From the Pleural Mesothelioma National Multicentric Registry (MESONAT), MESOPATH National Network on Mesothelioma (Ms Le Stang and Dr Galateau-Sallé), the EURACAN network (Dr Girard), and MESOBANK Clinicobiological Database and National Frozen Tissue Bank (Dr Galateau-Sallé), Léon Bérard Cancer Center, Lyon, France; the Department of Pathology, Cork University Hospital, Cork, Ireland (Dr Burke); the Frozen Tissue Bank InnovaBio, CHU de Caen, France (Ms Blaizot); the Department of Pathology, University Hospital Llandough, Cardiff, England (Dr Gibbs); INSERM U1086, ANTICIPE, Caen University, Caen, France (Drs Lebailly and Clin); the Department of Occupational Diseases, University Hospital, Caen, France (Dr Clin); the University of Lyon, Lyon, France (Dr Girard); and the Curie Montsouris Thorax Institute, Curie Institut, Paris, France (Dr Girard).
Arch Pathol Lab Med. 2020 Apr;144(4):446-456. doi: 10.5858/arpa.2018-0457-OA. Epub 2019 Aug 7.
CONTEXT.—: Pleural mesothelioma is a rare cancer with an often-challenging diagnosis because of its potential to be a great mimicker of many other tumors. Among them, primary lung and breast cancers are the 2 main causes of pleural metastasis. The development and application of targeted therapeutic agents have made it even more important to achieve an accurate diagnosis. In this setting, international guidelines have recommended the use of 2 positive and 2 negative immunohistochemical biomarkers.
OBJECTIVES.—: To define the most highly specific and sensitive minimum set of antibodies for routine practice to use for the separation of epithelioid malignant mesothelioma from lung and breast metastasis and to determine the most relevant expression cutoff.
DESIGN.—: To provide information at different levels of expression of 16 mesothelial and epithelial biomarkers, we performed a systematic review of articles published between 1979 and 2017, and we compared those data to results from the Mesothelioma Telepathology Network (MESOPATH) of the standardized panel used in routine practice database since 1998.
RESULTS.—: Our results indicate that the following panel of markers-calretinin (poly)/thyroid transcription factor 1 (TTF-1; clone 8G7G3/1) and calretinin (poly)/estrogen receptor-α (ER-α; clone EP1)-should be recommended; ultimately, based on the MESOPATH database, we highlight their relevance which are the most sensitive and specific panel useful to the differential diagnosis at 10% cutoff.
CONCLUSIONS.—: Highlighted by their relevance in the large cohort reported, we recommend 2 useful panels to the differential diagnosis at 10% cutoff.
胸膜间皮瘤是一种罕见的癌症，由于其可能与许多其他肿瘤混淆，因此诊断具有挑战性。其中，原发性肺癌和乳腺癌是胸膜转移的 2 个主要原因。靶向治疗药物的开发和应用使得准确诊断变得更加重要。在这种情况下，国际指南建议使用 2 种阳性和 2 种阴性免疫组织化学生物标志物。
确定最具特异性和敏感性的最小抗体组合，用于常规实践，以区分上皮样恶性间皮瘤与肺和乳腺转移，并确定最相关的表达临界值。
为了提供 16 种间皮和上皮生物标志物在不同表达水平的信息，我们对 1979 年至 2017 年发表的文章进行了系统回顾，并将这些数据与自 1998 年以来常规实践标准化面板的间皮瘤远程病理学网络（MESOPATH）数据库中的结果进行了比较。
我们的结果表明，以下标记物组合——钙结合蛋白（多）/甲状腺转录因子 1（TTF-1；克隆 8G7G3/1）和钙结合蛋白（多）/雌激素受体-α（ER-α；克隆 EP1）——应被推荐；最终，根据 MESOPATH 数据库，我们强调了它们在 10%截点处具有最高敏感性和特异性的最相关面板的相关性。
在报告的大型队列中，由于其相关性突出，我们推荐在 10%截点处进行鉴别诊断的 2 个有用的面板。
