Carcinoembryonic antigen and milk-fat globule protein staining of malignant mesothelioma and adenocarcinoma of the lung.

Immunohistologic markers have been of considerable value in differentiating malignant mesothelioma from adenocarcinoma. Recently, staining for milk-fat globule (MFG) protein has been suggested as a useful diagnostic test for this separation, but subsequent reports have been conflicting, with some authors finding clearcut differences, while others showed similar marking of both tumor types. To examine this technique further, we studied lung carcinomas and mesotheliomas with commercially available anti-MFG, and compared these results with those obtained with anticarcinoembryonic antigen (CEA), a commonly used immunomarker of carcinoma. We found that carcinomas showed strong cytoplasmic staining for MFG and CEA; however, a greater percentage of carcinomas were more strongly positive for CEA than for MFG. Mesotheliomas did not, for the most part, stain strongly with either antibody. In addition, carcinomas from different hospitals stained differently for MFG, but not for CEA. We conclude that although strong cytoplasmic staining for MFG is a reasonably reliable indicator of carcinoma, CEA staining provides a better separation and is considerably easier to interpret in lung cancer specimens.