Immunohistochemical Analysis and Mesothelioma Disease
An additional fascinating study is called, “Utility of D2-40, a novel mesothelial marker, in the diagnosis of malignant Mesothelioma” by Albert Y Chu, Leslie A Litzky, Theresa L Pasha, Geza Acs and Paul J Zhang – Department of Pathology and Laboratory Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA, USA – Contemporary Pathology (2005) 18, 105–110. Here is an excerpt: “Abstract – Although immunohistochemistry has proven to be useful in the differentiation of epithelioid mesothelioma from pulmonary or metastatic adenocarcinoma, no single antibody has demonstrated absolute sensitivity or specificity in making this distinction. Utilizing immunohistochemical analysis with D2-40, a lately obtainable monoclonal antibody that has been utilised as a lymphatic endothelial marker, we examined 53 circumstances of mesothelioma, 28 instances of reactive pleura, 30 circumstances of pulmonary adenocarcinoma, 35 circumstances of renal cell carcinoma, 26 instances of ovarian serous carcinoma, 16 cases of invasive breast carcinoma, 11 cases of prostatic adenocarcinoma, and seven cases of urothelial carcinoma. In addition, immunohistochemistry utilizing calretinin, cytokeratin five/6, and WT1 was performed on all cases of mesothelioma, pulmonary adenocarcinoma, ovarian serous carcinoma, and renal cell carcinoma. Predominantly, membranous D2-40 immunoreactivity was present in 51 of 53 (96%) mesotheliomas, 27 of 28 (96%) instances of reactive pleura, and 17 of 26 (65%) ovarian serous carcinomas membranous staining was not seen in any other tumors examined. Compared to other immunohistochemical markers of mesothelioma, D2-40 was as sensitive as calretinin and far more sensitive than cytokeratin five/6 and WT1. We conclude that D2-40 immunoreactivity is sensitive for cells of mesothelial origin, and may be useful in the differential diagnosis of epithelioid malignant mesothelioma vs adenocarcinoma.”
Another fascinating study is called, “The Immunohistochemical Diagnostic Panel for Epithelial Mesothelioma: A Reevaluation Following Heat-Induced Epitope Retrieval” by
Riera, Jose R. M.D. Astengo-Osuna, Carlos M.D. Longmate, Jeffrey A. Ph.D. Battifora, Hector M.D – American Journal of Surgical Pathology: December 1997 – Volume 21 – Problem 12 – pp 1409-1419. Here is an excerpt: “Abstract – The immunohistochemical diagnosis between epithelial mesothelioma and adenocarcinoma is presently based on the use of a panel of antibodies to adenocarcinoma-related antigens and a few antibodies to mesothelial-associated antigens. Considering that the introduction of epitope retrieval strategies, the sensitivity of numerous antibodies has been enhanced. Therefore, a reevaluation of the mesothelioma/adenocarcinoma diagnostic panel becomes required. We studied 268 paraffin-embedded formalin-fixed tumor samples that included 57 epithelial mesotheliomas and 211 adenocarcinomas of various origins, comparing an extensive antibody panel with and without heat-induced epitope retrieval (HIER). Marked boost in the sensitivity of many antibodies, with no loss of specificity, was discovered when HIER was employed. Following statistical analysis, the antibodies to the epithelial glycoproteins carcinoembryonic antigen, BerEp4, and Bg8 emerged as the best discriminators between adenocarcinoma and epithelial mesothelioma within the whole panel. The mesothelium-related antibodies, HBME-1, calretinin, and thrombomodulin had been much less sensitive and less distinct than the former, despite the fact that they had been discovered to be valuable on certain cases. Antibodies to cytokeratins and vimentin, despite the fact that of minor diagnostic value in this context, might be valuable to evaluate the top quality of antigen preservation. This study confirms the worth of immunohistochemistry to accurately distinguish mesothelioma from adenocarcinoma when an antibody panel approach is employed. The addition of heat-induced epitope retrieval strategies increases the effectiveness of the process and is recommended for most of the antibody panel members.”
An additional interesting study is referred to as, “A review of peritoneal mesothelioma at the Washington Cancer Institute.” – Surg Oncol Clin N Am. 2003 Jul12(3):605-21, xi. By
Sugarbaker PH, Welch LS, Mohamed F, Glehen O. Here is an excerpt: “Abstract –
This article reviews a single institution’s experience with 68 patients (21 females, 47 males) prospectively treated over the last 2 decades with an aggressive local-regional approach, combining maximal cytoreductive surgery with heated intraoperative intraperitoneal chemotherapy and early postoperative intraperitoneal chemotherapy. This multimodality treatment has resulted in a median survival of 67 months. Female patients had a significantly far better prognosis than males. The other considerable predictive factors of survival were: age, diagnosis by incidental findings, tumor extent, pathology, and completeness of cytoreduction.”
We all owe a debt of gratitude to these fine researchers. If you found any of these excerpts fascinating, please read the studies in their entirety.
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