Reply to 'MUC4 staining in sarcomatoid carcinomas' by Berg et al

Our plain-English summary of Reply to 'MUC4 staining in sarcomatoid carcinomas' by Berg et al, by V.J. Amatya, K. Kushitani, A.S. Mawas, et al (Modern Pathology, 2019).

The study

• Authors: V.J. Amatya, K. Kushitani, A.S. Mawas, Y. Miyata, M. Okada, T. Kishimoto, K. Inai, Y. Takeshima
• Journal: Modern Pathology
• Published: 2019;32(1):158
• Type of article: Letter, Comment
• Cited by: 2 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

In plain English

This is a short letter, not a new study. The authors replied to a letter by Berg et al., which had looked at whether staining tissue for MUC4, an immunohistochemical marker, can tell sarcomatoid mesothelioma apart from sarcomatoid carcinoma of the lung. As the authors described it, Berg et al. examined 6 sarcomatoid mesotheliomas and 13 sarcomatoid lung carcinomas. None of the six mesotheliomas showed MUC4. Among the lung carcinomas, one showed diffuse staining, three focal staining and nine none. In the authors' own earlier study, all five pure spindle cell carcinomas lacked MUC4, but most of the sarcomatoid component of pleomorphic carcinomas showed focal to diffuse staining. The authors also cited their 2018 study, in which a negative MUC4 result had 100% specificity and 86% sensitivity for separating epithelioid mesothelioma from lung adenocarcinoma and squamous cell carcinoma. The authors concluded that MUC4 still has use in the sarcomatoid distinction, although sensitivity differed between studies. They called for further study. The letter did not discuss 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: Letter to the editor (correspondence) replying to another group's letter; it reports no new data
• Who was studied: No new patients were studied. The letter discusses Berg et al.'s 6 sarcomatoid mesotheliomas and 13 sarcomatoid lung carcinomas, and the authors' own earlier series of 5 spindle cell carcinomas and 24 pleomorphic carcinomas of the lung
• Exposure: No asbestos or other exposure is discussed. The subject is MUC4 immunohistochemical staining of tumor tissue as a diagnostic test
• Main results:
  • As reported by the authors, Berg et al. found no MUC4 staining in any of their six sarcomatoid mesothelioma cases, which the authors said matched their own study
  • As reported by the authors, Berg et al. found that among their 13 sarcomatoid lung carcinomas, one had diffuse MUC4 staining, three had focal staining and nine had none
  • In the authors' own earlier (2017) study, none of the five pure spindle cell carcinomas showed MUC4, while most of the sarcomatoid component of pleomorphic carcinomas showed focal to diffuse staining
  • In the authors' separate 2018 study, a negative MUC4 result had 100% specificity and 86% sensitivity for distinguishing epithelioid mesothelioma from lung adenocarcinoma and squamous cell carcinoma
• The authors' conclusion: The authors concluded that MUC4 staining still has use in distinguishing sarcomatoid mesothelioma from sarcomatoid lung carcinoma, because a negative result had 100% specificity (also seen in Berg et al.'s study), although sensitivity differed between the studies
• Limitations the authors state:
  • The authors stated that more study of MUC4 in sarcomatoid lung carcinoma is needed, with more cases of pleomorphic carcinoma that have spindle cell components
  • The authors noted that the sensitivity of MUC4 for this distinction differed between studies

Topics

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

Medical terms in this study, explained in our Lexicon: Sarcomatoid, Carcinoma.

Related studies

• MUC4, a novel immunohistochemical marker identified by gene expression profiling, differentiates pleural sarcomatoid mesothelioma from lung sarcomatoid carcinoma — V.J. Amatya, K. Kushitani, et al. (2017)
• MUC4 Staining in Sarcomatoid Carcinomas — K.B. Berg, D. Ionescu, et al. (2019)
• Wilms tumor 1/cytokeratin dual-color immunostaining reveals distinctive staining patterns in metastatic melanoma, metastatic carcinoma, and mesothelial cells in pleural fluids: an effective first-line test for the workup of malignant effusions — J.R. Conner, E.S. Cibas, et al. (2014)
• GATA3 is a useful immunohistochemical marker for distinguishing sarcomatoid malignant mesothelioma from lung sarcomatoid carcinoma and organizing pleuritis — Z.H. Piao, X.C. Zhou, et al. (2021)
• Utility and pitfalls of immunohistochemistry in the differential diagnosis between epithelioid mesothelioma and poorly differentiated lung squamous cell carcinoma — K. Kushitani, V.J. Amatya, et al. (2017)
• Immunohistological staining of reactive mesothelium, mesothelioma, and lung carcinoma with a panel of monoclonal antibodies — A.K. Ghosh, K.C. Gatter, et al. (1987)

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