Department of Pathology and Laboratory Medicine, National Defense Medical College, Tokorozawa. Japan.
Histol Histopathol. 2013 May;28(5):663-70. doi: 10.14670/HH-28.663. Epub 2012 Dec 10.
It is difficult to distinguish desmoplastic malignant mesothelioma (DMM) from fibrous pleuritis (FP). We investigated the utility of immunohistochemistry as a way of differentiating between DMM and FP. We examined 11 DMMs and 46 FPs with the aid of antibodies against 18 cytokeratin (CK) subtypes, calponin, caldesmon, desmin, and GLUT-1. The best sensitivity and specificity cut-off values in the receiver operating characteristic curves (ROC) for CKs 7, 8, 17, 18, and 19, and GLUT-1 were each above 60%. When cases with either DMM or FP were partitioned by the staining score associated with the best sensitivity and specificity cut-off values in ROC, the incidence of a positive expression for CKs 7, 8, 17, 18, and 19, and GLUT-1 was significantly higher in DMM than in FP. In conclusion, immunohistochemistry for CKs 7, 8, 17, 18, and 19, and GLUT-1 may be useful, alongside histological characteristics, for separating DMM from FP.
鉴别促纤维增生性恶性间皮瘤（DMM）与纤维性胸膜炎（FP）较为困难。本研究旨在探讨免疫组织化学在鉴别 DMM 与 FP 中的作用。我们用 18 种细胞角蛋白（CK）亚型、钙调蛋白、钙黏蛋白、结蛋白和葡萄糖转运蛋白 1（GLUT-1）抗体检测了 11 例 DMM 和 46 例 FP。在受试者工作特征曲线（ROC）中，CK7、8、17、18 和 19 及 GLUT-1 的最佳敏感度和特异度截断值的敏感度和特异度均大于 60%。当根据 ROC 中最佳敏感度和特异度截断值的染色评分将 DMM 或 FP 病例进行分组时，CK7、8、17、18 和 19 及 GLUT-1 的阳性表达在 DMM 中明显高于 FP。综上，免疫组织化学检测 CK7、8、17、18 和 19 及 GLUT-1 联合组织学特征有助于鉴别 DMM 与 FP。
