The Role of CD90 in the Differential Diagnosis of Pleural Malignant Mesothelioma, Pulmonary Carcinoma and Comparison with Calretının

Our plain-English summary of The Role of CD90 in the Differential Diagnosis of Pleural Malignant Mesothelioma, Pulmonary Carcinoma and Comparison with Calretının, by N. Sahin, A.N. Akatli, M.R. Celik, et al (Pathology Oncology Research, 2017).

The study

• Authors: N. Sahin, A.N. Akatli, M.R. Celik, H. Ulutas, E.T. Samdanci, C. Colak
• Journal: Pathology Oncology Research
• Published: 2017;23(3):487-491
• Cited by: 3 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Pleural Malignant Mesothelioma (MM) is a fatal disease that has been associated with asbestos exposure. Differential diagnosis between the pleural infiltration of pulmonary carcinomas and MM is rather difficult particularly for epitheloid type mesothelioma.We aimed to investigate the utility of CD90, a cancer stem cell marker, in the differential diagnosis of MM and lung carcinoma, its prognostic significance and compare its value with that of Calretinin. Ninety pathology specimens including MM (n:30), pulmonary adenocarcinoma (n:30) and pulmonary squamous cell carcinoma (n:30) were used in this study. Immunohistochemical comparision of CD 90 and Calretinin was made in all groups. Calretinin was positive in 20 cases with MM (64.5 %), and was negative in 10 (32.3 %). CD 90 was positive in 25 of these cases (80 %) and negative in 5 (16 %). On the other hand pulmonary adenocarcinomas and squamous cell carcinomas showed positivity with CD90, 63,6 % and 73 %, respectively. We think that CD 90 has no place in the differential diagnosis between mesothelioma and pulmonary carcinoma because of the low specificity in spite of the high sensitivity.

In plain English

This laboratory study in Turkey tested whether a stain called CD90 helps pathologists distinguish pleural malignant mesothelioma from lung cancer spreading into the pleura. It compared CD90 with an established stain, calretinin. The authors stained 90 archived tissue samples: 30 mesotheliomas, 30 lung adenocarcinomas and 30 lung squamous cell carcinomas. Asbestos exposure was not examined. CD90 was positive in 25 of 30 mesotheliomas, but also in 19 of 30 adenocarcinomas and 22 of 30 squamous cell carcinomas. Calretinin was positive in 20 of 30 mesotheliomas and in none of the 30 adenocarcinomas or 30 squamous cell carcinomas. Comparing mesothelioma with adenocarcinoma, the authors reported a sensitivity of 83% and a specificity of 36.6% for CD90, against 66.6% and 100% for calretinin. CD90 positivity did not differ significantly among the three tumor groups (p = 0.238). It was not significantly related to lymphovascular invasion in either lung cancer type. The authors concluded that CD90 has no place in this diagnosis because of its low specificity. They called for larger studies of its prognostic value in squamous cell carcinoma.

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 pathology specimens, comparing two stains across three tumor groups
• Who was studied: 90 archived tissue specimens from the pathology department of Inonu University (Malatya, Turkey): 30 pleural malignant mesotheliomas (20 males, 10 females, mean age 66.3 years), 30 pulmonary adenocarcinomas and 30 pulmonary squamous cell carcinomas. Collection dates are not given.
• Exposure: Asbestos exposure was not studied. The study evaluated two laboratory stains (CD90 and calretinin) on tumor tissue.
• Main results:
  • In the 30 mesothelioma cases, calretinin was positive in 20 (printed as 64.5%) and negative in 10 (printed as 32.3%).
  • In the 30 mesothelioma cases, CD90 was positive in 25 (80%) and negative in 5 (16%).
  • Calretinin was negative in all 30 adenocarcinoma and all 30 squamous cell carcinoma cases. CD90 was positive in 19 adenocarcinoma cases (63.3%) and 22 squamous cell carcinoma cases (73%).
  • For distinguishing mesothelioma from adenocarcinoma, calretinin had a sensitivity of 66.6% and a specificity of 100%. CD90 had a sensitivity of 83% and a specificity of 36.6%.
  • Among mesothelioma cases, CD90 was positive in 8 that were calretinin-negative. Calretinin was positive in 3 that were CD90-negative.
  • CD90 positivity did not differ significantly among mesothelioma, adenocarcinoma and squamous cell carcinoma cases (p = 0.238).
  • Among the 19 CD90-positive adenocarcinoma cases, 7 (36.8%) had lymphovascular invasion and lymph node metastases. This relation was not statistically significant (p = 0.702).
  • Among the 22 CD90-positive squamous cell carcinoma cases, 17 (77%) had lymphovascular invasion and 14 (63.6%) had lymph node metastases. The relation with lymphovascular invasion was not statistically significant (p = 0.078). Because this p value was close to 0.05, the authors thought CD90 could be significant for lymphovascular invasion in this group.
• The authors' conclusion: The authors concluded that CD90 has no place in distinguishing mesothelioma from pulmonary carcinoma because of its low specificity, despite its high sensitivity.
• Limitations the authors state:
  • The authors stated that the possible link between CD90 and lymphovascular invasion in squamous cell carcinoma should be investigated in larger series.

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: Differential Diagnosis, Mesothelioma, Carcinoma, Asbestos Exposure, STEM, Calretinin, Pathology, Adenocarcinoma.

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