Spagnolo D V, Whitaker D, Carrello S, Radosevich J A, Rosen S T, Gould V E
Hospital Pathology Service, Sir Charles Gairdner Hospital, Queen Elizabeth II Medical Center, Nedlands, Western Australia.
Am J Clin Pathol. 1991 Mar;95(3):322-9. doi: 10.1093/ajcp/95.3.322.
Monoclonal antibody (MoAb) 44-3A6 recognizes a glandular differentiation-associated antigen and has been used to identify exocrine differentiation in pulmonary carcinomas. The authors assessed its value in the diagnosis of lung carcinomas metastatic to lung/pleura and pleural malignant mesothelioma (MM), using cell blocks derived from cytologic specimens. Sixty-three primary lung carcinomas, 31 metastatic adenocarcinomas (ACs) (from breast, gastrointestinal tract, or genitourinary tract), and 36 MMs were immunostained with 44-3A6, Leu-M1, and anti-carcinoembryonic antigen (CEA). The results confirm the value of 44-3A6 in identifying ACs but do not allow distinction between those of pulmonary, breast, GIT, or ovarian mucinous derivation. Endometrial, ovarian serous, and renal ACs are essentially nonreactive, as are almost all MMs. The occurrence of one positive MM predicates caution in interpreting 44-3A6 positivity in isolation, but, judiciously used with other discriminating antibodies such as Leu-M1 and anti-CEA, 44-3A6 is of value in the differential diagnosis of ACs and MMs. Further, its applicability to cytologic specimens may obviate the need for more invasive diagnostic procedures and lead to rapid, accurate diagnosis.
单克隆抗体（MoAb）44-3A6可识别一种与腺性分化相关的抗原，并已用于鉴定肺癌中的外分泌分化。作者使用来自细胞学标本的细胞块，评估了其在诊断肺/胸膜转移癌和胸膜恶性间皮瘤（MM）中的价值。对63例原发性肺癌、31例转移性腺癌（来自乳腺、胃肠道或泌尿生殖道）和36例MM进行了44-3A6、Leu-M1和抗癌胚抗原（CEA）免疫染色。结果证实了44-3A6在识别腺癌方面的价值，但无法区分肺、乳腺、胃肠道或卵巢黏液性来源的腺癌。子宫内膜、卵巢浆液性和肾腺癌基本无反应，几乎所有的MM也是如此。出现一例阳性MM提示单独解释44-3A6阳性时需谨慎，但与Leu-M1和抗CEA等其他鉴别抗体明智地联合使用时，44-3A6在腺癌和MM的鉴别诊断中有价值。此外，其对细胞学标本的适用性可能无需更具侵入性的诊断程序，并能实现快速、准确的诊断。
