Differentiation of adenocarcinoma of the lung from mesothelioma. Periodic acid-Schiff, monoclonal antibodies B72.3, and Leu M1.
The immunohistochemical reactivity of 38 mesotheliomas and 44 adeno-carcinomas or large cell carcinomas of the lung with monoclonal antibodies (MAb) B72.3 and Leu M1 was compared with their reactivity with the routine histochemic stains periodic acid-Schiff with diastase digestion (PAS-D) and alcian blue +/- hyaluronidase. Both MAbs reacted selectively with carcinomas when a positive test was set at greater than or equal to 10% reactive tumor cells. However, MAb B72.3 reacted with significantly more of the carcinomas (86%, chi-square test, P less than 0.01) and bound to a greater percentage of tumor cells (47 +/- 28%; mean +/- SD, t-test, P less than 0.001) than Leu M1 (57% and 25 +/- 28%, respectively). The similar reactivities of surgically resected tumor specimens and post mortem tissues with both antibodies confirmed antigen stability and suggested broad clinical utility. PAS-D stained 61% of the carcinomas. Using the markers for carcinomas (PAS-D, B72.3, and Leu M1), the tumors were classified into the correct group in 80 of 82 (98%) cases (95% confidence level: greater than 92% accuracy). The alcian blue stain was useful to confirm a diagnosis of dimorphic or epithelial mesothelioma (48% were positive).
Warnock
M L
ML
Department of Pathology, University of California, San Francisco 94143-0506.
Stoloff
A
A
Thor
A
A
D000230:Adenocarcinoma / Q000473:pathology*; D000368:Aged; D000423:Alcian Blue; D000911:Antibodies, Monoclonal; D018288:Carcinoma, Small Cell / Q000473:pathology*; D003594:Cytoplasmic Granules / Q000032:analysis; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007124:Immunoenzyme Techniques; D008175:Lung Neoplasms / Q000473:pathology*; D008297:Male; D008654:Mesothelioma / Q000473:pathology*; D008875:Middle Aged; D009077:Mucins / Q000032:analysis; D010503:Periodic Acid-Schiff Reaction
D000911:Antibodies, Monoclonal; D009077:Mucins; D000423:Alcian Blue