Ordóñez Nelson G
The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.
Hum Pathol. 2005 Apr;36(4):372-80. doi: 10.1016/j.humpath.2005.01.019.
Recent investigations have shown that podoplanin and the D2-40 monoclonal antibody, which reacts with an oncofetal antigen present in fetal germ cells, are highly reliable lymphatic endothelial markers. The observation that both of these markers are also expressed in normal and reactive mesothelial cells prompted an investigation into their potential value in the diagnosis of mesotheliomas. To determine whether podoplanin and D2-40 had any use in the diagnosis of these tumors, 40 mesotheliomas (29 epithelioid, 5 biphasic, and 6 sarcomatoid), 34 carcinomas of the lung (24 adenocarcinomas, 10 squamous carcinomas), 80 nonpulmonary adenocarcinomas (17 ovary, 10 breast, 10 colon, 10 kidney, 5 endometrium, 5 stomach, 5 pancreas, 5 prostate, 3 thyroid), 12 synovial sarcomas (6 biphasic and 6 monophasic), 5 angiosarcomas, and 2 adenomatoid tumors were immunostained with a monoclonal antibody to podoplanin and with the D2-40 antibody. Reactivity for both D2-40 and podoplanin was obtained in 25 (86%) of the 29 epithelioid mesotheliomas but in none of the carcinomas or sarcomatoid mesotheliomas. Positivity for D2-40 and podoplanin was also seen in the epithelioid components of 4 of 5 biphasic mesotheliomas and 4 of 6 synovial sarcomas, whereas the spindle cell components of these tumors were negative as were the monophasic synovial sarcomas. Two (40%) of the 5 angiosarcomas expressed these markers, thus confirming previous reports suggesting that some angiosarcomas may have lymphatic endothelial differentiation. Both of the adenomatoid tumors were also positive for D2-40 and podoplanin, a finding which provides further support for the mesothelial derivation of these tumors. It is concluded that, because of their high specificity and sensitivity for epithelioid mesotheliomas, D2-40 and podoplanin are very useful markers for the diagnosis of these tumors. When compared with the other markers that are currently available, in my opinion, they appear to be the best.
近期研究表明，血小板反应蛋白-1和D2-40单克隆抗体是高度可靠的淋巴管内皮标志物，D2-40单克隆抗体可与胎儿生殖细胞中存在的一种癌胚抗原发生反应。由于这两种标志物在正常和反应性间皮细胞中也有表达，因此对它们在间皮瘤诊断中的潜在价值进行了研究。为了确定血小板反应蛋白-1和D2-40在这些肿瘤诊断中的作用，对40例间皮瘤（29例上皮样、5例双向性和6例肉瘤样）、34例肺癌（24例腺癌、10例鳞癌）、80例非肺腺癌（17例卵巢癌、10例乳腺癌、10例结肠癌、10例肾癌、5例子宫内膜癌、5例胃癌、5例胰腺癌、5例前列腺癌、3例甲状腺癌）、12例滑膜肉瘤（6例双向性和6例单相性）、5例血管肉瘤和2例腺瘤样瘤用血小板反应蛋白-1单克隆抗体和D2-40抗体进行免疫染色。29例上皮样间皮瘤中有25例（86%）对D2-40和血小板反应蛋白-1呈阳性反应，但在癌或肉瘤样间皮瘤中均未出现阳性反应。在5例双向性间皮瘤中的4例以及6例滑膜肉瘤中的4例的上皮样成分中也观察到D2-40和血小板反应蛋白-1呈阳性，而这些肿瘤的梭形细胞成分以及单相性滑膜肉瘤均为阴性。5例血管肉瘤中有2例（40%）表达这些标志物，这证实了先前的报道，即一些血管肉瘤可能具有淋巴管内皮分化。2例腺瘤样瘤对D2-40和血小板反应蛋白-1也呈阳性，这一发现为这些肿瘤的间皮来源提供了进一步支持。结论是，由于D2-40和血小板反应蛋白-1对上皮样间皮瘤具有高特异性和敏感性，它们是诊断这些肿瘤非常有用的标志物。与目前可用的其他标志物相比，在我看来，它们似乎是最好的。
