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Wei C, Sun W, Cui M, Wang J. Primary sarcomatoid malignant mesothelioma of the liver: A case report. Asian J Surg 2023; 46:4058-4059. [PMID: 37105809 DOI: 10.1016/j.asjsur.2023.04.052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 04/12/2023] [Indexed: 04/29/2023] Open
Affiliation(s)
- Chanyan Wei
- Department of Radiology, Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, 650101, PR China
| | - Wenmei Sun
- Department of Radiology, Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, 650101, PR China
| | - Mengling Cui
- Department of Radiology, Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, 650101, PR China
| | - Jiaping Wang
- Department of Radiology, Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, 650101, PR China.
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Gloriane C Luna H, Severino Imasa M, Juat N, Hernandez KV, May Sayo T, Cristal-Luna G, Marie Asur-Galang S, Bellengan M, John Duga K, Brian Buenaobra B, De Los Santos MI, Medina D, Samo J, Minerva Literal V, Andrew Bascos N, Sy-Naval S. Expression landscapes in non-small cell lung cancer shaped by the thyroid transcription factor 1. Lung Cancer 2023; 176:121-131. [PMID: 36634573 DOI: 10.1016/j.lungcan.2022.12.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 12/20/2022] [Accepted: 12/24/2022] [Indexed: 12/28/2022]
Abstract
TTF-1-expressing non-small cell lung cancer (NSCLC) is one of the most prevalent lung cancer types worldwide. However, theparadoxical activity of TTF-1 in both lung carcinogenesis and tumor suppression is believed to be context-dependentwhich calls for a deeper understanding about the pathological expression of TTF-1. In addition, the expression circuitry of TTF-1-target genes in NSCLC has not been well examined which necessitates to revisit the involvement of TTF-1- in a multitude of oncologic pathways. We used RNA-seq and clinical data of patients from The Cancer Genome Atlas (TCGA) and Genotype-Tissue Expression (GTEx), including ChIP-seq data from different NSCLC cell lines, and mapped the proteome of NSCLC tumor. Our analysis showed significant variability in TTF-1 expression among NSCLC,and further clarified that this variability is orchestrated at the transcriptional level. We also found that high TTF-1 expression could negatively influence the survival outcomes of stage 1 LUAD which may be attributed to growth factor receptor-driven activation of mitogenic and angiogenic pathways. Mechanistically, TTF-1 may also control the genes associated with pathways involved in acquired TKI drug resistance or response to immune checkpoint inhibitors. Lastly, proteome-based biomarker discovery in stage 1 LUAD showed that TTF-1 positivity is potentially associated with the upregulation of several oncogenes which includes interferon proteins, MUC1, STAT3, and EIF2AK2. Collectively, this study highlights the potential involvement of TTF-1 in cell proliferation, immune evasion, and angiogenesis in early-stage NSCLC.
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Affiliation(s)
- Herdee Gloriane C Luna
- Department of Internal Medicine, Lung Center of the Philippines, Quezon Ave, Diliman, Quezon City, Metro Manila 1100, Philippines; Department of Internal Medicine, National Kidney and Transplant Institute, East Avenue, Diliman, Quezon City 1101, Philippines.
| | - Marcelo Severino Imasa
- Department of Internal Medicine, Lung Center of the Philippines, Quezon Ave, Diliman, Quezon City, Metro Manila 1100, Philippines
| | - Necy Juat
- Department of Internal Medicine, National Kidney and Transplant Institute, East Avenue, Diliman, Quezon City 1101, Philippines
| | - Katherine V Hernandez
- Department of Internal Medicine, East Avenue Medical Center, East Ave, Diliman, Quezon City, Metro Manila 1100, Philippines
| | - Treah May Sayo
- Department of Internal Pathology, Lung Center of the Philippines, Quezon Ave, Diliman, Quezon City, Metro Manila 1100, Philippines
| | - Gloria Cristal-Luna
- Department of Internal Medicine, National Kidney and Transplant Institute, East Avenue, Diliman, Quezon City 1101, Philippines
| | - Sheena Marie Asur-Galang
- Clinical Proteomics for Cancer Initiative, Department of Science and Technology, Philippine Council for Health Research and Development, Philippines
| | - Mirasol Bellengan
- Clinical Proteomics for Cancer Initiative, Department of Science and Technology, Philippine Council for Health Research and Development, Philippines
| | - Kent John Duga
- Clinical Proteomics for Cancer Initiative, Department of Science and Technology, Philippine Council for Health Research and Development, Philippines
| | - Bien Brian Buenaobra
- Clinical Proteomics for Cancer Initiative, Department of Science and Technology, Philippine Council for Health Research and Development, Philippines
| | - Marvin I De Los Santos
- Clinical Proteomics for Cancer Initiative, Department of Science and Technology, Philippine Council for Health Research and Development, Philippines
| | - Daniel Medina
- Clinical Proteomics for Cancer Initiative, Department of Science and Technology, Philippine Council for Health Research and Development, Philippines
| | - Jamirah Samo
- Clinical Proteomics for Cancer Initiative, Department of Science and Technology, Philippine Council for Health Research and Development, Philippines
| | - Venus Minerva Literal
- Clinical Proteomics for Cancer Initiative, Department of Science and Technology, Philippine Council for Health Research and Development, Philippines
| | - Neil Andrew Bascos
- National Institute of Molecular Biology and Biotechnology, University of the Philippines - Diliman, Diliman, Quezon City, Metro Manila, Philippines; Protein, Proteomics and Metabolomics Facility, Philippine Genome Center, University of the Philippines System, Philippines
| | - Sullian Sy-Naval
- Department of Internal Medicine, Lung Center of the Philippines, Quezon Ave, Diliman, Quezon City, Metro Manila 1100, Philippines
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Burke AP, Hardy N, Fanaroff R, Legesse T. Sarcomatoid Mesothelioma with Bland Histologic Features: A Potential Pitfall in Diagnosis. AJSP: REVIEWS & REPORTS 2022; 27:87-93. [PMID: 37538296 PMCID: PMC10398945 DOI: 10.1097/pcr.0000000000000506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/05/2023]
Abstract
Sarcomatoid mesotheliomas can be challenging to diagnose on small biopsy specimens, where limited material may preclude definitive assessment of invasion and lesional cells can have relatively bland cytology with no mesothelial marker expression. We report a case of a patient who presented with a pleural effusion and had subsequent pleural biopsy that showed a bland, uniform spindle cell proliferation in a mildly myxoid background. There was little if any collagen; no chest wall, soft tissue, or fat; and mesothelial markers were negative. The cells were positive for pancytokeratin and GATA3 by immunohistochemistry, and in situ hybridization showed a "negative" result for homozygous loss of CDKN2A; however, there was partial (heterozygous) loss of one allele. A diagnosis of atypical spindle cell proliferation was made based on these findings. Several months later, the patient had a repeat pleural biopsy that showed spindled cells with more pleomorphism, areas of invasion into the chest wall, and the same partial loss of CDKN2A, consistent with a sarcomatoid mesothelioma. This case underscores the challenges present on small biopsy specimens, the fact that sarcomatoid mesotheliomas can be relatively bland appearing with focal pleomorphism, and that heterozygous loss of CDKN2A should be considered a positive result indicative of a neoplastic process.
