Department of Pathology, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan.
Department of Pathology and Clinical Pathology, South Valley University, Qena, Egypt.
Sci Rep. 2018 Jan 9;8(1):134. doi: 10.1038/s41598-017-18545-x.
The differential diagnosis of epithelioid mesothelioma from lung adenocarcinoma and squamous cell carcinoma requires the positive and negative immunohistochemical markers of mesothelioma. The IMIG guideline has suggested the use of Calretinin, D2-40, WT1, and CK5/6 as mesothelial markers, TTF-1, Napsin-A, Claudin 4, CEA as lung adenocarcinoma markers p40, p63, CK5/6, MOC-31 as squamous cell markers. However, use of other immunohistochemical markers is still necessary. We evaluated 65 epithelioid mesotheliomas, 60 adenocarcinomas, and 57 squamous cell carcinomas of the lung for MUC4 expression by immunohistochemistry and compared with the previously known immunohistochemical markers. MUC4 expression was not found in any of 65 cases of epithelioid mesothelioma. In contrast, MUC4 expression was observed in 50/60(83.3%) cases of lung adenocarcinoma and 50/56(89.3%) cases of lung squamous cell carcinoma. The negative MUC4 expression showed 100% sensitivity, 86.2% specificity and accuracy rate of 91.2% to differentiate epithelioid mesothelioma from lung carcinoma. The sensitivity, specificity, and accuracy of MUC4 are comparable to that of previously known markers of lung adenocarcinoma and squamous cell carcinoma, namely CEA, Claudin 4 and better than that of MOC-31. In conclusion, MUC4 immunohistochemistry is useful for differentiation of epithelioid mesothelioma from lung carcinoma, either adenocarcinoma or squamous cell carcinoma.
上皮样间皮瘤与肺腺癌和肺鳞癌的鉴别诊断需要间皮瘤的阳性和阴性免疫组织化学标志物。IMIG 指南建议使用钙视网膜蛋白、D2-40、WT1 和 CK5/6 作为间皮标志物，TTF-1、Napsin-A、Claudin 4、CEA 作为肺腺癌标志物，p40、p63、CK5/6、MOC-31 作为肺鳞癌标志物。然而，仍然需要使用其他免疫组织化学标志物。我们通过免疫组织化学评估了 65 例上皮样间皮瘤、60 例腺癌和 57 例肺鳞癌的 MUC4 表达，并与之前已知的免疫组织化学标志物进行了比较。上皮样间皮瘤 65 例中均未见 MUC4 表达。相比之下，肺腺癌 60 例中有 50 例（83.3%）和肺鳞癌 56 例中有 50 例（89.3%）观察到 MUC4 表达。MUC4 阴性表达对鉴别上皮样间皮瘤与肺癌的敏感性为 100%，特异性为 86.2%，准确率为 91.2%。MUC4 的敏感性、特异性和准确性与肺腺癌和肺鳞癌的已知标志物（如 CEA、Claudin 4）相当，优于 MOC-31。总之，MUC4 免疫组织化学有助于鉴别上皮样间皮瘤与肺癌，无论是腺癌还是鳞癌。
