Ozdemir Hanife Gulnihal, Kokten Sermin Coban, Barisik Nagehan Ozdemir
Department of Pathology, Osmaniye Public Hospital, Osmaniye, Turkey.
University of Health Sciences Kartal Dr Lutfi Kırdar Training and Research Hospital, Istanbul, Turkey.
J Pathol Transl Med. 2020 Nov;54(6):497-503. doi: 10.4132/jptm.2020.09.14. Epub 2020 Nov 9.
Malignant mesothelioma is a highly aggressive tumor that can be confused with a benign mesothelial lesion, especially cytomorphologic lesions. BRCA1-associated protein 1 (BAP1) acts as a tumor suppressor. In this study, we aim to investigate the value of BAP1 staining of malignant mesothelioma cases with expression loss and diagnosis in cell block and biopsy tissue.
Between January 2009 and March 2017, 64 mesotheliomas, 117 reactive mesothelial hyperplasias, and 20 fibrinous pleuritis/pericarditis were diagnosed with morphologic and immunohistochemical findings in our pathology clinic and were included in the study. Formalin-fixed, paraffin-embedded tissues were immunohistochemically examined for BAP1. Inflammatory and stromal cells were used as positive internal controls. BAP1 was assessed for nuclear staining in mesothelial cells.
Examinations of the relationship between patient diagnosis and BAP1 biopsy status showed that the BAP1 loss rate (76.6%) was significantly higher in malignant mesothelioma cases than in other benign diseases (0%) (p<.001). Sensitivity and specificity were 76.56% and 100%, respectively, for biopsy tissue from malignant mesothelioma. Sensitivity and specificity were both 100% for BAP1 test on cell block tissue. Furthermore, the consistency between BAP1 cell block and biopsy results was excellent (ĸ=0.90) and the correlation was significant (p<.001).
This study shows that BAP1 expression loss in both cytology and biopsy tissue in biopsy-confirmed malignant mesothelioma cases is an essential parameter for malignant mesothelioma diagnosis.
恶性间皮瘤是一种侵袭性很强的肿瘤，可能会与良性间皮病变混淆，尤其是细胞形态学病变。乳腺癌1号基因关联蛋白1（BAP1）作为一种肿瘤抑制因子。在本研究中，我们旨在探讨BAP1染色在细胞块和活检组织中对表达缺失的恶性间皮瘤病例的诊断价值。
2009年1月至2017年3月期间，在我们的病理科通过形态学和免疫组化检查诊断出64例间皮瘤、117例反应性间皮增生和20例纤维素性胸膜炎/心包炎，并纳入本研究。对福尔马林固定、石蜡包埋的组织进行BAP1免疫组化检查。炎症细胞和基质细胞用作阳性内对照。评估BAP1在间皮细胞中的核染色情况。
对患者诊断与BAP1活检状态之间的关系进行检查发现，恶性间皮瘤病例的BAP1缺失率（76.6%）显著高于其他良性疾病（0%）（p<0.001）。对于恶性间皮瘤的活检组织，敏感性和特异性分别为76.56%和100%。对于细胞块组织的BAP1检测，敏感性和特异性均为100%。此外，BAP1细胞块与活检结果之间的一致性极佳（ĸ=0.90），相关性显著（p<0.001）。
本研究表明，在活检确诊的恶性间皮瘤病例中，细胞学和活检组织中的BAP1表达缺失是恶性间皮瘤诊断的一个重要参数。
