Kitazume H, Kitamura K, Mukai K, Inayama Y, Kawano N, Nakamura N, Sano J, Mitsui K, Yoshida S, Nakatani Y
Division of Anatomic and Surgical Pathology, Hospital of Yokohama City University, Yokohama City University School of Medicine, Yokohama, Japan.
Cancer. 2000 Feb 25;90(1):55-60. doi: 10.1002/(sici)1097-0142(20000225)90:1<55::aid-cncr8>3.0.co;2-p.
The differential diagnosis between reactive mesothelial cells (RMs), malignant mesotheliomas (MMs), and adenocarcinomas (ACs) is often difficult in cytologic specimens, and the utility of various immunohistochemical markers have been explored. Because recent immunohistologic studies have suggested that E-cadherin (E-cad) and calretinin (Cal) may be useful markers for epithelial and mesothelial differentiations, respectively, the authors investigated their utility in cytologic diagnosis.
In this retrospective study, immunostaining was performed on smears retrieved from Papanicolaou-stained slides of effusions using the labeled streptavidin-biotin method. Sixteen cases of RM, 9 cases of MM, and 52 cases of AC from various sites, including 13 pulmonary primaries, were examined with primary antibodies against E-cad and Cal.
The positive rates for E-cad and Cal, respectively, were as follows: RM, 0/16 (0%) and 16/16 (100%); MM, 9/9 (100%) and 8/8 (100%); and AC, 45/52 (86.5%) and 0/51 (0%). The E-cad expression by neoplastic cells was strongest in the intercellular junctions, and poorly differentiated neoplastic cells in the single cell form showed the weakest expression.
In contrast to the results of previous immunohistochemical studies, the current study indicates that MMs constantly express E-cad, whereas RMs lack its expression in cytologic specimens, which would be useful in the differential diagnosis between the two. On the other hand, E-cad expression is not reliable for distinguishing AC from MM. The Cal expression can be a very useful marker for the distinction between AC and the mesothelial lineage. The combined immunostaining for E-cad and Cal has utility in differential diagnosis among RM, MM, and AC.
在细胞学标本中，反应性间皮细胞（RMs）、恶性间皮瘤（MMs）和腺癌（ACs）的鉴别诊断通常很困难，人们已经探索了各种免疫组化标志物的效用。由于最近的免疫组织学研究表明，E-钙黏蛋白（E-cad）和钙视网膜蛋白（Cal）可能分别是上皮和间皮分化的有用标志物，作者研究了它们在细胞学诊断中的效用。
在这项回顾性研究中，使用标记链霉亲和素-生物素法对从巴氏染色的积液玻片上获取的涂片进行免疫染色。对16例RMs、9例MMs和52例来自不同部位的ACs（包括13例肺原发性肿瘤）进行了抗E-cad和Cal的一抗检测。
E-cad和Cal的阳性率分别如下：RMs，0/16（0%）和16/16（100%）；MMs，9/9（100%）和8/8（100%）；ACs，45/52（86.5%）和0/51（0%）。肿瘤细胞的E-cad表达在细胞间连接处最强，单细胞形式的低分化肿瘤细胞表达最弱。
与先前免疫组化研究结果相反，本研究表明MMs在细胞学标本中持续表达E-cad，而RMs缺乏其表达，这在两者的鉴别诊断中很有用。另一方面，E-cad表达对于区分AC和MM不可靠。Cal表达可以是区分AC和间皮谱系的非常有用的标志物。E-cad和Cal联合免疫染色在RMs、MMs和ACs的鉴别诊断中有用。
