Value of calretinin immunostaining in diagnostic pathology: a review and update

Our plain-English summary of Value of calretinin immunostaining in diagnostic pathology: a review and update, by N.G. Ordóñez (Applied Immunohistochemistry & Molecular Morphology, 2014).

The study

• Author: N.G. Ordóñez
• Journal: Applied Immunohistochemistry & Molecular Morphology
• Published: 2014;22(6):401-15
• Type of article: Review
• Cited by: 25 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Calretinin is a member of the EF-hand family of calcium-binding proteins. Because its expression is highly restricted to mesotheliomas, calretinin is, at present, the most commonly used positive mesothelioma marker that is most often recommended to be included in the various immunohistochemical panels used to assist in the differential diagnosis of these tumors. Calretinin expression has also been reported to be commonly expressed in a wide variety of other neoplasms, including sex cord-stromal tumors, adrenal cortical neoplasms, olfactory neuroblastomas, Schwann cell tumors, cardiac myxomas, and ameloblastomas. This article reviews the information that is currently available on calretinin expression in tumors and on its application as an immunohistochemical marker in diagnostic pathology.

In plain English

This article was a review of published research on calretinin, a protein that pathologists detect with special stains (immunohistochemistry) to help tell tumor types apart. It did not study asbestos exposure. The author, from The University of Texas MD Anderson Cancer Center, gathered results from earlier studies. Across pooled published series, 884 of 966 epithelioid mesotheliomas (92%) and 174 of 335 sarcomatoid mesotheliomas (52%) were reported to stain for calretinin, as were 110 of 111 adenomatoid tumors (99%). Reported rates in lung adenocarcinomas ranged from 0% to 23%, and the author's own earlier studies found 4% to 8%. Calretinin was also reported in tumors that can resemble mesothelioma, including 64 of 277 ovarian serous carcinomas (23%). A cited study by other researchers found it in 4 of 31 solitary fibrous tumors. The author described calretinin as the most commonly used positive mesothelioma marker. The author noted that reported rates in sarcomatoid mesothelioma vary widely for unclear reasons. Two published comparisons found polyclonal antibodies more sensitive than monoclonal ones.

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: narrative literature review (single author)
• Who was studied: Published studies on calretinin expression in normal tissues and in tumors, including mesotheliomas, carcinomas, sex cord-stromal, adrenal, nervous system, soft-tissue, skin and other tumors; no new patients were studied
• Main results:
  • In pooled published studies (Table 1), 884 (92%) of 966 epithelioid mesotheliomas were reported calretinin positive
  • In a combined review of 335 sarcomatoid mesotheliomas from 18 published studies, 174 (52%) were reported calretinin positive
  • In a combined review of 111 adenomatoid tumors from 5 published studies, 110 (99%) were reported calretinin positive
  • Reported calretinin expression in lung adenocarcinomas ranged from 0% to 23% across studies; in the author's own published studies it was 4% to 8%
  • In a combined review of 10 published studies, 64 (23%) of 277 ovarian serous carcinomas were reported to express calretinin
  • A study by Barak et al, cited in the review, reported calretinin in 4 (13%) of 31 solitary fibrous tumors. The author took this to mean calretinin has no practical value for distinguishing solitary fibrous tumors of the pleura from sarcomatoid mesotheliomas
  • Two published comparative studies (in mesotheliomas and in adrenal cortical tumors) concluded that the polyclonal calretinin antibody was more sensitive than the monoclonal one
• The authors' conclusion: The author concluded that calretinin is currently the most commonly used positive mesothelioma marker, recommended as a primary marker in panels for epithelioid mesothelioma. In the author's opinion it is also a very helpful marker for sarcomatoid mesothelioma, especially when used with broad-spectrum keratin or keratin 7 stains.
• Limitations the authors state:
  • Reported calretinin positivity in sarcomatoid mesotheliomas varied widely between series, and the author stated the cause of these discrepancies is unclear
  • The author knew of only 2 published comparative studies of commercially obtained calretinin antibodies in tumors

Topics

Medical terms in this study, explained in our Lexicon: Calretinin, Pathology, Mesothelioma, Differential Diagnosis, Neoplasm.

Related studies

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• Calretinin but not caveolin-1 correlates with tumour histology and survival in malignant mesothelioma — B. Thapa, M. Walkiewicz, et al. (2016)
• The diagnostic utility of D2-40, calretinin, CK5/6, desmin and MOC-31 in the differentiation of mesothelioma from adenocarcinoma in pleural effusion cytology — T.S. Hyun, M. Barnes, et al. (2012)
• Mesothelin, Calretinin, and Megakaryocyte Potentiating Factor as Biomarkers of Malignant Pleural Mesothelioma — C. Jiménez-Ramírez, S. Casjens, et al. (2019)
• Immunohistochemical expression of calretinin in ameloblastoma, adenomatoid odontogenic tumor, and keratocystic odontogenic tumor: a comparative study — A. Koneru, K. Hallikeri, et al. (2014)
• Value of thrombomodulin immunostaining in the diagnosis of mesothelioma — N.G. Ordóñez (1997)

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