Performance of the Monoclonal Antibody B72.3 in Diagnosis of Malignant Carcinomatous Serous Effusions-A Systematic Review and Meta-Analysis of Diagnostic Performance

Our plain-English summary of Performance of the Monoclonal Antibody B72.3 in Diagnosis of Malignant Carcinomatous Serous Effusions-A Systematic Review and Meta-Analysis of Diagnostic Performance, by A.H. Lin, M. Hsu, J.K.M. Ng, et al (Cytopathology, 2025).

The study

• Authors: A.H. Lin, M. Hsu, J.K.M. Ng, S.J. Farahani, J.J.X. Li, J. Nano, H. Raeisi-Dehkordi, W. Tang, P. Vielh, T. Muka
• Journal: Cytopathology
• Published: 2025;36(4):399-407
• Type of article: Systematic review, Meta-analysis
• Cited by: 2 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Objectives: Immunocytochemistry is often required in the cytologic assessment of malignant serous effusion, particularly for differentiating metastatic carcinoma from mesothelioma. To summarise the diagnostic performance of the monoclonal antibody B72.3, a systematic review and meta-analysis was conducted.

Methods: Five databases were searched for relevant studies and reviewed for data extraction and risk of bias assessment. Pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR) and area under curve of summary receiver operating characteristics (AUC-SROC) were calculated for the diagnostic performance of B72.3. Heterogeneity and publication bias were assessed by the I2 index and Deeks' funnel plot.

Results: In total, 19 studies (1159 cases) were included. Overall pooled sensitivity and specificity were 0.76 (0.72-0.79) and 0.90 (0.74-1.00), respectively. The NLR, PLR and DOR were 0.27 (0.21-0.34), 7.66 (< 0.001-20.46) and 28.26 (0-75.96), respectively. The AUC-SROC was 0.98, indicating a good overall diagnostic accuracy for B72.3. Subgroup analysis for adenocarcinoma (0.75, 0.71-0.79), mesothelioma (0.92, 0.85-0.98) and benign/reactive mesothelial cells (0.96, 0.93-1.00) showed similar sensitivity and specificity, while the sensitivity for adenocarcinomas of the gastrointestinal/hepatobiliary tract (0.56, 0.41-0.71) and breast (0.55, 0.38-0.71) was significantly lower. High heterogeneity was observed in the majority of our analyses, while no evidence of publication bias was identified.

Conclusions: B72.3 has an acceptable performance with low sensitivity. With a good specificity, B72.3 may find use in an immunocytochemical panel for excluding benign mesothelial processes.

© 2025 The Author(s). Cytopathology published by John Wiley & Sons Ltd.

In plain English

This article was a systematic review and meta-analysis of earlier studies. The authors searched five databases up to 30 June 2024 for studies testing B72.3, an antibody stain, on body-cavity fluid samples (serous effusions). The stain helps tell metastatic carcinoma cells from mesothelial cells, including mesothelioma. They combined 19 studies (17 case-control, 2 case series) with 1,159 cases; 13 of the studies were from the United States. Overall pooled sensitivity (share of carcinoma cases detected) was 0.76 (95% CI 0.72 to 0.79), and specificity (share of non-carcinoma cases correctly negative) was 0.90 (95% CI 0.74 to 1.00). Specificity was 0.92 (0.85 to 0.98) against mesothelioma and 0.96 (95% CI 0.93 to 1.00) against benign or reactive mesothelial cells. Sensitivity was 0.56 (0.41 to 0.71) for gastrointestinal/hepatobiliary and 0.55 (0.38 to 0.71) for breast adenocarcinomas, which the authors called significantly lower. Results varied widely between studies, many of which were conducted before 2000. Asbestos exposure was not examined. The authors concluded that B72.3 has acceptable performance with low sensitivity. Given its good specificity, they wrote, it may help in a stain panel for excluding benign mesothelial processes.

