The search for the optimal immunohistochemical panel for the diagnosis of malignant mesothelioma

Our plain-English summary of The search for the optimal immunohistochemical panel for the diagnosis of malignant mesothelioma, by L.M. Weiss, H. Battifora (Human Pathology, 1993).

The study

• Authors: L.M. Weiss, H. Battifora
• Journal: Human Pathology
• Published: 1993;24(4):345-6
• Type of article: Comment, Editorial
• Cited by: 31 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Summary of the article

In this editorial, the authors commented on a study by Brown et al, published in the same issue of Human Pathology. That study examined immunohistochemical markers for distinguishing malignant pleural epithelioid mesothelioma from pulmonary adenocarcinoma. The authors noted that most antibodies used in this differential diagnosis recognized epitopes found more often in adenocarcinoma, so a diagnosis of mesothelioma rested largely on negative results. They stated that Brown et al showed that anti-CEA, B72.3 and Leu-M1, used together as a panel, were highly effective in distinguishing most cases. They listed factors to keep in mind when applying the findings. Sensitivity may vary between laboratories. The same monoclonal antibodies would need to be used. The results applied only to pleural epithelioid mesothelioma versus lung adenocarcinoma. The results also depended on the original diagnoses, which for 14 mesotheliomas rested only on histologic, immunohistochemical and clinical data. They added that scoring any unequivocal focal staining as positive meant that staining patterns could not be used, such as the membranous pattern of HMFG-2 and EMA in mesothelioma. They summarized other studies of Ber-EP4 and Lewis blood group antigens. In one study, Ber-EP4 stained 87% of 83 adenocarcinomas but only one of 115 mesotheliomas. They concluded that they looked forward to future studies following Brown et al's model in the search for the ideal diagnostic panel.

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 two-page editorial in Human Pathology, not an original study. The authors commented on a study by Brown and colleagues in the same issue that used panels of antibody stains on tissue to tell malignant pleural epithelioid mesothelioma apart from lung adenocarcinoma. The editorial reported no new patients or data and did not discuss asbestos exposure. The authors noted that most of these stains react more often with adenocarcinoma, so a mesothelioma diagnosis is supported by a series of negative results. They wrote that Brown and colleagues showed that anti-CEA, B72.3 and Leu-M1, used together, were highly effective in distinguishing most cases, and that combining antibodies lowers the chance of a false-negative result. They listed limits of that study: staining sensitivity may vary between laboratories, the same antibodies would presumably have to be used, the results apply only to pleural epithelioid mesothelioma versus lung adenocarcinoma, and they are only as good as the original diagnoses. The authors concluded that they looked forward to future studies comparing newer antibodies with those Brown and colleagues tested.

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: Editorial commentary on another study (Brown et al) published in the same journal issue; no original data
• Who was studied: No study population of its own. The editorial discusses Brown et al's study of malignant pleural epithelioid mesothelioma versus adenocarcinoma of the lung.
• Main results:
  • The authors noted that because most antibodies used in this diagnosis react more often with adenocarcinoma, a diagnosis of malignant mesothelioma is supported by a series of negative results.
  • According to the authors, Brown et al showed that anti-CEA, B72.3 and Leu-M1, used together in a panel, were highly effective in distinguishing most cases of malignant pleural epithelioid mesothelioma from lung adenocarcinoma.
  • The authors stated that using a combination of antibodies significantly decreases the chance of a false-negative result.
  • The authors pointed out that antibodies such as HMFG-2 and EMA stain both tumors, but in malignant mesothelioma the staining is almost always membranous, a pattern difference that could help with diagnosis.
  • Citing other researchers' studies, the authors wrote that the antibody Ber-EP4 and antibodies against Lewis blood antigens may be of greater value than vimentin or CA-125 in this diagnostic setting.
• The authors' conclusion: The authors concluded that they looked forward to future studies following Brown et al's model that compare newer antibodies with those tested, in the continuing search for the ideal panel to tell malignant mesothelioma from other tumors.
• Limitations the authors state:
  • Limitation of the Brown et al study noted by the authors: staining sensitivity may vary from laboratory to laboratory.
  • Limitation of the Brown et al study noted by the authors: the same monoclonal antibodies would presumably have to be used to apply its results.
  • Limitation of the Brown et al study noted by the authors: the results apply only to pleural epithelioid mesothelioma versus lung adenocarcinoma. Peritoneal mesotheliomas have been reported to stain slightly differently.
  • Limitation of the Brown et al study noted by the authors: the results are only as good as the original diagnoses, and preconceptions about expected staining could have influenced the diagnoses.
  • Limitation of the Brown et al study noted by the authors: any unequivocal positive staining, however focal, counted as positive, so differences in staining pattern could not be used.

Topics

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

Medical terms in this study, explained in our Lexicon: Malignant Mesothelioma, Pathology, Epithelioid, Mesothelioma, Adenocarcinoma, Differential Diagnosis, B72.3 (TAG-72), Monoclonal.

Related studies

• How to assess the best immunohistochemical panel in the diagnosis of malignant pleural mesothelioma in a pathology lab — M. Mlika, O. Lamzibri, et al. (2018)
• Combined use of novel epithelial (MOC-31) and mesothelial (HBME-1) immunohistochemical markers for optimal first line diagnostic distinction between mesothelioma and metastatic carcinoma in pleura — C. González-Lois, C. Ballestín, et al. (2001)
• Immunohistochemical distinction of malignant mesothelioma from pulmonary adenocarcinoma with anti-surfactant apoprotein, anti-Lewisa, and anti-Tn antibodies — M. Noguchi, T. Nakajima, et al. (1989)
• Immunohistochemical detection of MTAP and BAP1 protein loss for mesothelioma diagnosis: Comparison with 9p21 FISH and BAP1 immunohistochemistry — T. Hida, M. Hamasaki, et al. (2017)
• Immunohistochemical analysis still has a limited role in the diagnosis of malignant mesothelioma. A study of thirteen antibodies — F. Roberts, C.M. Harper, et al. (2001)
• Distinguishing malignant mesothelioma from pulmonary adenocarcinoma: an immuno-histochemical approach using a panel of monoclonal antibodies — S.E. Tuttle, J.G. Lucas, et al. (1990)

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