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Affiliation(s)
| | - Naomi Hardy
- University of Maryland Medical Center. 22 S. Greene St., Baltimore, MD 21201
| | - Rachel Fanaroff
- University of Maryland Medical Center, 22 S. Greene St., Baltimore MD 21201
| | - Teklu Legesse
- University of Maryland School of Medicine, 22 S. Greene St., Baltimore, MD 21201
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Takano GHS, Amorim RF, Ferreira VM, Vianna LMDS, de Castro TMML, Carneiro MDV, Oliveira ÍDA, Motoyama AB, Carneiro FP. Initial panel of immunocytochemical markers for identification of primary carcinoma site for effusions and peritoneal washings from women. INTERNATIONAL JOURNAL OF CLINICAL AND EXPERIMENTAL PATHOLOGY 2022; 15:191-200. [PMID: 35535203 PMCID: PMC9077109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Accepted: 02/08/2022] [Indexed: 06/14/2023]
Abstract
INTRODUCTION In women, most malignant effusions are from breast and ovary primary carcinomas that have metastasized to body cavity fluids (pleural, peritoneal and pericardial). When carcinoma is diagnosed in effusions, it is not possible to identify its site of origin solely by cytology (morphology); therefore, immunocytochemistry is used as a complementary method. There are no immunocytochemical markers with 100% sensitivity and specificity for identifying carcinoma primary site. The markers most used are TTF-1 for the lung, GATA-3 for the breast, and PAX-8 for the ovary. The aim of this study was to evaluate the sensitivity and specificity of a panel including these markers for detecting the primary site of carcinoma in effusions. METHODS Samples of pleural, pericardial, and peritoneal effusions and peritoneal washings with carcinoma of known primary site from women (n = 60) and men (n = 18) were prepared by using the cell block method, and immunocytochemistry was performed to evaluate the expression of primary site markers (TTF-1, PAX-8, and GATA-3). RESULTS In women, the breast was the most frequent primary site of metastatic carcinoma to both pleural and pericardial cavities, followed by the lung, whereas the ovary was the most frequent primary site of carcinoma within peritoneal effusions and washings, followed by the gastrointestinal tract (stomach or intestine). The expected profiles for carcinomas of the most common primary sites were: breast (GATA-3 (+), PAX-8 (-), TTF-1 (-)), ovary (PAX-8 (+), GATA-3 (-), TTF-1 (-)), lung (TTF-1 (+), PAX-8 (-) GATA-3 (-)) and gastrointestinal tract (PAX-8 (-), GATA-3 (-), TTF-1 (-)). These were observed in 88.23% (45/51) of women's samples with carcinoma from these primary sites. By using TTF-1 as the sole primary site marker, 6.25% of carcinomas of primary site other than the lung would have been misdiagnosed. CONCLUSION An initial panel of markers including GATA-3, PAX-8, and TTF-1 allows, with high sensitivity and specificity, the identification or exclusion of frequent primary sites of carcinoma in effusions from women. Our results highlight the importance of using a panel of markers to avoid misidentification of the primary site of tumor.
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Affiliation(s)
- Gustavo Henrique Soares Takano
- Pathological Anatomy Unit of University Hospital of BrasiliaBrasília 999074, Brazil
- Pathology Department of Brasília UniversityBrasília 999074, Brazil
| | | | | | | | | | | | | | | | - Fabiana Pirani Carneiro
- Pathological Anatomy Unit of University Hospital of BrasiliaBrasília 999074, Brazil
- Pathology Department of Brasília UniversityBrasília 999074, Brazil
- Institute of Psychology of Brasília UniversityBrasília 999074, Brazil
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A Novel Strategy for the Diagnosis of Pulmonary High-Grade Neuroendocrine Tumor. Diagnostics (Basel) 2021; 11:diagnostics11111945. [PMID: 34829292 PMCID: PMC8625242 DOI: 10.3390/diagnostics11111945] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 10/05/2021] [Accepted: 10/15/2021] [Indexed: 01/04/2023] Open
Abstract
Correctly diagnosing a histologic type of lung cancer is important for selecting the appropriate treatment because the aggressiveness, chemotherapy regimen, surgical approach, and prognosis vary significantly among histologic types. Pulmonary NETs, which are characterized by neuroendocrine morphologies, represent approximately 20% of all lung cancers. In particular, high-grade neuroendocrine tumors (small cell lung cancer and large cell neuroendocrine tumor) are highly proliferative cancers that have a poorer prognosis than other non-small cell lung cancers. The combination of hematoxylin and eosin staining, Ki-67, and immunostaining of classic neuroendocrine markers, such as chromogranin A, CD56, and synaptophysin, are normally used to diagnose high-grade neuroendocrine tumors; however, they are frequently heterogeneous. This article reviews the diagnostic methods of lung cancer diagnosis focused on immunostaining. In particular, we describe the usefulness of immunostaining by Stathmin-1, which is a cytosolic phosphoprotein and a key regulator of cell division due to its microtubule depolymerization in a phosphorylation-dependent manner, for the diagnosis of high-grade neuroendocrine tumors.