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: Systematic review and meta-analysis of diagnostic accuracy studies; the 19 included studies were 17 case-control studies and 2 case series
• Who was studied: 19 published studies with sample sizes from 19 to 154, totalling 1,159 cases of serous effusion cytology; most of the studies were from the United States (13 studies), followed by the Netherlands (2) and Norway (2); literature searched up to 30 June 2024
• Exposure: Not an asbestos exposure study. The test examined was immunocytochemical staining with the monoclonal antibody B72.3 on effusion fluid cytology. The stain is used to diagnose carcinoma and distinguish it from mesothelial cells (mesothelioma and benign or reactive mesothelial cells).
• Main results:
  • Across all included studies, pooled sensitivity of B72.3 for carcinoma was 0.76 (95% CI 0.72 to 0.79) and pooled specificity was 0.90 (95% CI 0.74 to 1.00)
  • Overall negative likelihood ratio 0.27 (95% CI 0.21 to 0.34); positive likelihood ratio 7.66 (95% CI less than 0.001 to 20.46); diagnostic odds ratio 28.26 (95% CI 0 to 75.96)
  • The area under the summary receiver operating characteristic curve was 0.98, which the authors described as good overall diagnostic accuracy
  • In subgroup analysis, sensitivity for adenocarcinoma was 0.75 (0.71 to 0.79). Specificity against mesothelioma was 0.92 (0.85 to 0.98), and specificity against benign or reactive mesothelial cells was 0.96 (0.93 to 1.00).
  • Among 404 metastatic adenocarcinoma cases with known primary site, sensitivity was 0.74 (95% CI 0.63 to 0.84) for female genital primaries and 0.70 (95% CI 0.60 to 0.79) for lung
  • Sensitivity was 0.56 (0.41 to 0.71) for gastrointestinal/hepatobiliary tract adenocarcinomas and 0.55 (0.38 to 0.71) for breast adenocarcinomas, described by the authors as significantly lower
  • Meta-regression found only year of publication to be a significant source of the differences between studies (p = 0.002)
  • Deeks' test did not show significant publication bias (p = 0.29)
• The authors' conclusion: The authors concluded that B72.3 has acceptable performance with low sensitivity. Because of its good specificity, they suggested it may find use in an immunocytochemical panel for excluding benign mesothelial processes.
• Limitations the authors state:
  • High heterogeneity between the included studies
  • A large proportion of the included studies were conducted before 2000, with only one study published between 2020 and 2024
  • It is unclear how dated staining protocols affected performance
  • The most common risk of bias was lack of blinding of assessors to the reference diagnosis (14 studies), followed by non-consecutive case collection (7 studies)
  • Eight reports could not be retrieved because no electronic versions were available; all were published before 1993

Topics

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

Medical terms in this study, explained in our Lexicon: Monoclonal Antibody, B72.3 (TAG-72), Systematic Review, Meta-Analysis, Carcinoma, Mesothelioma, Odds Ratio, Adenocarcinoma.

Related studies

• Diagnostic value of monoclonal antibody B72.3 in detecting adenocarcinoma cells in serous effusions — A.F. Lauritzen (1989)
• MOC31 for the Diagnosis of Metastatic Carcinoma and Mesothelial Lesions in Effusion Fluid-A Systematic Review and Meta-Analysis — A.H. Lin, M. Hsu, et al. (2025)
• Immunocytochemical staining of serous effusions with the monoclonal antibody Ber-EP4 — M. De Angelis, I.D. Buley, et al. (1992)
• Diagnostic accuracy of calretinin for malignant mesothelioma in serous effusions: a meta-analysis — D. Li, B. Wang, et al. (2015)
• Monoclonal antibody HBME-1 reacts with a minor subset of B cells with villous surface and can be useful in the diagnosis of hairy cell leukemia and other indolent lymphoproliferations of villous B lymphocytes — L. Krenács, J. Tóth-Lipták, et al. (2013)
• Diagnostic performance and safety of image-guided pleural biopsy and medical thoracoscopy for undiagnosed exudative pleural effusion: a systematic review and network meta-analysis — S. Lyu, Z. Zheng, et al. (2026)

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