Specific expression of human intelectin-1 in malignant pleural mesothelioma and gastrointestinal goblet cells

Our plain-English summary of Specific expression of human intelectin-1 in malignant pleural mesothelioma and gastrointestinal goblet cells, by K. Washimi, T. Yokose, M. Yamashita, et al (PloS One, 2012).

The study

• Authors: K. Washimi, T. Yokose, M. Yamashita, T. Kageyama, K. Suzuki, M. Yoshihara, Y. Miyagi, H. Hayashi, S. Tsuji
• Journal: PloS One
• Published: 2012;7(7):e39889
• Cited by: 36 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Malignant pleural mesothelioma (MPM) is a fatal tumor. It is often hard to discriminate MPM from metastatic tumors of other types because currently, there are no reliable immunopathological markers for MPM. MPM is differentially diagnosed by some immunohistochemical tests on pathology specimens. In the present study, we investigated the expression of intelectin-1, a new mesothelioma marker, in normal tissues in the whole body and in many cancers, including MPM, by immunohistochemical analysis. We found that in normal tissues, human intelectin-1 was mainly secreted from gastrointestinal goblet cells along with mucus into the intestinal lumen, and it was also expressed, to a lesser extent, in mesothelial cells and urinary epithelial cells. Eighty-eight percent of epithelioid-type MPMs expressed intelectin-1, whereas sarcomatoid-type MPMs, biphasic MPMs, and poorly differentiated MPMs were rarely positive for intelectin-1. Intelectin-1 was not expressed in other cancers, except in mucus-producing adenocarcinoma. These results suggest that intelectin-1 is a better marker for epithelioid-type MPM than other mesothelioma markers because of its specificity and the simplicity of pathological assessment. Pleural intelectin-1 could be a useful diagnostic marker for MPM with applications in histopathological identification of MPM.

In plain English

This Japanese laboratory study tested whether a stain for the protein intelectin-1 helps pathologists recognize malignant pleural mesothelioma (MPM) in tissue. It did not examine asbestos exposure. The authors stained normal tissues (mostly from autopsies; gallbladder and breast from surgery), mesothelioma samples from two Yokohama hospitals (1998 to 2011), and other cancers. In normal tissue, intelectin-1 was found in goblet cells of the duodenum, small intestine and colon. It was also found, less often, in mesothelial cells (lining cells of body cavities such as the pleura) and some urinary tract cells. Of 26 epithelioid-type MPMs, 23 stained positive, similar to other markers tested. Positive staining was rare in poorly differentiated (1 of 3), biphasic (1 of 3) and sarcomatoid (0 of 7) MPMs. Only 1 of 88 lung cancers stained positive. Among the other cancers, positives were mostly in some mucus-producing adenocarcinomas. Requiring both intelectin-1 and calretinin to stain positive, the authors reported 88% sensitivity in the 26 epithelioid MPMs and 100% specificity against the cancers they tested. They concluded intelectin-1 staining could help diagnose epithelioid-type MPM but could not replace other markers.

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: Laboratory immunohistochemistry study of archived human tissue samples (staining with a monoclonal antibody against intelectin-1, compared with other mesothelioma markers)
• Who was studied: Normal tissues from autopsies at Kanagawa Cancer Center (2006 to 2010), except gallbladder (cholecyst) and breast samples, which came from patients who had surgery there in the same years. Mesothelioma samples from Kanagawa Cancer Center or Yokohama Municipal Citizen's Hospital (1998 to 2011): 26 epithelioid, 3 poorly differentiated, 3 biphasic and 7 sarcomatoid MPMs. Other primary cancers from Kanagawa Cancer Center (1999 to 2012), including 88 lung cancers.
• Exposure: Not studied. Asbestos exposure was not measured or analysed; asbestos is mentioned only as background in the introduction.
• Main results:
  • In normal tissues, intelectin-1 was produced by goblet cells in the duodenum, small intestine and colon, but not in normal stomach tissue.
  • Mesothelial cells in the pleura, peritoneum, tunica vaginalis and pericardium often expressed intelectin-1 (pleura: 3 of 10 samples in Table 1).
  • 23 of 26 epithelioid-type MPMs (88%) stained positive for intelectin-1. For the other markers in the same 26 cases, Table 2 gives calretinin 26/26, CK5/6 24/26, podoplanin 23/26, WT-1 23/26 and mesothelin 25/26.
  • In epithelioid-type MPM, the average Allred staining score for intelectin-1 (5.8) was similar to that of calretinin (6.0), CK5/6 (6.2), podoplanin (5.5), WT-1 (5.9) and mesothelin (5.7).
  • Sarcomatoid, poorly differentiated and biphasic MPMs rarely stained positive. Table 2 gives 0/7 sarcomatoid, 1/3 poorly differentiated and 1/3 biphasic.
  • In lung cancer, intelectin-1 was positive in 1 of 88 cases. Calretinin, CK5/6, podoplanin and mesothelin were positive in about 23%, 44%, 14% and 40% of lung cancers, respectively.
  • Among the other cancers tested, the authors reported no significant intelectin-1 staining except some mucus-producing adenocarcinomas. Table 3 gives gastric adenocarcinoma 4/10, all mucous type.
  • Requiring staining for both intelectin-1 and calretinin, the authors reported 88% sensitivity for epithelioid-type MPM (23 of the 26 cases) and 100% specificity against the cancers they tested, which they gave as n = 201. No non-MPM tumor was positive for both stains.
• The authors' conclusion: The authors concluded that intelectin-1 staining could be useful in diagnosing epithelioid-type MPM. Combined with calretinin, it could help in that diagnosis.
• Limitations the authors state:
  • Non-epithelioid MPM expressed little intelectin-1, so the stain could not replace all other MPM markers.
  • How these markers are expressed in tumors that have spread to the pleura from elsewhere is not well characterized, and further work is needed to design a staining panel for pleural tumors.

Topics

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

Medical terms in this study, explained in our Lexicon: Pleural Mesothelioma, Pathology, Mesothelioma, Mesothelial Cells, Epithelioid, Sarcomatoid, Biphasic Mesothelioma, Adenocarcinoma.

Related studies

• Identification of DAB2 and Intelectin-1 as Novel Positive Immunohistochemical Markers of Epithelioid Mesothelioma by Transcriptome Microarray Analysis for Its Differentiation From Pulmonary Adenocarcinoma — M. Kuraoka, V.J. Amatya, et al. (2017)
• Clinicopathological significance of intelectin-1 in colorectal cancer: Intelectin-1 participates in tumor suppression and favorable progress — N. Katsuya, K. Sentani, et al. (2020)
• Identification of intelectin overexpression in malignant pleural mesothelioma by serial analysis of gene expression (SAGE) — A. Wali, P.J. Morin, et al. (2005)
• A case of malignant mesothelioma pleural effusion with MOC-31, BerEP4, and calretinin expression — P. Zhao (2019)
• Expression status of candidate genes in mesothelioma tissues and cell lines — O. Melaiu, E. Melissari, et al. (2015)
• 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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