title: Usefulness of EMA, GLUT-1, and XIAP for the cytologic diagnosis of malignant mesothelioma in body cavity fluids.
abstract: We compared the effectiveness of epithelial membrane antigen (EMA) with 2 newly described markers, X-linked inhibitor of apoptosis protein (XIAP) and an isoform of glucose transporter (GLUT-1), in the distinction between malignant mesothelioma (MM) and benign effusion (BE) in body cavity fluids. Immunohistochemical studies were performed on cell block sections from 35 cases of histologically confirmed MM and 38 BEs, using antibodies to EMA, XIAP, GLUT-1 (GLUT-1m, monoclonal; GLUT-1p, polyclonal). Results were graded based on the percentage of cells staining: negative (0%), 1+ (<25%), 2+ (25%-49%), 3+ (50%-74%), and 4+ (75%-100%). The performance of each marker was compared using receiver operating characteristic curve analysis. EMA demonstrated the best accuracy, with an area under the curve of 0.91 as compared with XIAP (0.67), GLUT-1m (0.74), and GLUT-1p (0.80). Based on these findings, EMA is a better marker than XIAP or GLUT-1 for the diagnosis of MM.
authors.affiliation: Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
authors.forename: Jian
authors.initials: J
authors.lastname: Shen
authors.forename: Geraldine S
authors.initials: GS
authors.lastname: Pinkus
authors.forename: Vikram
authors.initials: V
authors.lastname: Deshpande
authors.forename: Edmund S
authors.initials: ES
authors.lastname: Cibas
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019540:Area Under Curve; D014408:Biomarkers, Tumor / Q000032:analysis; D003937:Diagnosis, Differential; D005260:Female; D051272:Glucose Transporter Type 1 / Q000096:biosynthesis*; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008654:Mesothelioma / Q000175:diagnosis* / Q000378:metabolism; D008875:Middle Aged; D018396:Mucin-1 / Q000096:biosynthesis*; D016066:Pleural Effusion, Malignant / Q000175:diagnosis* / Q000378:metabolism; D010997:Pleural Neoplasms / Q000175:diagnosis* / Q000378:metabolism; D012680:Sensitivity and Specificity; D051636:X-Linked Inhibitor of Apoptosis Protein / Q000096:biosynthesis*
chemical_list: D014408:Biomarkers, Tumor; D051272:Glucose Transporter Type 1; D018396:Mucin-1; D051636:X-Linked Inhibitor of Apoptosis Protein; C496866:XIAP protein, human