Collins C L, Ordonez N G, Schaefer R, Cook C D, Xie S S, Granger J, Hsu P L, Fink L, Hsu S M
Department of Pathology, University of Arkansas for Medical Sciences, Little Rock.
Am J Pathol. 1992 Oct;141(4):827-33.
Thrombomodulin (TM) is a glycoprotein of molecular weight 75,000 kd that is normally present in restricted numbers of cells, including endothelial and mesothelial cells. In this study, the authors tested the possibility of using anti-TM to facilitate the diagnosis of mesothelioma. All of the 31 mesotheliomas and the two mesothelioma cell lines (MS-1 and MS-2) tested were stained positively with anti-TM. The specificity of anti-TM staining in mesothelioma cells was further confirmed by in situ hybridization of MS-1 cells with a TM-specific probe. The expression of TM in MS-1 cells was increased markedly when these cells were induced by 12-0-tetradecanyl phorbol 13-acetate (TPA) to differentiate. The expression of TM in mesothelioma cells, however, did not correlate with any particular phase of the cell cycle. In an attempt to differentiate pleural mesothelioma from pulmonary adenocarcinoma, the authors compared the expression of TM, carcinoembryonic antigen (CEA), and Leu M1 in these two types of tumors. Only four of 48 (8%) pulmonary adenocarcinomas were stained positively by antibodies to TM. Therefore, immunohistochemical staining with antibodies to TM yielded 100% sensitivity and 92% specificity for diagnosis of mesothelioma. All of the mesotheliomas stained negatively for CEA and Leu M1, except for one, which showed minimal focal positivity for Leu M1. In contrast, 79% and 60% of adenocarcinomas stained positively for CEA and Leu M1, respectively. These findings suggest that immunocytochemical staining with anti-TM should be added to the battery of tests to increase the diagnostic sensitivity and specificity for differentiating mesothelioma from pulmonary adenocarcinoma.
血栓调节蛋白（TM）是一种分子量为75,000kd的糖蛋白，通常仅存在于有限数量的细胞中，包括内皮细胞和间皮细胞。在本研究中，作者测试了使用抗TM抗体来辅助诊断间皮瘤的可能性。所检测的31例间皮瘤以及两种间皮瘤细胞系（MS-1和MS-2）均被抗TM抗体阳性染色。通过用TM特异性探针与MS-1细胞进行原位杂交，进一步证实了抗TM染色在间皮瘤细胞中的特异性。当MS-1细胞被12-0-十四烷酰佛波醇-13-乙酸酯（TPA）诱导分化时，TM在这些细胞中的表达显著增加。然而，间皮瘤细胞中TM的表达与细胞周期的任何特定阶段均无关联。为了鉴别胸膜间皮瘤与肺腺癌，作者比较了这两种肿瘤中TM、癌胚抗原（CEA）和Leu M1的表达。48例肺腺癌中仅有4例（8%）被抗TM抗体阳性染色。因此，用抗TM抗体进行免疫组化染色对间皮瘤诊断的敏感性为100%，特异性为92%。除1例间皮瘤对Leu M1显示极轻微局灶性阳性外，所有间皮瘤对CEA和Leu M1染色均为阴性。相比之下，分别有79%和60%的腺癌对CEA和Leu M1染色呈阳性。这些发现表明，应将抗TM免疫细胞化学染色添加到检测项目中，以提高鉴别间皮瘤与肺腺癌的诊断敏感性和特异性。
