Use of antibodies to carcinoembryonic antigen and human milk fat globule to distinguish carcinoma, mesothelioma, and reactive mesothelium

Our plain-English summary of Use of antibodies to carcinoembryonic antigen and human milk fat globule to distinguish carcinoma, mesothelioma, and reactive mesothelium, by R.J. Marshall, A. Herbert, S.G. Braye, et al (Journal of Clinical Pathology, 1984).

The study

• Authors: R.J. Marshall, A. Herbert, S.G. Braye, D.B. Jones
• Journal: Journal of Clinical Pathology
• Published: 1984;37(11):1215-21
• Cited by: 107 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Antibodies raised against human milk fat globule (HMFG 1 and 2) and carcinoembryonic antigen were used in an immunoperoxidase technique to differentiate mesothelioma, carcinoma, and benign, reactive mesothelium. Sixteen mesotheliomas, 27 lung carcinomas, and 13 specimens of reactive mesothelium were examined. Staining for carcinoembryonic antigen was not seen in reactive mesothelium or mesothelioma but was present in 22 of 27 carcinomas. Mesothelioma and carcinoma usually stained with HMFG 1 and 2; reactive mesothelium did not. These three antibodies may help to distinguish carcinoma, mesothelioma, and reactive mesothelium.

In plain English

This laboratory study tested whether three antibodies could help pathologists tell apart malignant mesothelioma, lung carcinoma and benign reactive mesothelium in tissue samples. One antibody targeted carcinoembryonic antigen (CEA). The other two, called HMFG 1 and HMFG 2, were raised against human milk fat globule. The authors stained tissue from 16 mesotheliomas, 27 lung carcinomas and 13 specimens of reactive mesothelium. The article did not report asbestos exposure. CEA staining was not seen in any mesothelioma or any reactive mesothelium, but 22 of 27 carcinomas stained. Twelve of 16 mesotheliomas stained with both HMFG antibodies. Ten of 13 reactive mesothelium specimens stained with neither, and the other three with only one. Twenty-four of 27 carcinomas stained with both. The authors concluded that anti-CEA does not separate reactive mesothelium from mesothelioma, while the HMFG antibodies do help make that distinction and generally indicate malignancy, but are not specific for carcinoma or mesothelioma. They noted that staining was often patchy, so a small biopsy might appear negative.

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) diagnostic study of stored tissue specimens, comparing staining with three antibodies across tissue types
• Who was studied: Tissue specimens: 16 malignant mesotheliomas (7 biphasic, 8 epithelial, 1 mesenchymal), 27 lung carcinomas (8 squamous, 8 oat cell, 4 large cell, 7 adenocarcinomas) and 13 specimens of reactive mesothelium (8 pleurae removed after pneumothorax, 3 pericardial and 2 pleural cases of reaction to tumour infiltration)
• Exposure: Not reported: the article gives no information on asbestos or other exposures of the patients. The study tested antibody staining, not exposure.
• Main results:
  • No mesothelioma stained with anti-CEA
  • No reactive mesothelial cells stained with anti-CEA
  • 22 of 27 lung carcinomas stained with anti-CEA. The article calls this staining strong, but its detailed results describe weak staining in two oat cell carcinomas and one adenocarcinoma.
  • 12 of 16 mesotheliomas stained with both HMFG 1 and HMFG 2; only two were negative with both
  • 10 of 13 reactive (benign) mesothelium specimens stained with neither HMFG antibody; the other three stained with one but never both
  • 24 of 27 carcinomas stained with both HMFG antibodies; the other three stained with HMFG 2 only
• The authors' conclusion: The authors concluded that anti-CEA antibodies do not help distinguish reactive mesothelium from mesothelioma, whereas the HMFG antibodies do help with this distinction and generally indicate malignancy, though they are not specific for either carcinoma or mesothelioma
• Limitations the authors state:
  • Staining was often focal. In two mesothelioma and four carcinoma specimens the positive areas were so widely separated that a small biopsy might have appeared negative, which the authors said affects the value of these antibodies on biopsy specimens.

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: Carcinoembryonic Antigen (CEA), Carcinoma, Mesothelioma, Mesothelium.

Related studies

• Immunocytological staining reactions of anti-carcinoembryonic antigen, Ca, and anti-human milk fat globule monoclonal antibodies on benign and malignant exfoliated mesothelial cells — A.K. Ghosh, E.B. Butler (1987)
• The distinction of adenocarcinoma from malignant mesothelioma in cell blocks of effusions: the role of routine mucin histochemistry and immunohistochemical assessment of carcinoembryonic antigen, keratin proteins, epithelial membrane antigen, and milk fat globule-derived antigen — E.S. Cibas, J.M. Corson, et al. (1987)
• Immunohistological staining of reactive mesothelium, mesothelioma, and lung carcinoma with a panel of monoclonal antibodies — A.K. Ghosh, K.C. Gatter, et al. (1987)
• The value of anticarcinoembryonic antigen, human milk factor globulin, and antikeratin antibodies in differentiating mesothelioma from lung carcinoma — V.M. Joglekar, D. Oliver, et al. (1991)
• Keratin proteins and carcinoembryonic antigen in lung carcinoma: an immunoperoxidase study of fifty-four cases, with ultrastructural correlations — J.W. Said, G. Nash, et al. (1983)
• Ber-EP4 for differentiating adenocarcinoma from reactive and neoplastic mesothelial cells in serous effusions. Comparison with carcinoembryonic antigen, B72.3 and Leu-M1 — M.E. Bailey, R.W. Brown, et al. (1996)

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