas than CEA and stained most cases of adenocarcinomas metastatic from sites which usually fail to express CEA. Combination of staining results for UEA-1, SBA, and anti-CEA produced a test with high sensitivity and specificity, identifying 40 of 46 (87%) of adenocarcinomas tested, with no false positive results. It is concluded that UEA-1 and SBA staining of effusion specimens warrants further study, and may provide a useful adjunct to CEA staining.

In plain English

This laboratory study from the Royal Brisbane Hospital, Australia, tested whether four lectins (plant proteins that bind specific sugars) could help distinguish adenocarcinoma cells, a type of cancer cell, from mesothelial cells, which line the chest and abdominal cavities. The study did not examine asbestos exposure. Cell blocks from 42 pleural effusions, 25 peritoneal effusions and 14 peritoneal washings were stained with the lectins Con A, WGA, UEA-1 and SBA, and with anti-CEA, an established marker. Samples included 46 adenocarcinomas, 31 benign or reactive mesothelial cell cases, three lymphomas and one mesothelioma. Con A and WGA did not separate mesothelial cells from adenocarcinomas. UEA-1 stained 30 of 46 (65%) adenocarcinomas and SBA stained 31 of 46 (67%). Neither stained any mesothelial cells, including the one mesothelioma. Anti-CEA stained 24 of 46 (52%) adenocarcinomas and no mesothelial cells. Combining UEA-1, SBA and anti-CEA identified 40 of 46 (87%) adenocarcinomas with no false positives. The author concluded that UEA-1 and SBA staining warrants further study and may be a useful adjunct to CEA staining. The author also cautioned that lectin binding results must be interpreted carefully.

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: staining of cell blocks from routine cytology specimens with four lectins and anti-CEA, with results compared by diagnosis
• Who was studied: 81 specimens (42 pleural effusions, 25 peritoneal effusions, 14 peritoneal washings) submitted to the cytology department of the Royal Brisbane Hospital, Australia. Diagnoses were confirmed by histology. 31 cases were benign and 50 malignant: 10 benign mesothelial cells, 21 reactive mesothelial cells, 1 mesothelioma (listed under peritoneal fluid in table 1), 46 adenocarcinomas and 3 lymphomas. Dates are not stated.
• Exposure: No asbestos or other environmental exposure was studied. The test variables were staining with four lectins (Concanavalin A, wheat germ agglutinin, Ulex europaeus agglutinin I, soybean agglutinin) and with polyclonal anti-CEA serum. A specimen counted as positive if at least 10% of its cells stained.
• Main results:
  • Con A and WGA did not discriminate between mesothelial cells and adenocarcinomas. Con A stained all 46 adenocarcinomas and all mesothelial specimens. WGA stained 34 of 46 adenocarcinomas, 7 of 10 benign and 11 of 21 reactive mesothelial specimens, and the mesothelioma.
  • UEA-1 stained 30 of 46 (65%) adenocarcinomas and no benign, reactive or malignant mesothelial cells.
  • SBA stained 31 of 46 (67%) adenocarcinomas and no mesothelial cells. Occasional macrophages stained with SBA, but these were rare and could be identified by their appearance.
  • Anti-CEA stained 24 of 46 (52%) adenocarcinomas and no mesothelial cells. Most ovarian and endometrial tumours were CEA-negative (ovary 2 of 10, endometrium 1 of 4), while UEA-1 and SBA labelled most adenocarcinomas from these sites.
  • Combining the UEA-1, SBA and anti-CEA results identified 40 of 46 (87%) adenocarcinomas, with specificity of 100% (no false positives).
  • All three lymphoma cases were negative with UEA-1, SBA and anti-CEA.
• The authors' conclusion: The author concluded that UEA-1 and SBA staining of effusion specimens warrants further study and may provide a useful adjunct to CEA staining.
• Limitations the authors state:
  • Lectin binding to free simple sugars, as used in the controls, does not adequately reflect binding at the cellular level. Fixation, nearby sugars and detection methods affect the observed binding strength, so results need cautious interpretation.
  • The reason UEA-1 and SBA do not bind mesothelial cells is unknown, and the author found no published reports on their binding to mesothelium.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Pleural plaques and thickening.

Medical terms in this study, explained in our Lexicon: Carcinoembryonic Antigen (CEA), Cell Block, Pleural Effusion, Mesothelial Cells, Adenocarcinoma, Reactive Mesothelial Cells, Mesothelioma.

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• Calretinin. A selective marker of normal and neoplastic mesothelial cells in serous effusions — M.C. Barberis, M. Faleri, et al. (1997)
• Sialic acid-binding lectin (leczyme) induces apoptosis to malignant mesothelioma and exerts synergistic antitumor effects with TRAIL — T. Tatsuta, M. Hosono, et al. (2014)
• Diagnostic problems in serous effusions — C.W. Bedrossian (1998)
• Use of antisera to epithelial membrane antigen for the cytodiagnosis of malignancy in serous effusions — A. To, D.V. Coleman, et al. (1981)
• Utility of HBME-1 immunostaining in serous effusions — V. Ascoli, C. Carnovale-Scalzo, et al. (1997)

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