Myogenic antigen expression is useful for differentiation between epithelioid mesothelioma and non-neoplastic mesothelial cells

Our plain-English summary of Myogenic antigen expression is useful for differentiation between epithelioid mesothelioma and non-neoplastic mesothelial cells, by H. Tsukiji, Y. Takeshima, V.J. Amatya, et al (Histopathology, 2010).

The study

• Authors: H. Tsukiji, Y. Takeshima, V.J. Amatya, K. Kushitani, K. Inai
• Journal: Histopathology
• Published: 2010;56(7):969-74
• Type of article: Letter
• Cited by: 5 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Summary of the article

This research letter examined whether desmin and other myogenic (muscle-related) markers help pathologists distinguish epithelioid mesothelioma (EM) from non-neoplastic mesothelial cells (NMC), a distinction the authors described as often difficult. The authors, from the Department of Pathology at Hiroshima University, Japan, retrieved 63 EM cases (57 pleural, six peritoneal) and 44 cases of pleural or peritoneal NMC from their surgical files. NMC were grouped as normal-looking mesothelial cells (19 cases), reactive mesothelial cells (20 cases) and reactive mesothelial hyperplasia (5 cases, per the summary table). Tissue sections were stained for desmin, smooth muscle actin (SMA), calponin, muscle-specific actin (MSA), CD10 and h-caldesmon, and graded by the percentage of positive cells. Desmin was positive in 38/44 NMC (86.4%) but only 6/60 EM (10%) (P < 0.001), and all six positive EMs scored only 1+. SMA (22/52, 42.3%) and calponin (7/18, 38.9%) were more often positive in EM than in NMC (9.1% and 4.5%). MSA (10/19, 52.6%), CD10 (11/32, 34.4%) and h-caldesmon (3/57, 5.3%; not significant) were positive only in EM. The authors stated that the higher expression of these other markers in EM was not of practical use for differential diagnosis. They concluded that desmin was the most useful myogenic marker, followed by SMA and MSA.

PubMed has no abstract for this study, and the article doesn't print one. We wrote this summary from the full article with the help of AI. It is not the authors' wording.

In plain English

This was a short research letter from pathologists at Hiroshima University, Japan. It asked whether staining for desmin and other muscle-related proteins helps pathologists distinguish epithelioid mesothelioma from non-cancerous mesothelial cells. The authors took 63 epithelioid mesothelioma cases (57 pleural, six peritoneal) and 44 non-cancerous mesothelial cell samples from their surgical files. All 44 non-cancerous samples were stained for six markers, but only 18 to 60 mesotheliomas were tested per marker. Desmin stained 38 of 44 non-cancerous samples (86.4%) but only 6 of 60 mesotheliomas tested (10%), a statistically significant difference. All six positive mesotheliomas showed the lowest staining grade (fewer than 25% of cells). Smooth muscle actin, calponin, muscle-specific actin and CD10 were more often positive in the mesotheliomas than in the non-cancerous samples. h-caldesmon was positive in 3 of 57 mesotheliomas and no non-cancerous samples, a difference that was not statistically significant. The authors wrote that these other markers were not of practical use for the distinction. Yet they concluded that desmin was the most useful marker, followed by smooth muscle actin and muscle-specific actin.

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: Retrospective immunohistochemical (tissue staining) study of archived surgical specimens, published as a letter to the editor
• Who was studied: 63 epithelioid mesothelioma cases (57 pleural, 6 peritoneal) and 44 pleural or peritoneal non-neoplastic mesothelial cell samples from the surgical files of the authors' department (Hiroshima University, Japan). The non-neoplastic samples were split into normal-looking mesothelial cells (19), reactive mesothelial cells (20) and reactive mesothelial hyperplasia (5, per Table 3). Dates were not given.
• Main results:
  • Desmin was positive in 38 of 44 non-neoplastic mesothelial cell samples (86.4%) versus 6 of 60 epithelioid mesotheliomas (10%); the difference was statistically significant (P less than 0.001 in Table 2)
  • All six desmin-positive mesotheliomas showed only grade 1+, defined as fewer than 25% of cells staining
  • Grading scale used: 1+ fewer than 25%, 2+ 26 to 50%, 3+ more than 50% of cells staining
  • Smooth muscle actin and calponin were positive more often in epithelioid mesotheliomas (42.3%, 22 of 52; and 38.9%, 7 of 18) than in non-neoplastic mesothelial cells (9.1% and 4.5%)
  • Muscle-specific actin, CD10 and h-caldesmon were expressed only in epithelioid mesotheliomas, at low rates: muscle-specific actin 10 of 19 (52.6%), CD10 11 of 32 (34.4%), h-caldesmon 3 of 57 (5.3%; not statistically significant per Table 2)
  • Desmin positivity was similar across the non-neoplastic subgroups: normal-looking mesothelial cells 17 of 19 (89.5%), reactive mesothelial cells 17 of 20 (85%), reactive hyperplasia 4 of 5 (80%)
  • The authors stated that, although smooth muscle actin, muscle-specific actin, calponin, CD10 and h-caldesmon were expressed more in mesotheliomas, this expression was not of practical use for the distinction
• The authors' conclusion: The authors concluded that, among the myogenic markers tested, desmin was the most useful for differentiating epithelioid mesothelioma from reactive mesothelial cells, followed by smooth muscle actin and muscle-specific actin, and that pathologists should recognize desmin's utility for mesothelioma diagnosis

Topics

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

Medical terms in this study, explained in our Lexicon: Epithelioid, Mesothelioma, Mesothelial Cells, Desmin, Pathology, Reactive Mesothelial Cells, Reactive Mesothelial Hyperplasia, Differential Diagnosis.

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