Mesothelioma-binding antibodies: thrombomodulin, OV 632 and HBME-1 and their use in the diagnosis of malignant mesothelioma

Our plain-English summary of Mesothelioma-binding antibodies: thrombomodulin, OV 632 and HBME-1 and their use in the diagnosis of malignant mesothelioma, by R.L. Attanoos, H. Goddard, A.R. Gibbs (Histopathology, 1996).

The study

• Authors: R.L. Attanoos, H. Goddard, A.R. Gibbs
• Journal: Histopathology
• Published: 1996;29(3):209-15
• Cited by: 67 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

The aim of this study was to examine the expression of three putative mesothelioma-binding antibodies, thrombomodulin, OV 632 and HBME-1 in 42 malignant mesotheliomas (27 pleural and 15 peritoneal) and 32 pulmonary adenocarcinomas. Evaluation of their use in differentiating between the mesotheliomas and pulmonary adenocarcinomas was assessed. Thrombomodulin was expressed by 22 of 42 (52%) mesotheliomas but was seen in eight of 12 pure epithelial-type mesotheliomas of the pleura and in all four papillary epithelial peritoneal mesotheliomas. For pure epithelial mesotheliomas thrombomodulin was 75% sensitive. Only two of 32 pulmonary adenocarcinomas were immunoreactive yielding a 94% specificity for thrombomodulin. In comparison, OV 632 and HBME-1 showed 67% and 62% antibody sensitivity, respectively, for malignant mesothelioma but this was accompanied by low specificity (OV 632, 37%; HBME-1, 28%). Both OV 632 and HBME-1 are considered unsuitable for use in differentiating between mesotheliomas and pulmonary adenocarcinomas. We advocate the use of thrombomodulin as a mesothelioma-binding antibody in the standard panel of antibodies used in the evaluation of malignant mesothelioma.

In plain English

In this laboratory study, the authors stained stored tumour tissue from Llandough Hospital, Penarth, to see whether three antibodies (thrombomodulin, OV 632 and HBME-1) could help tell malignant mesothelioma apart from pulmonary adenocarcinoma, a lung cancer that can look similar. They tested 42 mesotheliomas (27 pleural, 15 peritoneal) and 32 pulmonary adenocarcinomas. Asbestos exposure was not studied. Thrombomodulin stained 52% of mesotheliomas overall and 75% of epithelial-type mesotheliomas, but only 2 of 32 (6%) adenocarcinomas, a specificity of 94%. OV 632 stained 85% of pleural and 27% of peritoneal mesotheliomas, but also 63% of adenocarcinomas. HBME-1 stained 59% of pleural and 67% of peritoneal mesotheliomas, but 72% of adenocarcinomas. The authors concluded that only thrombomodulin was specific enough for routine use, chiefly for epithelial-type mesothelioma, and that OV 632 and HBME-1 were unsuitable. They noted that a negative thrombomodulin result is unhelpful, because 48% of mesotheliomas were negative, and that thrombomodulin appeared less useful in the peritoneum.

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: Comparative immunohistochemical (antibody staining) study of archived tumour tissue blocks
• Who was studied: Paraffin-embedded tumour blocks from 42 malignant mesotheliomas (27 pleural, 15 peritoneal) and 32 pulmonary adenocarcinomas, taken from the files of the Department of Histopathology, Llandough Hospital, Penarth. Dates of the cases are not given.
• Exposure: This was not a study of asbestos exposure. No fiber types, products, jobs or doses are reported. What was tested was three antibodies used as stains on tumour tissue: thrombomodulin, OV 632 and HBME-1.
• Main results:
  • Thrombomodulin stained 52% of all 42 mesotheliomas (sensitivity 52%). Counting only epithelial-type mesotheliomas, sensitivity was 75%.
  • Among pure epithelial-type mesotheliomas, thrombomodulin was strongly positive in 8 of 12 (67%) pleural cases and in all 4 (100%) papillary peritoneal cases.
  • Thrombomodulin stained only 2 of 32 (6%) pulmonary adenocarcinomas, a specificity of 94%.
  • The sarcomatous (spindle-cell) part of the tumours stained only focally for thrombomodulin: in 4 of 10 mixed pleural, 4 of 11 mixed peritoneal and 2 of 5 pure sarcomatous pleural mesotheliomas.
  • OV 632 stained 23 of 27 (85%) pleural mesotheliomas.
  • OV 632 stained 4 of 15 (27%) peritoneal mesotheliomas.
  • OV 632 also stained 63% of the 32 pulmonary adenocarcinomas.
  • HBME-1 stained 16 of 27 (59%) pleural and 10 of 15 (67%) peritoneal mesotheliomas.
  • HBME-1 stained a higher share of pulmonary adenocarcinomas (72% of 32) than of mesotheliomas.
  • HBME-1 did not stain the sarcomatous element in any mixed case or in any of the five pure sarcomatous pleural mesotheliomas.
  • For mesothelioma, sensitivity was 64% for OV 632 and 62% for HBME-1. Specificity was low: 37% for OV 632 and 28% for HBME-1. The abstract gives 67% for OV 632 sensitivity.
• The authors' conclusion: The authors concluded that only thrombomodulin was specific enough to be used in routine practice. They considered it useful for distinguishing epithelial-type mesothelioma from pulmonary adenocarcinoma. In their view, neither OV 632 nor HBME-1 was a suitable way to tell the two tumours apart.
• Limitations the authors state:
  • A negative thrombomodulin result does not help distinguish the two tumours, because 48% of mesotheliomas were false negatives.
  • False negatives with thrombomodulin rose to 60% among the five pure sarcomatous pleural mesotheliomas.
  • Thrombomodulin appeared less useful for diagnosing peritoneal mesothelioma.
  • The method for using OV 632 on formalin-fixed, paraffin-embedded tissue was poorly verified, so the staining procedure had to be modified.

Topics

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

Medical terms in this study, explained in our Lexicon: Mesothelioma, HBME-1, Malignant Mesothelioma, Adenocarcinoma, Pleura, Peritoneal Mesothelioma.

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• Immunohistochemical evaluation of two antibodies against PD-L1 and prognostic significance of PD-L1 expression in epithelioid peritoneal malignant mesothelioma: A RENAPE study — S. Valmary-Degano, P. Colpart, et al. (2017)
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• Value of thrombomodulin immunostaining in the diagnosis of mesothelioma — N.G. Ordóñez (1997)
• Differential Diagnosis of Epithelioid Malignant Mesothelioma With Lung and Breast Pleural Metastasis: A Systematic Review Compared With a Standardized Panel of Antibodies-A New Proposal That May Influence Pathologic Practice — N. Le Stang, L. Burke, et al. (2020)
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