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Rossi G, Davoli F, Poletti V, Cavazza A, Lococo F. When the Diagnosis of Mesothelioma Challenges Textbooks and Guidelines. J Clin Med 2021; 10:jcm10112434. [PMID: 34070888 PMCID: PMC8198453 DOI: 10.3390/jcm10112434] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2021] [Revised: 05/25/2021] [Accepted: 05/27/2021] [Indexed: 01/15/2023] Open
Abstract
The diagnosis of malignant mesothelioma (MPM) does not pose difficulties when presenting with usual clinico-radiologic features and morphology. Pathology textbooks and national/international guidelines generally describe the findings of classic MPM, underlining common clinical presentation, the gold standard of sampling techniques, usual morphologic variants, immunohistochemical results of several positive and negative primary antibodies in the differential diagnosis, and the role of novel molecular markers. Nevertheless, MPM often does not follow the golden rules in routine practice, while the literature generally does not sufficiently emphasize unusual features of its manifestation. This gap may potentially create problems for patients in sustaining a difficult diagnosis of MPM in clinical practice and during legal disputes. Indeed, the guidelines accidentally tend to favor the job of lawyers and pathologists defending asbestos-producing industries against patients suffering from MPM characterized by uncommon features. The current review is aimed at underlining the wide spectrum of clinical and radiological presentation of MPM, the possibility to consistently use cytology for diagnostic intent, the aberrant immunohistochemical expression using so-called specific negative and positive primary antibodies, and finally proposing some alternative and more unbiased approaches to the diagnosis of MPM.
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Affiliation(s)
- Giulio Rossi
- Anatomy and Pathological Histology Unit, Infermi Hospital, 47923 Rimini, Italy
- Operative Unit of Pathologic Anatomy, AUSL Romagna, Santa Maria delle Croci Hospital of Ravenna, 47923 Rimini, Italy
- Correspondence: ; Tel.: +39-0544-285-368; Fax: +39-054-4285-758
| | - Fabio Davoli
- Thoracic Surgery Unit, Department of Thoracic Diseases, AUSL Romagna, S. Maria delle Croci Hospital, 48121 Ravenna, Italy;
| | - Venerino Poletti
- Pulmonology Unit, Thoracic Diseases Department, G.B. Morgagni Hospital, 47121 Forlì, Italy;
- Department of Respiratory Diseases and Allergy, Aarhus University Hospital, 8200 Aarhus, Denmark
| | - Alberto Cavazza
- Department of Pathology, Arcispedale S Maria Nuova, IRCCS Reggio Emilia, 42124 Reggio Emilia, Italy;
| | - Filippo Lococo
- Department of Thoracic Surgery, Faculty of Medicine, University Cattolica del Sacro Cuore, 20123 Rome, Italy;
- Thoracic Surgery Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
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Nicholas V, Say B, Aasi SZ, Rieger KE, Brown RA. TTF-1 expression in a case of cutaneous sarcomatoid squamous cell carcinoma. J Cutan Pathol 2021; 48:821-823. [PMID: 33458834 DOI: 10.1111/cup.13963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 12/30/2020] [Accepted: 01/08/2021] [Indexed: 11/30/2022]
Affiliation(s)
- Veronica Nicholas
- Department of Pathology, Stanford University School of Medicine, Stanford, California, USA
| | - Brandon Say
- Department of Pathology, Stanford University School of Medicine, Stanford, California, USA
| | - Sumaira Z Aasi
- Department of Dermatology, Stanford University School of Medicine, Stanford, California, USA
| | - Kerri E Rieger
- Department of Pathology, Stanford University School of Medicine, Stanford, California, USA.,Department of Dermatology, Stanford University School of Medicine, Stanford, California, USA
| | - Ryanne A Brown
- Department of Pathology, Stanford University School of Medicine, Stanford, California, USA.,Department of Dermatology, Stanford University School of Medicine, Stanford, California, USA.,Pathology and Laboratory Services Section, Veterans Affairs Palo Alto Health Care System, Palo Alto, California, USA
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Le Stang N, Burke L, Blaizot G, Gibbs AR, Lebailly P, Clin B, Girard N, Galateau-Sallé F. Differential Diagnosis of Epithelioid Malignant Mesothelioma With Lung and Breast Pleural Metastasis: A Systematic Review Compared With a Standardized Panel of Antibodies-A New Proposal That May Influence Pathologic Practice. Arch Pathol Lab Med 2020; 144:446-456. [PMID: 31389715 DOI: 10.5858/arpa.2018-0457-oa] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
CONTEXT.— Pleural mesothelioma is a rare cancer with an often-challenging diagnosis because of its potential to be a great mimicker of many other tumors. Among them, primary lung and breast cancers are the 2 main causes of pleural metastasis. The development and application of targeted therapeutic agents have made it even more important to achieve an accurate diagnosis. In this setting, international guidelines have recommended the use of 2 positive and 2 negative immunohistochemical biomarkers. OBJECTIVES.— To define the most highly specific and sensitive minimum set of antibodies for routine practice to use for the separation of epithelioid malignant mesothelioma from lung and breast metastasis and to determine the most relevant expression cutoff. DESIGN.— To provide information at different levels of expression of 16 mesothelial and epithelial biomarkers, we performed a systematic review of articles published between 1979 and 2017, and we compared those data to results from the Mesothelioma Telepathology Network (MESOPATH) of the standardized panel used in routine practice database since 1998. RESULTS.— Our results indicate that the following panel of markers-calretinin (poly)/thyroid transcription factor 1 (TTF-1; clone 8G7G3/1) and calretinin (poly)/estrogen receptor-α (ER-α; clone EP1)-should be recommended; ultimately, based on the MESOPATH database, we highlight their relevance which are the most sensitive and specific panel useful to the differential diagnosis at 10% cutoff. CONCLUSIONS.— Highlighted by their relevance in the large cohort reported, we recommend 2 useful panels to the differential diagnosis at 10% cutoff.
