title: The diagnostic utility of immunohistochemistry in distinguishing between epithelioid mesotheliomas and squamous carcinomas of the lung: a comparative study.
abstract: As both mesotheliomas and squamous carcinomas can present a wide variety of morphological patterns, they can on occasion be confused. Recently, some groups of investigators have called attention to the difficulties that sometimes exist in distinguishing between these malignancies and the need to define a panel of markers that can assist in reaching the correct diagnosis. The aim of the present study is to compare the value of the various immunohistochemical markers currently available for the diagnosis of mesothelioma and squamous carcinoma of the lung. A total of 30 epithelioid pleural mesotheliomas exhibiting a solid or predominantly solid pattern, and 30 nonkeratinizing squamous carcinomas of the lung were investigated for the expression of the following markers: podoplanin, calretinin, mesothelin, WT1, keratin 5/6, keratin 7, p63, carcinoembryonic antigen (CEA), MOC-31, Ber-EP4, B72.3, BG-8 (Lewis(y)), leu-M1 (CD15), and thyroid transcription factor-1 (TTF-1). All 30 (100%) of the mesotheliomas reacted for calretinin, mesothelin and keratin 7, 93% each for podoplanin, WT1 and keratin 5/6, 13% for Ber-EP4, 7% each for p63, MOC-31 and BG-8, and 0% for B72.3, CEA, leu-M1 and TTF-1. All 30 (100%) of the squamous carcinomas were positive for p63 and keratin 5/6, 97% for MOC-31, 87% for Ber-EP4, 80% for BG-8, 77% for CEA, 57% for keratin 7, 40% for calretinin and B72.3, 30% for leu-M1, 27% for mesothelin, 15% for podoplanin, and 0% for WT 1 and TTF-1. After analyzing the results, it is concluded that from a practical point-of-view, a combination of two positive mesothelioma markers (WT1 and calretinin or mesothelin) with two negative mesothelioma markers (p63 and MOC-31) would allow the differential diagnosis to be established between epithelioid mesotheliomas and squamous carcinomas of the lung in nearly all instances.
authors.affiliation: Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA. nordonez@mdanderson.org
authors.forename: Nelson G
authors.initials: NG
authors.lastname: Ordóñez
mesh_terms: D014408:Biomarkers, Tumor / Q000032:analysis*; D064032:Calbindin 2; D002294:Carcinoma, Squamous Cell / Q000378:metabolism / Q000473:pathology*; D003937:Diagnosis, Differential; D015622:Epithelioid Cells / Q000737:chemistry / Q000473:pathology; D058851:GPI-Linked Proteins; D006801:Humans; D007150:Immunohistochemistry; D053555:Keratin-5; D053553:Keratin-6; D007633:Keratins / Q000032:analysis; D008175:Lung Neoplasms / Q000378:metabolism / Q000473:pathology*; D008562:Membrane Glycoproteins / Q000032:analysis; D000090204:Mesothelin; D008654:Mesothelioma / Q000378:metabolism / Q000473:pathology*; D064030:S100 Calcium Binding Protein G / Q000032:analysis; D025721:WT1 Proteins / Q000032:analysis; D000098853:Podoplanin
chemical_list: D014408:Biomarkers, Tumor; D064032:Calbindin 2; D058851:GPI-Linked Proteins; D053555:Keratin-5; D053553:Keratin-6; D007633:Keratins; D008562:Membrane Glycoproteins; D000090204:Mesothelin; D064030:S100 Calcium Binding Protein G; D025721:WT1 Proteins; C576764:CALB2 protein, human; C503940:KRT5 protein, human; C507569:KRT6A protein, human; C507570:KRT6B protein, human; C507571:KRT6C protein, human; C117468:PDPN protein, human; D000098853:Podoplanin