title: Utility of glucose transporter 1 in the distinction of benign and malignant thoracic and abdominal mesothelial lesions.
abstract: BACKGROUND
  Malignant mesothelioma, of either peritoneum or pleura, is an uncommon cancer. The diagnosis is often difficult to make, in part because of the overlapping morphology of reactive and malignant mesothelial cells. Glucose transporter 1 (GLUT-1) is a glucose transporter typically found on erythrocytes, which is aberrantly expressed in various carcinomas. It has recently been reported as specific and sensitive in discriminating malignant pleural mesothelioma from reactive hyperplasia. The application of GLUT-1 staining in peritoneal mesothelioma has not been fully explored.
  
  
  OBJECTIVE
  To determine if GLUT-1 staining is helpful in distinguishing abdominal mesotheliomas from benign, reactive mesothelial lesions and to further study its utility in the thorax.
  
  
  METHODS
  Tissue microarrays containing 135 abdominal malignant mesotheliomas and 30 malignant pleural mesotheliomas were stained with an antibody to GLUT-1, as were 56 reactive mesothelial lesions.
  
  
  RESULTS
  The overall sensitivity and specificity for GLUT-1 in mesothelioma was 53% and 98%, respectively. The sensitivity in epithelioid malignant mesothelioma was 49% and in sarcomatoid/biphasic malignant mesothelioma, 66%. In the thorax, the sensitivity was 50% and in the abdomen it was 54%. The positive predictive value of GLUT-1 immunoreactivity was 98% and the negative predictive value was 40%.
  
  
  CONCLUSIONS
  Glucose transporter 1 staining of thoracic mesotheliomas showed high specificity but lower sensitivity than previously reported. Abdominal malignant mesotheliomas showed similar results. Because of low sensitivity, only positive staining is informative. In both sites, the utility of the stain was limited by nonspecific staining (eg, in necrotic areas) as well as bright labeling of erythrocytes and occasional lymphoid elements. Despite these limitations, GLUT-1 can help differentiate malignant mesothelioma from reactive benign mesothelium.
authors: Department of Pathology and Cell Biology, Columbia University Medical Center, New York, New York 10032, USA. sml2179@columbia.edu
authors: Stephen M
authors: SM
authors: Lagana
authors: Robert N
authors: RN
authors: Taub
authors: Alain C
authors: AC
authors: Borczuk
mesh_terms: D000008:Abdominal Neoplasms / Q000175:diagnosis* / Q000378:metabolism; D014408:Biomarkers, Tumor; D003937:Diagnosis, Differential; D051272:Glucose Transporter Type 1 / Q000378:metabolism*; D006801:Humans; D007150:Immunohistochemistry; D008654:Mesothelioma / Q000175:diagnosis* / Q000378:metabolism; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D013899:Thoracic Neoplasms / Q000175:diagnosis* / Q000378:metabolism; D046888:Tissue Array Analysis
chemical_list: D014408:Biomarkers, Tumor; D051272:Glucose Transporter Type 1