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Affiliation(s)
- Nolwenn Le Stang
- From the Pleural Mesothelioma National Multicentric Registry (MESONAT), MESOPATH National Network on Mesothelioma (Ms Le Stang and Dr Galateau-Sallé), the EURACAN network (Dr Girard), and MESOBANK Clinicobiological Database and National Frozen Tissue Bank (Dr Galateau-Sallé), Léon Bérard Cancer Center, Lyon, France; the Department of Pathology, Cork University Hospital, Cork, Ireland (Dr Burke); the Frozen Tissue Bank InnovaBio, CHU de Caen, France (Ms Blaizot); the Department of Pathology, University Hospital Llandough, Cardiff, England (Dr Gibbs); INSERM U1086, ANTICIPE, Caen University, Caen, France (Drs Lebailly and Clin); the Department of Occupational Diseases, University Hospital, Caen, France (Dr Clin); the University of Lyon, Lyon, France (Dr Girard); and the Curie Montsouris Thorax Institute, Curie Institut, Paris, France (Dr Girard)
| | - Louise Burke
- From the Pleural Mesothelioma National Multicentric Registry (MESONAT), MESOPATH National Network on Mesothelioma (Ms Le Stang and Dr Galateau-Sallé), the EURACAN network (Dr Girard), and MESOBANK Clinicobiological Database and National Frozen Tissue Bank (Dr Galateau-Sallé), Léon Bérard Cancer Center, Lyon, France; the Department of Pathology, Cork University Hospital, Cork, Ireland (Dr Burke); the Frozen Tissue Bank InnovaBio, CHU de Caen, France (Ms Blaizot); the Department of Pathology, University Hospital Llandough, Cardiff, England (Dr Gibbs); INSERM U1086, ANTICIPE, Caen University, Caen, France (Drs Lebailly and Clin); the Department of Occupational Diseases, University Hospital, Caen, France (Dr Clin); the University of Lyon, Lyon, France (Dr Girard); and the Curie Montsouris Thorax Institute, Curie Institut, Paris, France (Dr Girard)
| | - Gaetane Blaizot
- From the Pleural Mesothelioma National Multicentric Registry (MESONAT), MESOPATH National Network on Mesothelioma (Ms Le Stang and Dr Galateau-Sallé), the EURACAN network (Dr Girard), and MESOBANK Clinicobiological Database and National Frozen Tissue Bank (Dr Galateau-Sallé), Léon Bérard Cancer Center, Lyon, France; the Department of Pathology, Cork University Hospital, Cork, Ireland (Dr Burke); the Frozen Tissue Bank InnovaBio, CHU de Caen, France (Ms Blaizot); the Department of Pathology, University Hospital Llandough, Cardiff, England (Dr Gibbs); INSERM U1086, ANTICIPE, Caen University, Caen, France (Drs Lebailly and Clin); the Department of Occupational Diseases, University Hospital, Caen, France (Dr Clin); the University of Lyon, Lyon, France (Dr Girard); and the Curie Montsouris Thorax Institute, Curie Institut, Paris, France (Dr Girard)
| | - Allen R Gibbs
- From the Pleural Mesothelioma National Multicentric Registry (MESONAT), MESOPATH National Network on Mesothelioma (Ms Le Stang and Dr Galateau-Sallé), the EURACAN network (Dr Girard), and MESOBANK Clinicobiological Database and National Frozen Tissue Bank (Dr Galateau-Sallé), Léon Bérard Cancer Center, Lyon, France; the Department of Pathology, Cork University Hospital, Cork, Ireland (Dr Burke); the Frozen Tissue Bank InnovaBio, CHU de Caen, France (Ms Blaizot); the Department of Pathology, University Hospital Llandough, Cardiff, England (Dr Gibbs); INSERM U1086, ANTICIPE, Caen University, Caen, France (Drs Lebailly and Clin); the Department of Occupational Diseases, University Hospital, Caen, France (Dr Clin); the University of Lyon, Lyon, France (Dr Girard); and the Curie Montsouris Thorax Institute, Curie Institut, Paris, France (Dr Girard)
| | - Pierre Lebailly
- From the Pleural Mesothelioma National Multicentric Registry (MESONAT), MESOPATH National Network on Mesothelioma (Ms Le Stang and Dr Galateau-Sallé), the EURACAN network (Dr Girard), and MESOBANK Clinicobiological Database and National Frozen Tissue Bank (Dr Galateau-Sallé), Léon Bérard Cancer Center, Lyon, France; the Department of Pathology, Cork University Hospital, Cork, Ireland (Dr Burke); the Frozen Tissue Bank InnovaBio, CHU de Caen, France (Ms Blaizot); the Department of Pathology, University Hospital Llandough, Cardiff, England (Dr Gibbs); INSERM U1086, ANTICIPE, Caen University, Caen, France (Drs Lebailly and Clin); the Department of Occupational Diseases, University Hospital, Caen, France (Dr Clin); the University of Lyon, Lyon, France (Dr Girard); and the Curie Montsouris Thorax Institute, Curie Institut, Paris, France (Dr Girard)
| | - Bénédicte Clin
- From the Pleural Mesothelioma National Multicentric Registry (MESONAT), MESOPATH National Network on Mesothelioma (Ms Le Stang and Dr Galateau-Sallé), the EURACAN network (Dr Girard), and MESOBANK Clinicobiological Database and National Frozen Tissue Bank (Dr Galateau-Sallé), Léon Bérard Cancer Center, Lyon, France; the Department of Pathology, Cork University Hospital, Cork, Ireland (Dr Burke); the Frozen Tissue Bank InnovaBio, CHU de Caen, France (Ms Blaizot); the Department of Pathology, University Hospital Llandough, Cardiff, England (Dr Gibbs); INSERM U1086, ANTICIPE, Caen University, Caen, France (Drs Lebailly and Clin); the Department of Occupational Diseases, University Hospital, Caen, France (Dr Clin); the University of Lyon, Lyon, France (Dr Girard); and the Curie Montsouris Thorax Institute, Curie Institut, Paris, France (Dr Girard)
