Thrombomodulin expression in transitional cell carcinoma

Our plain-English summary of Thrombomodulin expression in transitional cell carcinoma, by N.G. Ordóñez (American Journal of Clinical Pathology, 1998).

The study

• Author: N.G. Ordóñez
• Journal: American Journal of Clinical Pathology
• Published: 1998;110(3):385-90
• Cited by: 61 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Thrombomodulin (TM) is a surface glycoprotein reported to be expressed in a variety of tumors, including mesotheliomas, endothelial vascular tumors, squamous carcinomas, and various adenocarcinomas. This study evaluated TM expression in transitional cell carcinomas (TCCs) and determined whether immunostaining for TM has practical value in the diagnosis of TCCs. TM expression was observed in 96 of 106 primary tumors (bladder, 64/72; renal pelvis, 12/14; ureter, 3/3; prostate, 17/17) and in 21 of 23 metastatic TCCs. Among the adenocarcinomas, only 3 of 18 originating in the bladder, 7 of 46 in the lung, 4 of 21 in the breast, 2 of 24 in the ovary, and 2 of 4 in the pancreas expressed this marker. No staining was observed in the 22 renal cell carcinomas or the 35 adenocarcinomas of the prostate, 13 of the endometrium, or 12 of the colon. Nearly all squamous cell carcinomas (lung, 21/27; skin, 7/7; uterine cervix, 6/6; esophagus, 2/2; bladder, 2/2) reacted for TM. TM is a sensitive marker for TCC. TM immunostaining can assist in distinguishing this tumor from others, especially renal cell carcinomas and adenocarcinomas of the prostate, colon, and bladder, but it has no value in separating TCC from squamous cell carcinomas.

In plain English

This laboratory study tested whether staining for thrombomodulin, a protein found on some cells, could help pathologists recognize transitional cell carcinoma, a cancer of the urinary tract lining. It did not study asbestos exposure. Mesothelioma appears only as background from earlier studies. The author stained stored tumor samples from The University of Texas M. D. Anderson Cancer Center in Houston: 106 primary and 23 metastatic transitional cell carcinomas, 195 adenocarcinomas and 44 squamous cell carcinomas. Thrombomodulin was found in 45 of 46 papillary and all 12 in situ bladder tumors, 7 of 14 sarcomatoid bladder tumors, 12 of 14 renal pelvis tumors, all ureter and prostate transitional cell tumors, and 21 of 23 metastatic tumors. It was absent in all 35 prostate adenocarcinomas and all 22 renal cell carcinomas. It appeared in few other adenocarcinomas, such as 7 of 46 from the lung. Most squamous cell carcinomas stained. The author concluded that the marker seems helpful in separating transitional cell carcinoma from renal cell carcinoma and prostate adenocarcinoma, but not from 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 (immunohistochemical) study of archived, formalin-fixed tumor tissue stained with an antibody to thrombomodulin
• Who was studied: Archived tumor specimens from the pathology files of The University of Texas M. D. Anderson Cancer Center, Houston. They comprised 106 primary transitional cell carcinomas (72 bladder, 14 renal pelvis, 3 ureter, 17 prostate) and 23 metastatic transitional cell carcinomas (20 to lung, 3 to lymph nodes). The study also included 195 adenocarcinomas from various sites and 44 squamous cell carcinomas. No dates are given.
• Main results:
  • Bladder transitional cell carcinomas: 45 of 46 papillary tumors and all 12 in situ tumors reacted for thrombomodulin
  • Sarcomatoid bladder carcinomas: 7 of 14 stained positively. In 3 of these, staining was limited to the conventional areas and the sarcomatoid component was negative.
  • 12 of 14 renal pelvis tumors expressed thrombomodulin, as did all ureter (3) and prostate (17) transitional cell carcinomas and 21 of 23 metastatic transitional cell carcinomas
  • None of the renal cell carcinomas (0/22) or prostate adenocarcinomas (0/35) reacted for thrombomodulin
  • No kidney, colon (0/12) or endometrial (0/13) adenocarcinomas were positive
  • Few other adenocarcinomas reacted (per Table II): bladder 3/18, lung 7/46, breast 4/21, ovary 2/24, pancreas 2/4. The 3 positive bladder adenocarcinomas were all nonurachal.
  • Lung adenocarcinomas: 7 (15%) of 46 reacted
  • Most squamous cell carcinomas reacted: lung 21/27, skin 7/7, uterine cervix 6/6, esophagus 2/2, bladder 2/2. Staining intensity correlated with the degree of squamous differentiation.
• The authors' conclusion: The author concluded that thrombomodulin is commonly expressed in transitional cell carcinomas. Staining for it seems helpful in distinguishing them from renal cell carcinomas and prostate adenocarcinomas, but it does not help separate them from squamous cell carcinomas.

Topics

Medical terms in this study, explained in our Lexicon: Carcinoma, Glycoprotein, Mesothelioma, Adenocarcinoma, Squamous Cell Carcinoma.

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• Value of thrombomodulin immunostaining in the diagnosis of mesothelioma — N.G. Ordóñez (1997)
• A comparative immunohistochemical study of malignant mesothelioma and renal cell carcinoma: the diagnostic utility of Leu-M1, Ber EP4, Tamm-Horsfall protein and thrombomodulin — R.L. Attanoos, H. Goddard, et al. (1995)
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