How useful is GLUT-1 in differentiating mesothelial hyperplasia and fibrosing pleuritis from epithelioid and sarcomatoid mesotheliomas? An international collaborative study.
OBJECTIVE
Mesothelial hyperplasia (MH) and fibrosing pleuritis (FP) can be difficult to distinguish from epithelioid (MM-E) and sarcomatoid (MM-S) malignant pleural mesotheliomas. GLUT-1 has shown variable results regarding its sensitivity and specificity when used to evaluate mesothelial proliferations. We evaluated the utility of GLUT-1 immunostaining in differentiating MH and FP from MM-E and MM-S.


METHODS
In this retrospective study, diagnostically well-characterized cases (MH=31, FP=29, MM-E=41, MM-S=29) were collected and manually stained for GLUT-1. All slides were visually scored by 2 pathologists; using the following system: 0%, 1+ 1-25%, 2+ 26-50% and 3+ >51% cells staining.


RESULTS
All benign cases (n=60) were negative for GLUT-1 while 45 of 78 (58%) MM [21 of 41 (50%) MM-E, 21 of 29 (72%) MM-S and 3 of 3 biphasic mesothelioma (100%)] had 1+ to 3+ staining. Of the MM-E, 10 had 1+, and 11 had 2+ staining; of the MM-S 3 had 1+, 15 had 2+ and 3 had 3+ staining. Both sarcomatoid and epithelioid components of the 3 biphasic mesotheliomas revealed 1+ staining. All 5 desmoplastic MM were negative.


CONCLUSIONS
Positive staining with GLUT-1 is helpful since it is present in half of MM-E and three-quarter of MM-S. Although all reactive mesothelial lesions were negative, the absence of immunoreactivity does not exclude the diagnosis of MM. As with all IHC stains used for diagnostic purposes, GLUT-1 has to be a part of a panel, and the results interpreted in the context of clinical, radiological and histological findings.
The University of Chicago Medical Center, 5841 South Maryland Avenue, Chicago, IL 60637, USA. Electronic address: Aliya.husain@uchospitals.edu.
Aliya N
AN
Husain
The University of Chicago Medical Center, 5841 South Maryland Avenue, Chicago, IL 60637, USA.
M Kamran
MK
Mirza
Llandough Hospital, Penlan Road, Llandough, Penarth, South Glamorgan, UK.
Allen
A
Gibbs
Tokyo Women's Medical University Yachiyo Medical Center, 477-96 Owada-Shinden, Yachiyo 276-8524, Japan.
Kenzo
K
Hiroshima
The University of Chicago Medical Center, 5841 South Maryland Avenue, Chicago, IL 60637, USA.
Yiqing
Y
Chi
The University of Chicago Medical Center, 5841 South Maryland Avenue, Chicago, IL 60637, USA.
Redouane
R
Boumendjel
Laboratoire d'Anatomie Pathalogique, Caen, France.
Nolwenn
N
Stang
The University of Chicago Medical Center, 5841 South Maryland Avenue, Chicago, IL 60637, USA.
Thomas
T
Krausz
Laboratoire d'Anatomie Pathalogique, Caen, France.
Francoise
F
Galateau-Salle
D014408:Biomarkers, Tumor / Q000276:immunology / Q000378:metabolism*; D049109:Cell Proliferation; D003299:Cooperative Behavior; D003937:Diagnosis, Differential; D015622:Epithelioid Cells / Q000473:pathology; D004848:Epithelium / Q000473:pathology*; D005355:Fibrosis / Q000175:diagnosis*; D051272:Glucose Transporter Type 1 / Q000276:immunology / Q000378:metabolism*; D006801:Humans; D006965:Hyperplasia / Q000175:diagnosis*; D007150:Immunohistochemistry; D007391:International Cooperation; D008654:Mesothelioma / Q000175:diagnosis*; D010994:Pleura / Q000473:pathology*; D010998:Pleurisy / Q000175:diagnosis*; D012189:Retrospective Studies; D012509:Sarcoma / Q000175:diagnosis*; D012680:Sensitivity and Specificity
D014408:Biomarkers, Tumor; D051272:Glucose Transporter Type 1
Epithelioid mesothelioma; Fibrosing pleuritis; GLUT-1; Malignant mesothelioma; Mesothelial hyperplasia; Sarcomatoid mesothelioma