| | - Nicolas Girard
- From the Pleural Mesothelioma National Multicentric Registry (MESONAT), MESOPATH National Network on Mesothelioma (Ms Le Stang and Dr Galateau-Sallé), the EURACAN network (Dr Girard), and MESOBANK Clinicobiological Database and National Frozen Tissue Bank (Dr Galateau-Sallé), Léon Bérard Cancer Center, Lyon, France; the Department of Pathology, Cork University Hospital, Cork, Ireland (Dr Burke); the Frozen Tissue Bank InnovaBio, CHU de Caen, France (Ms Blaizot); the Department of Pathology, University Hospital Llandough, Cardiff, England (Dr Gibbs); INSERM U1086, ANTICIPE, Caen University, Caen, France (Drs Lebailly and Clin); the Department of Occupational Diseases, University Hospital, Caen, France (Dr Clin); the University of Lyon, Lyon, France (Dr Girard); and the Curie Montsouris Thorax Institute, Curie Institut, Paris, France (Dr Girard)
| | - Françoise Galateau-Sallé
- From the Pleural Mesothelioma National Multicentric Registry (MESONAT), MESOPATH National Network on Mesothelioma (Ms Le Stang and Dr Galateau-Sallé), the EURACAN network (Dr Girard), and MESOBANK Clinicobiological Database and National Frozen Tissue Bank (Dr Galateau-Sallé), Léon Bérard Cancer Center, Lyon, France; the Department of Pathology, Cork University Hospital, Cork, Ireland (Dr Burke); the Frozen Tissue Bank InnovaBio, CHU de Caen, France (Ms Blaizot); the Department of Pathology, University Hospital Llandough, Cardiff, England (Dr Gibbs); INSERM U1086, ANTICIPE, Caen University, Caen, France (Drs Lebailly and Clin); the Department of Occupational Diseases, University Hospital, Caen, France (Dr Clin); the University of Lyon, Lyon, France (Dr Girard); and the Curie Montsouris Thorax Institute, Curie Institut, Paris, France (Dr Girard)
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Warth A, Fink L. [Immunophenotyping of lung tumors : An update]. DER PATHOLOGE 2019; 40:506-513. [PMID: 30937512 DOI: 10.1007/s00292-019-0589-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
The WHO Classification of Lung Tumors (2015) established the use of immunohistochemical stainings for resection specimens, however, detailed recommendations had been missing. Now, an international expert panel has summarized key questions for daily routine practice and provided recommendations to assist the community in the appropriate use of immunohistochemistry in this context. This article provides an overview of the most important aspects.
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Affiliation(s)
- A Warth
- Institut für Pathologie, Zytopathologie und Molekularpathologie, MVZ ÜGP Gießen/Wetzlar/Limburg, Forsthausstr. 1, 35578, Wetzlar, Deutschland.
| | - L Fink
- Institut für Pathologie, Zytopathologie und Molekularpathologie, MVZ ÜGP Gießen/Wetzlar/Limburg, Forsthausstr. 1, 35578, Wetzlar, Deutschland
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The Incidence of Labelling of Non-Lung Adenocarcinomas With Antibodies Against TTF-1 and Diagnostic Implications. Appl Immunohistochem Mol Morphol 2019; 28:471-476. [PMID: 31135446 DOI: 10.1097/pai.0000000000000775] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Thyroid transcription factor 1 (TTF-1) is an immunohistochemical marker in the identification of lung and thyroid tumors. However, positive labelling for TTF-1 can occur in tumors from other sites, and this can result in misdiagnosis if only a limited panel of antibodies is used. We assessed the frequency of expression of 3 TTF-1 antibody clones, namely, 8G7G3/1, SPT24, and SP141 on a tissue microarray of 104 colorectal cancer (CRC), and whole-tumor sections of 165 CRC with known microsatellite instability (MSI) status. We also analyzed the expression of TTF-1 in a tissue microarray of 112 prostatic adenocarcinomas. The association of TTF-1 expression with clinicopathologic parameters and patient survival was analyzed. Six of 104 (5.7%) primary colorectal carcinomas expressed TTF-1 with SPT24 and SP141 clones, whereas only 2 (2%) of these tumors labeled positive for TTF-1 with clone 8G7G3/1. A significant association of TTF-1 expression with younger age at diagnosis (P=0.001) was found, but not with stage, or survival. The SP141 clone also labelled 24/165 (14.5%) of 165 CRC with known MSI status. There was an association with younger age (P<0.001), but not with MSI status or survival. TTF-1 expression was found in 39/112 (34%) prostate adenocarcinomas with 6/112 (5.3%) labelling with clone 8G7G3/1, 26/112 (23%) with clone SP141, and 31/112 (28%) with clone SPT24. TTF-1 expression appeared to be associated with extracapsular extension (P=0.022) and with higher stage (P=0.039). Here too TTF-1 expression was not associated with survival. The mRNA expression of TTF-1 in these tumors was confirmed by RTPCR, indicating that this is not false-positive labelling. Depending on the clone used, TTF-1 expression can vary with the SP141 and SPT24 clones exhibiting higher incidence of labelling. Pathologists should be aware of the differences in performance profiles of the different TTF-1 clones in diagnostic practice.
