Utility of HBME-1 immunostaining in serous effusions

Our plain-English summary of Utility of HBME-1 immunostaining in serous effusions, by V. Ascoli, C. Carnovale-Scalzo, S. Taccogna, et al (Cytopathology, 1997).

The study

• Authors: V. Ascoli, C. Carnovale-Scalzo, S. Taccogna, F. Nardi
• Journal: Cytopathology
• Published: 1997;8(5):328-35
• Cited by: 17 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

HBME-1 is an anti-mesothelial cell monoclonal antibody derived from human mesothelioma cells. We investigated 227 body cavity effusions to test its utility in differentiating mesothelioma from adenocarcinoma. HBME-1 outlined cell membranes in non-neoplastic mesothelial cells. Thick surface staining was observed on all mesotheliomas. HBME-1 reactivity was also detected in 24% of metastatic carcinomatous effusions. Most ovarian carcinomas (83%) reacted with this antibody, showing surface staining. Cytoplasmic HBME-1 immunoreactivity was observed in a small proportion of non-ovarian adenocarcinomas (14%). Despite its limited specificity, HBME-1 might be added to the battery of other markers of epithelial and/or mesothelial differentiation to be used in cases of suspected mesothelioma. Evaluation of suspicious cells should include careful study of the pattern of immunostaining.

In plain English

This study, from a cytology laboratory in Rome, Italy, tested whether a laboratory stain called HBME-1, an antibody that marks mesothelial cells, helps tell mesothelioma apart from adenocarcinoma in body-cavity fluid samples. The authors examined 227 fluid samples (pleural, peritoneal, pericardial and one hydrocoele) from 118 men and 109 women aged 22 to 81. These included fluids with benign mesothelial cells, fluids from patients with mesothelioma, fluids with metastatic adenocarcinoma, and seven samples whose origin could not be settled. The study did not look at asbestos exposure. HBME-1 was detected in benign mesothelial cells in every case and stained all mesotheliomas, mostly as thick staining around the cell surface. It also stained 24% of metastatic carcinoma fluids, including 83% of ovarian cancers, which showed a surface pattern like mesothelioma. Other cancers that stained mostly did so inside the cell. Three of the seven uncertain samples were positive. The authors concluded that, despite its limited specificity, HBME-1 can be added to other markers for this diagnosis, with careful attention to the staining pattern.

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: Diagnostic laboratory study of stored and fresh body-cavity fluid specimens using immunostaining (immunocytochemistry)
• Who was studied: 227 fluid specimens (134 pleural, 90 peritoneal, one hydrocoele, two pericardial) from 118 men and 109 women aged 22 to 81, at a cytology laboratory in Rome, Italy. They were grouped as 48 fluids with benign or reactive mesothelial cells, 47 from patients with mesothelioma (38 epithelial, nine biphasic), 125 with metastatic adenocarcinoma, and 7 with malignant cells of uncertain origin. Dates of collection are not given.
• Exposure: No asbestos or other exposure was studied. The test examined was staining with the HBME-1 antibody, compared with other markers (cytokeratin, Ber-EP4, CEA, EMA, and in uncertain cases additional markers).
• Main results:
  • In fluids with benign mesothelial cells, HBME-1 was detected in every case, mainly as staining around the cell edge.
  • All mesotheliomas stained with HBME-1, typically with thick staining of the cell surface.
  • In mesothelioma fluids, most cases showed staining in at least 70% of tumour cells.
  • HBME-1 also stained 24% of the metastatic carcinoma fluids (group of 125).
  • Most ovarian cancers (83%) stained with HBME-1.
  • Most breast (89%), lung (93%) and gastrointestinal (86%) cancers did not stain.
  • In stained carcinomas the staining was mainly inside the cell (cytoplasmic), except in ovarian carcinomas, which showed staining at the cell edge like mesothelioma.
  • Among carcinoma fluids, abdominal (peritoneal) fluids stained more often (40%) than pleural fluids (10%).
  • Of the 7 samples of uncertain origin (mesothelioma versus metastatic carcinoma), 3 stained with HBME-1.
  • Macrophages and other inflammatory cells did not stain.
• The authors' conclusion: The authors concluded that, despite its limited specificity, HBME-1 can be added to the antibodies used in fluids to distinguish mesothelioma from adenocarcinoma, particularly in the pleural cavity, when interpreted together with other markers and the staining pattern.
• Limitations the authors state:
  • HBME-1 is not specific to mesothelial cells, since about a quarter of carcinoma fluids also stained.
  • Serous ovarian cancers stain at the cell edge in the same way as mesothelioma, which the authors called a major drawback.
  • Its value for telling malignant from benign mesothelial cells appears limited because both stain.
  • HBME-1 did not resolve cases that remained uncertain after other marker panels.
  • Thyroid tumours are expected to stain with HBME-1, which may cause diagnostic difficulty with mesothelioma.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Mesothelioma, Pleural plaques and thickening.

Medical terms in this study, explained in our Lexicon: HBME-1, Mesothelial Cells, Monoclonal Antibody, Mesothelioma, Adenocarcinoma, Carcinoma.

Related studies

• Cytological differential diagnosis among adenocarcinoma, epithelial mesothelioma, and reactive mesothelial cells in serous effusions by immunocytochemistry — X.Y. Su, G.D. Li, et al. (2011)
• 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)
• Diagnostic problems in serous effusions — C.W. Bedrossian (1998)
• Usefulness of Claudin 4 in the cytological diagnosis of serosal effusions — S. Lonardi, C. Manera, et al. (2011)
• Calretinin. A selective marker of normal and neoplastic mesothelial cells in serous effusions — M.C. Barberis, M. Faleri, et al. (1997)
• MMP-7 is a highly specific negative marker for benign and malignant mesothelial cells in serous effusions — B. Davidson, H.T. Stavnes, et al. (2016)

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