MMP-7 is a highly specific negative marker for benign and malignant mesothelial cells in serous effusions

Our plain-English summary of MMP-7 is a highly specific negative marker for benign and malignant mesothelial cells in serous effusions, by B. Davidson, H.T. Stavnes, E. Hellesylt, et al (Human Pathology, 2016).

The study

• Authors: B. Davidson, H.T. Stavnes, E. Hellesylt, T. Hager, P. Zeppa, M. Pinamonti, J. Wohlschlaeger
• Journal: Human Pathology
• Published: 2016;47(1):104-8
• Cited by: 13 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

The aim of this study was to analyze the diagnostic role of MMP-7 in effusion cytology. Effusions (n = 356), consisting of 307 carcinomas (184 ovarian, 55 breast, 32 lung, 36 carcinomas of other origin) and 49 malignant mesotheliomas, were analyzed for MMP-7 expression using immunohistochemistry. MMP-7 was expressed in 124/307 (40%) carcinomas and was uniformly absent in malignant mesotheliomas (0/49; 0%; P < .001). Reactive mesothelial cells were similarly MMP-7 negative in all carcinoma specimens. In carcinomas, expression was most frequent in tumors of ovarian and other female genital (cervical and endometrial) origin (P < .001). The sensitivity and specificity of this marker in the differential diagnosis between high-grade serous carcinoma and malignant mesothelioma were 46% and 100%, respectively. In conclusion, MMP-7 expression is highly specific, though only of moderate sensitivity, for the diagnosis of carcinoma in the differential diagnosis from both benign and malignant mesothelial cells.

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In plain English

This laboratory study asked whether a protein called MMP-7, detected by staining cells in fluid samples (effusions), helps tell carcinoma cells apart from mesothelial cells. The authors tested 356 effusion samples, most from the Norwegian Radium Hospital (1998-2007) and the rest from hospitals in Germany, Denmark and Italy. The samples were 307 carcinomas of various origins and 49 malignant mesotheliomas (35 pleural, 14 peritoneal). MMP-7 was found in 124 of 307 carcinomas (40%) and in none of the 49 mesotheliomas, a statistically significant difference. Reactive (non-cancerous) mesothelial cells seen in carcinoma samples were also negative. When the test was used to distinguish high-grade serous ovarian carcinoma from malignant mesothelioma, its sensitivity was 46% and its specificity 100%. Among carcinomas, staining was more frequent in ovarian and other female genital cancers than in breast, lung or gastrointestinal cancers. The authors concluded that MMP-7 effectively separated carcinomas from benign and malignant mesothelial cells but performed less well at identifying a carcinoma's organ of origin. The study did not examine asbestos exposure.

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: Diagnostic laboratory study of archived effusion specimens analyzed by immunohistochemistry
• Who was studied: 356 effusion specimens: 307 carcinomas (184 ovarian, 55 breast, 32 lung, 17 other gynecological, 17 gastrointestinal, 2 urogenital) and 49 malignant mesotheliomas (14 peritoneal, 35 pleural; all epithelioid or biphasic type). 313 specimens came from the Norwegian Radium Hospital (1998-2007); the others came from Essen, Germany (21), Ålborg, Denmark (9), Trieste, Italy (9) and Salerno, Italy (4).
• Exposure: Not an asbestos exposure study. The factor examined was MMP-7 protein expression, detected with a mouse monoclonal antibody. The article reports no fiber types, jobs or asbestos exposure.
• Main results:
  • MMP-7 was expressed in 124 of 307 carcinoma specimens (40%), most often in fewer than 25% of cells. It was expressed in none of the 49 malignant mesothelioma effusions (0%). The difference was statistically significant (P less than .001).
  • Reactive mesothelial cells, when present in carcinoma effusions, were uniformly MMP-7 negative. The data were not shown.
  • For distinguishing high-grade serous carcinoma from malignant mesothelioma, MMP-7 had a sensitivity of 46% and a specificity of 100%.
  • Among carcinomas, expression was more frequent in ovarian and other female genital (cervical and endometrial) cancers than in carcinomas from the breast, lung or gastrointestinal organs (P less than .001).
  • Among ovarian carcinoma types, expression was 87% (7 of 8) in clear cell carcinoma, 46% (71 of 153) in high-grade serous carcinoma and 38% (5 of 13) in low-grade serous carcinoma.
  • In 121 patients with high-grade serous carcinoma effusions, MMP-7 expression showed no association with progression-free or overall survival. The data were not shown.
• The authors' conclusion: The authors concluded that MMP-7 expression effectively differentiated metastatic carcinomas from reactive and malignant mesothelial cells, but performed less well in determining a metastatic carcinoma's organ of origin.
• Limitations the authors state:
  • The gastrointestinal carcinoma series was small and included tumors from different sites along the gastrointestinal tract. The authors said a larger series is needed.
  • Urogenital carcinomas were left out of the six-group statistical comparison because there were so few of them.

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: Mesothelial Cells, Cytology, Carcinoma, Malignant Mesothelioma, Immunohistochemistry, Reactive Mesothelial Cells, Differential Diagnosis.

Related studies

• The diagnostic role of BAP1 in serous effusions — B. Davidson, M. Tötsch, et al. (2018)
• Cytological differential diagnosis among adenocarcinoma, epithelial mesothelioma, and reactive mesothelial cells in serous effusions by immunocytochemistry — X.Y. Su, G.D. Li, et al. (2011)
• CD24 is highly useful in differentiating high-grade serous carcinoma from benign and malignant mesothelial cells — B. Davidson (2016)
• Detection of cancer cells in effusions from patients diagnosed with gynaecological malignancies. Evaluation of five epithelial markers — B. Davidson, B. Risberg, et al. (1999)
• Calretinin. A selective marker of normal and neoplastic mesothelial cells in serous effusions — M.C. Barberis, M. Faleri, et al. (1997)
• IMP3/L523S, a novel immunocytochemical marker that distinguishes benign and malignant cells: the expression profiles of IMP3/L523S in effusion cytology — K. Ikeda, G. Tate, et al. (2010)

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