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Yatabe Y, Dacic S, Borczuk AC, Warth A, Russell PA, Lantuejoul S, Beasley MB, Thunnissen E, Pelosi G, Rekhtman N, Bubendorf L, Mino-Kenudson M, Yoshida A, Geisinger KR, Noguchi M, Chirieac LR, Bolting J, Chung JH, Chou TY, Chen G, Poleri C, Lopez-Rios F, Papotti M, Sholl LM, Roden AC, Travis WD, Hirsch FR, Kerr KM, Tsao MS, Nicholson AG, Wistuba I, Moreira AL. Best Practices Recommendations for Diagnostic Immunohistochemistry in Lung Cancer. J Thorac Oncol 2019; 14:377-407. [PMID: 30572031 PMCID: PMC6422775 DOI: 10.1016/j.jtho.2018.12.005] [Citation(s) in RCA: 191] [Impact Index Per Article: 38.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Revised: 12/03/2018] [Accepted: 12/05/2018] [Indexed: 01/04/2023]
Abstract
Since the 2015 WHO classification was introduced into clinical practice, immunohistochemistry (IHC) has figured prominently in lung cancer diagnosis. In addition to distinction of small cell versus non-small cell carcinoma, patients' treatment of choice is directly linked to histologic subtypes of non-small cell carcinoma, which pertains to IHC results, particularly for poorly differentiated tumors. The use of IHC has improved diagnostic accuracy in the classification of lung carcinoma, but the interpretation of IHC results remains challenging in some instances. Also, pathologists must be aware of many interpretation pitfalls, and the use of IHC should be efficient to spare the tissue for molecular testing. The International Association for the Study of Lung Cancer Pathology Committee received questions on practical application and interpretation of IHC in lung cancer diagnosis. After discussions in several International Association for the Study of Lung Cancer Pathology Committee meetings, the issues and caveats were summarized in terms of 11 key questions covering common and important diagnostic situations in a daily clinical practice with some relevant challenging queries. The questions cover topics such as the best IHC markers for distinguishing NSCLC subtypes, differences in thyroid transcription factor 1 clones, and the utility of IHC in diagnosing uncommon subtypes of lung cancer and distinguishing primary from metastatic tumors. This article provides answers and explanations for the key questions about the use of IHC in diagnosis of lung carcinoma, representing viewpoints of experts in thoracic pathology that should assist the community in the appropriate use of IHC in diagnostic pathology.
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Affiliation(s)
- Yasushi Yatabe
- Department of Pathology and Molecular Diagnostics, Aichi Cancer Center, Nagoya, Japan.
| | - Sanja Dacic
- Department of Pathology University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Alain C Borczuk
- Department of Pathology, Weill Cornell Medicine, New York, New York
| | - Arne Warth
- Institute of Pathology, Cytopathology, and Molecular Pathology MVZ UEGP Giessen, Wetzlar, Limburg, Germany
| | - Prudence A Russell
- Anatomical Pathology Department, St. Vincent's Hospital and the University of Melbourne, Fitzroy, Victoria, Australia
| | - Sylvie Lantuejoul
- Department of Biopathology, Centre Léon Bérard, Grenoble Alpes University, Lyon, France
| | - Mary Beth Beasley
- Department of Pathology, Mount Sinai Medical Center, New York, New York
| | - Erik Thunnissen
- Department of Pathology, VU University Medical Center, Amsterdam, The Netherlands
| | - Giuseppe Pelosi
- Department of Oncology and Hemato-Oncology, University of Milan and IRCCS MultiMedica, Milan, Italy
| | - Natasha Rekhtman
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Lukas Bubendorf
- Institute of Pathology, University Hospital Basel, Basel, Switzerland
| | - Mari Mino-Kenudson
- Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Akihiko Yoshida
- Department of Pathology and Clinical Laboratories, National Cancer Center Hospital, Tokyo, Japan
| | - Kim R Geisinger
- Department of Pathology, The University of Mississippi Medical Center, Jackson, Mississippi
| | - Masayuki Noguchi
- Department of Pathology, Institute of Basic Medical Sciences, University of Tsukuba, Tsukuba, Japan
| | - Lucian R Chirieac
- Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Johan Bolting
- Department of Immunology Genetics and Pathology, Science for Life Laboratory, Uppsala University, Uppsala, Sweden
| | - Jin-Haeng Chung
- Department of Pathology and Respiratory Center, Seoul National University Bundang Hospital, Seongnam city, Gyeonggi- do, Republic of Korea
| | - Teh-Ying Chou
- Division of Molecular Pathology, Department of Pathology and Laboratory Medicine, Taipei Veterans General Hospital, Taipei, Republic of China
| | - Gang Chen
- Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai, People's Republic of China
| | - Claudia Poleri
- Office of Pathology Consultants, Buenos Aires, Argentina
| | - Fernando Lopez-Rios
- Laboratorio de Dianas Terapeuticas, Hospital Universitario HM Sanchinarro, Madrid, Spain
| | - Mauro Papotti
- Department of Oncology, University of Turin, Turin, Italy
| | - Lynette M Sholl
- Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Anja C Roden
- Department of Laboratory Medicine and Pathology, Mayo Clinic Rochester, Minnesota
| | - William D Travis
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Fred R Hirsch
- University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Keith M Kerr
- Department of Pathology, Aberdeen Royal Infirmary, Aberdeen University Medical School, Aberdeen, Scotland, United Kingdom
| | - Ming-Sound Tsao
- Department of Pathology, University Health Network/Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada
| | - Andrew G Nicholson
- Department of Histopathology, Royal Brompton and Harefield National Health Service Foundation Trust and National Heart and Lung Institute, Imperial College, London, United Kingdom
| | - Ignacio Wistuba
- Department of Translational Molecular Pathology, M. D. Anderson Cancer Center, Houston, Texas
| | - Andre L Moreira
- Department of Pathology, New York University Langone Health, New York, New York
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Abstract
