Monoclonal antibody Ber-EP4: its use in the differential diagnosis of malignant mesothelioma and carcinoma in cell blocks of malignant effusions and FNA specimens.
Formol sublimate-fixed cell blocks derived from 129 malignant pleural (and some peritoneal) effusions, 8 benign effusions with reactive mesothelial cells, and 23 FNA specimens, were immunostained with monoclonal antibody Ber-EP4 to assess its ability to distinguish malignant mesothelioma (MM) from carcinoma. Only 2 of 44 (4%) well-characterized MM were Ber-EP4+, while none of 8 benign mesothelial proliferations reacted with the antibody. Fifty-seven percent of 23 pulmonary adenocarcinomas (AC) and 60% of 43 pulmonary carcinomas of all other histological types were Ber-EP4+. Of 40 metastatic AC originating from breast, gastrointestinal tract, ovary, endometrium, and kidney, 80% were Ber-EP4+. The predictive value of positive Ber-EP4 staining in distinguishing AC from MM was 96%. The predictive value of a negative Ber-EP4 in excluding MM was 70%, when the differential diagnosis was adenocarcinoma. These results suggest that Ber-EP4 is helpful in differentiating MM and AC if used together with other discriminating antibodies.
Maguire
B
B
Hospital Service, Queen Elizabeth II Medical Centre, Nedlands, Western Australia.
Whitaker
D
D
Carrello
S
S
Spagnolo
D
D
D000911:Antibodies, Monoclonal; D001202:Ascitic Fluid / Q000473:pathology*; D001707:Biopsy, Needle; D002277:Carcinoma / Q000473:pathology* / Q000556:secondary; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology; D008654:Mesothelioma / Q000473:pathology*; D010534:Peritoneal Neoplasms / Q000473:pathology / Q000556:secondary; D016066:Pleural Effusion, Malignant / Q000473:pathology*; D010997:Pleural Neoplasms / Q000473:pathology / Q000556:secondary
D000911:Antibodies, Monoclonal