Ordóñez Nelson G
University of Texas M.D. Anderson Cancer Center, Houston, Texas 77030, USA.
Mod Pathol. 2003 Mar;16(3):192-7. doi: 10.1097/01.MP.0000056981.16578.C3.
Mesothelin is a cell surface antigen of unknown function that is strongly expressed in mesothelial cells. Although it was reported in 1992 that immunostaining with the K1 anti-mesothelin antibody could be very useful in distinguishing between epithelioid mesotheliomas and pulmonary adenocarcinomas, no further studies have been published on the value of this marker in the diagnosis of mesotheliomas. To determine whether mesothelin can assist in discriminating epithelioid mesotheliomas from lung adenocarcinomas or from other carcinomas metastatic to the serosal membranes, 55 mesotheliomas (44 epithelioid, 3 biphasic, and 8 sarcomatoid), 48 carcinomas of the lung (31 adenocarcinomas, 17 squamous carcinomas), and 86 nonpulmonary adenocarcinomas (14 ovary, 5 peritoneum, 9 endometrium, 11 pancreas, 4 stomach, 16 colon, 12 breast, 9 kidney, 4 thyroid, and 2 prostate) were investigated for mesothelin expression using the recently available 5B2 anti-mesothelin monoclonal antibody. Reactivity was obtained in all 44 (100%) of the epithelioid mesotheliomas, 12 (39%) of the lung adenocarcinomas, and 42 (49%) of the nonpulmonary adenocarcinomas (14 [100%] ovary; 5 [100%] peritoneum; 6 [67%] endometrium; 10 [91%] pancreas; 2 [50%] stomach; 5 [31%] colon; and in none [0] of the breast, kidney, thyroid, or prostate). Three (18%) of the squamous carcinomas of the lung, but none of the sarcomatoid mesotheliomas, exhibited positivity for this marker, nor was any reactivity seen in the spindle cell component of the biphasic mesotheliomas. It is concluded that despite the low specificity of mesothelin for discriminating between epithelioid mesotheliomas and adenocarcinomas, immunostaining for this marker may have some utility in those instances in which the results obtained with the standard panel of immunohistochemical markers used for the diagnosis of mesotheliomas are equivocal. Because mesothelin is a highly sensitive positive marker for epithelioid mesotheliomas, a negative staining for this marker is an indication against such a diagnosis; however, because of its limited utility, it is not recommended for inclusion in the standard panel of immunohistochemical markers used in the distinction between mesotheliomas and adenocarcinomas.
间皮素是一种功能未知的细胞表面抗原，在间皮细胞中强烈表达。尽管1992年有报道称，用K1抗间皮素抗体进行免疫染色在鉴别上皮样间皮瘤和肺腺癌方面可能非常有用，但关于该标志物在间皮瘤诊断中的价值尚未有进一步研究发表。为了确定间皮素是否有助于区分上皮样间皮瘤与肺腺癌或转移至浆膜的其他癌，我们使用最近可得的5B2抗间皮素单克隆抗体，对55例间皮瘤（44例上皮样、3例双向性和8例肉瘤样）、48例肺癌（31例腺癌、17例鳞癌）和86例非肺腺癌（14例卵巢癌、5例腹膜癌、9例子宫内膜癌、11例胰腺癌、4例胃癌、16例结肠癌、12例乳腺癌, 9例肾癌、4例甲状腺癌和2例前列腺癌）进行了间皮素表达研究。在所有44例（100%）上皮样间皮瘤、12例（39%）肺腺癌和42例（49%）非肺腺癌（14例卵巢癌[100%]；5例腹膜癌[100%]；6例子宫内膜癌[67%]；10例胰腺癌[91%]；2例胃癌[50%]；5例结肠癌[31%]）中检测到反应性；而在乳腺癌、肾癌、甲状腺癌或前列腺癌中均未检测到反应性（0例）。3例（18%）肺鳞癌显示该标志物阳性，但肉瘤样间皮瘤均为阴性，双向性间皮瘤的梭形细胞成分也未检测到反应性。结论是，尽管间皮素在区分上皮样间皮瘤和腺癌方面特异性较低，但在使用用于诊断间皮瘤的标准免疫组化标志物检测结果不明确的情况下，该标志物的免疫染色可能具有一定作用。由于间皮素是上皮样间皮瘤的高敏感阳性标志物，该标志物染色阴性可排除这种诊断；然而，由于其应用有限，不建议将其纳入用于区分间皮瘤和腺癌的标准免疫组化标志物组合中。