Non-small cell lung carcinoma (NSCLC) accounts for significant morbidity and mortality worldwide, with most patients diagnosed at advanced stages and managed increasingly with targeted therapies and immunotherapy. In this review, we discuss diagnostic and predictive immunohistochemical markers in NSCLC, one of the most common tumors encountered in surgical pathology. We highlight 2 emerging diagnostic markers: nuclear protein in testis (NUT) for NUT carcinoma; SMARCA4 for SMARCA4-deficient thoracic tumors. Given their highly aggressive behavior, proper recognition facilitates optimal management. For patients with advanced NSCLCs, we discuss the utility and limitations of immunohistochemistry (IHC) for the "must-test" predictive biomarkers: anaplastic lymphoma kinase, ROS1, programmed cell death protein 1, and epidermal growth factor receptor. IHC using mutant-specific BRAF V600E, RET, pan-TRK, and LKB1 antibodies can be orthogonal tools for screening or confirmation of molecular events. ERBB2 and MET alterations include both activating mutations and gene amplifications, detection of which relies on molecular methods with a minimal role for IHC in NSCLC. IHC sits at the intersection of an integrated surgical pathology and molecular diagnostic practice, serves as a powerful functional surrogate for molecular testing, and is an indispensable tool of precision medicine in the care of lung cancer patients.
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Abstract
Carcinoma of unknown primary is defined as metastatic carcinoma without a clinically obvious primary tumor. Determining the tissue of origin in carcinoma of unknown primary is important for site-directed therapy. Immunohistochemistry is the most widely used tool for the work-up of metastases, but molecular profiling assays are also available. This review provides an overview of immunohistochemical stains in the work-up of metastatic carcinoma, with a focus on newer site-specific markers, and discusses the role of gene expression profiling assays for determining tissue of origin. The utility of cytopathology specimens in the evaluation of carcinoma of unknown primary also is highlighted.
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Affiliation(s)
- Erika E Doxtader
- Department of Pathology, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, USA.
| | - Deborah J Chute
- Department of Pathology, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, USA
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14
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Pleural malignant mesothelioma versus pleuropulmonary synovial sarcoma: a clinicopathological study of 22 cases with molecular analysis and survival data. Pathology 2018; 50:629-634. [PMID: 30170702 DOI: 10.1016/j.pathol.2018.06.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Revised: 06/14/2018] [Accepted: 06/25/2018] [Indexed: 01/02/2023]
Abstract
The aim of this study was to carry out a comparative analysis by transducin-like enhancer of split 1 (TLE1) immunohistochemistry and molecular analysis of SYT-SSX, for 16 pleural predominantly sarcomatoid mesotheliomas and six cases of pleuropulmonary synovial sarcoma (five pleural in distribution only, with one case of a predominantly subpleural upper lobe synovial sarcoma), all of which were solely or predominantly monophasic. Our comparison included survival and some clinical data. We consider that the following points emerged from this study.
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15
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Bae JM, Kim JH, Park JH, Park HE, Cho NY, Kang GH. Clinicopathological and molecular implications of aberrant thyroid transcription factor-1 expression in colorectal carcinomas: an immunohistochemical analysis of 1319 cases using three different antibody clones. Histopathology 2017; 72:423-432. [DOI: 10.1111/his.13398] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Accepted: 09/12/2017] [Indexed: 11/28/2022]
Affiliation(s)
- Jeong Mo Bae
- Department of Pathology; Seoul National University Hospital; Seoul National University College of Medicine; Seoul Korea
| | - Jung Ho Kim
- Department of Pathology; Seoul National University Hospital; Seoul National University College of Medicine; Seoul Korea
| | - Jeong Hwan Park
- Department of Pathology; SMG-SNU Boramae Medical Centre; Seoul Korea
| | - Hye Eun Park
- Department of Pathology; Seoul National University Hospital; Seoul National University College of Medicine; Seoul Korea
| | - Nam-Yun Cho
- Laboratory of Epigenetics; Cancer Research Institute; Seoul National University College of Medicine; Seoul Korea
| | - Gyeong Hoon Kang
- Department of Pathology; Seoul National University Hospital; Seoul National University College of Medicine; Seoul Korea
- Laboratory of Epigenetics; Cancer Research Institute; Seoul National University College of Medicine; Seoul Korea
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16
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The differential diagnosis between pleural sarcomatoid mesothelioma and spindle cell/pleomorphic (sarcomatoid) carcinomas of the lung: evidence-based guidelines from the International Mesothelioma Panel and the MESOPATH National Reference Center. Hum Pathol 2017; 67:160-168. [DOI: 10.1016/j.humpath.2017.07.015] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2017] [Revised: 07/21/2017] [Accepted: 07/27/2017] [Indexed: 11/22/2022]
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Weber J, Peng H, Rader C. From rabbit antibody repertoires to rabbit monoclonal antibodies. Exp Mol Med 2017; 49:e305. [PMID: 28336958 PMCID: PMC5382564 DOI: 10.1038/emm.2017.23] [Citation(s) in RCA: 96] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2016] [Accepted: 12/22/2016] [Indexed: 12/11/2022] Open
Abstract
In this review, we explain why and how rabbit monoclonal antibodies have become outstanding reagents for laboratory research and increasingly for diagnostic and therapeutic applications. Starting with the unique ontogeny of rabbit B cells that affords highly distinctive antibody repertoires rich in in vivo pruned binders of high diversity, affinity and specificity, we describe the generation of rabbit monoclonal antibodies by hybridoma technology, phage display and alternative methods, along with an account of successful humanization strategies.
