Attanoos R L, Griffin A, Gibbs A R
Department of Histopathology, Llandough Hospital, Cardiff and Vale NHS Trust, Penarth, Cardiff, Wales, UK.
Histopathology. 2003 Sep;43(3):231-8. doi: 10.1046/j.1365-2559.2003.01686.x.
To evaluate the expression of the intermediate filament desmin in reactive mesothelium and malignant mesothelioma and to compare its utility with five other previously reported immunomarkers claimed to be of use in distinguishing reactive from neoplastic mesothelium.
Sixty cases of malignant pleural mesothelioma and 40 cases of reactive mesothelial hyperplasia formed the study group. Cases were immunohistochemically stained with desmin, epithelial membrane antigen (EMA), p53, Bcl-2, P-glycoprotein and platelet-derived growth factor receptor (PDGF-R) beta-chain by the avidin-biotin complex method. The cohort of malignant pleural mesotheliomas were immunoreactive to desmin, EMA and p53 in 6/60 (10%), 48/60 (80%) and 27/60 (45%), respectively. In comparison, the cohort of reactive mesothelial hyperplasias were immunoreactive to desmin, EMA and p53 in 34/40 (85%), 8/40 (20%) and 0/40 (0%), respectively. In a smaller cohort (n = 15) of malignant pleural mesotheliomas, Bcl-2, P-glycoprotein and PDGF-R beta-chain were expressed in 0/15 (0%), 2/15 (13%) and 15/15 (100%), respectively. In a small cohort (n = 15) of reactive mesothelial hyperplasias, Bcl-2, P-glycoprotein and PDGF-R beta-chain were immunoreactive in 0/15 (0%), 0/15 (0%) and 6/15 (40%), respectively.
Desmin and EMA appear to be the most useful markers in distinguishing benign from malignant mesothelial proliferations. Desmin appears to be preferentially expressed in reactive mesothelium and EMA appears to be preferentially expressed in neoplastic mesothelium. The complementary use of both markers is advocated in ascertaining the nature of mesothelial proliferations. Immunohistochemical detection of mutated p53 oncoprotein appeared to be of less utility in this study on account of the low marker sensitivity for malignant mesothelioma. However, p53 antibody may be of use as a second-line marker of neoplastic mesothelium within a standard immunohistochemical panel of antibodies. In this study, Bcl-2, P-glycoprotein and PDGF-R beta-chain appear to be of no use in distinguishing reactive from neoplastic mesothelium, although more formal evaluation of these markers is required.
评估中间丝结蛋白在反应性间皮和恶性间皮瘤中的表达，并将其与其他五种先前报道的免疫标志物的效用进行比较，这些标志物据称可用于区分反应性间皮和肿瘤性间皮。
60例恶性胸膜间皮瘤和40例反应性间皮增生构成研究组。采用抗生物素蛋白-生物素复合物法对标本进行结蛋白、上皮膜抗原（EMA）、p53、Bcl-2、P-糖蛋白和血小板衍生生长因子受体（PDGF-R）β链的免疫组织化学染色。恶性胸膜间皮瘤组中，结蛋白、EMA和p53的免疫反应阳性率分别为6/60（10%）、48/60（80%）和27/60（45%）。相比之下，反应性间皮增生组中，结蛋白、EMA和p53的免疫反应阳性率分别为34/40（85%）、8/40（20%）和0/40（0%）。在一个较小的恶性胸膜间皮瘤队列（n = 15）中，Bcl-2、P-糖蛋白和PDGF-Rβ链的表达率分别为0/15（0%）、2/15（13%）和15/15（100%）。在一个较小的反应性间皮增生队列（n = 15）中，Bcl-2、P-糖蛋白和PDGF-Rβ链的免疫反应阳性率分别为0/15（0%）、0/15（0%）和6/15（40%）。
结蛋白和EMA似乎是区分良性和恶性间皮增生最有用的标志物。结蛋白似乎在反应性间皮中优先表达，而EMA似乎在肿瘤性间皮中优先表达。在确定间皮增生的性质时，提倡同时使用这两种标志物。在本研究中，由于恶性间皮瘤的标志物敏感性较低，突变型p53癌蛋白的免疫组织化学检测似乎用处较小。然而，在标准的免疫组织化学抗体组合中，p53抗体可作为肿瘤性间皮的二线标志物。在本研究中，Bcl-2、P-糖蛋白和PDGF-Rβ链似乎在区分反应性间皮和肿瘤性间皮方面没有用处，尽管需要对这些标志物进行更正式的评估。