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Affiliation(s)
- Justus Weber
- Department of Immunology and Microbiology, The Scripps Research Institute, Jupiter, FL, USA
| | - Haiyong Peng
- Department of Immunology and Microbiology, The Scripps Research Institute, Jupiter, FL, USA
| | - Christoph Rader
- Department of Immunology and Microbiology, The Scripps Research Institute, Jupiter, FL, USA
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Pelosi G, Scarpa A, Forest F, Sonzogni A. The impact of immunohistochemistry on the classification of lung tumors. Expert Rev Respir Med 2016; 10:1105-21. [PMID: 27617475 DOI: 10.1080/17476348.2017.1235975] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
INTRODUCTION To highlight the role of immunohistochemistry to lung cancer classification on the basis of existing guidelines and future perspectives. AREAS COVERED Four orienting key-issues were structured according to an extensive review on the English literature: a) cancer subtyping; b) best biomarkers and rules to follow; c) negative and positive profiling; d) suggestions towards an evidence-based proposal for lung cancer subtyping. A sparing material approach based on a limited number of specific markers is highly desirable. It includes p40 for squamous cell carcinoma ('no p40, no squamous'), TTF1 for adenocarcinoma, synaptophysin for neuroendocrine tumors and vimentin for sarcomatoid carcinoma. A close relationship between genotype and phenotype also supports a diagnostic role for negative profiles. Expert commentary: Highly specific and sensitive IHC markers according to positive and negative diagnostic algorithms seem appropriate for individual patients' lung cancer subtyping.
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Affiliation(s)
- Giuseppe Pelosi
- a Department of Oncology and Hemato-Oncology , Università degli Studi di Milano , Milan , Italy
| | - Aldo Scarpa
- b Department of Pathology and Diagnostics , University and Hospital Trust of Verona , Verona , Italy.,c ARC-Net Research Centre , University and Hospital Trust of Verona , Verona , Italy
| | - Fabien Forest
- d Department of Pathology , University Hospital Center (CHU), North Hospital , Saint Etienne , France
| | - Angelica Sonzogni
- e Department of Pathology and Laboratory Medicine , Fondazione IRCCS Istituto Nazionale Tumori , Milan , Italy
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Case BW. Pathology analysis for mesothelioma study in the United Kingdom: Current practice and historical development. JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART B, CRITICAL REVIEWS 2016; 19:201-212. [PMID: 27705547 DOI: 10.1080/10937404.2016.1195320] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Following up on the largest case-control study of malignant mesothelioma yet performed, investigators at the London School of Hygiene and Tropical Medicine assessed 1732 male and 670 female cases as of May 2013. Epidemiological findings of a subset of these were published previously, excluding patients who died or who refused to be interviewed. Pathology reports were collected for subjects, including those both eligible and ineligible for epidemiology study based on vital status. The current investigation examined 860 cases having pathology reports available. Sixty-one cases were diagnosed using cytology only, often with equivocal diagnoses, while 799 reported at least a biopsy of the tumor. Of these, 748 had pathology sufficiently detailed for evaluation. These reports were examined for basis of diagnosis, differences between study cases and ineligible cases, pathology characteristics, and immunohistochemical and other tests used. The most prominent subtype was epithelioid (64% of study cases but only 49% of ineligible cases). Biphasic subtype was present in 10% of study cases and 16% of those ineligible. Sarcomatoid subtype was present in 7% of study cases and 19% of ineligible cases, most of whom died. Twelve percent of study cases displayed no specified subtype, versus 7% of ineligible cases. Of recorded immunohistochemical stains specific for mesothelial cell origin, calretinin (95%) and CK 5/6 or CK5 alone (84%) were by far the most common. Calretinin and CK 5/6 or CK 5 alone were also most sensitive and positive in 92% of cases presenting with surgical pathology report. Ninety percent of cases had at least one immunohistochemical marker for possible lung carcinoma applied, with BER-Ep4 and TTF-1 the most frequent at 68% and CEA at 58%. TTF-1 and CEA were positive in 1% or less of cases. Patterns of use and positive and negative results for each of these as well as other immunohistochemical stains are presented and discussed, along with a brief historical description of their development and use. Possible effects of the pathologic analysis on the results of previously published and future epidemiological studies are discussed.
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Affiliation(s)
- B W Case
- a Department of Pathology and School of Environment , McGill University , Montreal , Québec , Canada
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