Department of Pathology, The University of Texas, M D Anderson Cancer Center, Houston, TX, USA.
Department of Pathology, The University of Texas, M D Anderson Cancer Center, Houston, TX, USA.
Pathol Res Pract. 2020 Dec;216(12):153267. doi: 10.1016/j.prp.2020.153267. Epub 2020 Nov 2.
Fifty-three cases of sarcomatoid pleural mesothelioma were evaluated for CDKN2A (p16) homozygous deletion and correlated with BRCA-associated protein-1 (BAP1) expression by immunohistochemistry. The patients are 45 men and 8 women between the ages of 37 and 79 years (average age: 58 years), who presented with symptoms of chest pain, cough, and weight loss. Diagnostic imaging showed the presence of diffuse pleural thickening with encasement of the lung parenchyma in all the cases. All patients were surgically treated with extrapleural pneumonectomy. Loss of BAP1 reactivity was seen in 49 tumors and p16 homozygous deletion was seen in 41 tumors, while in 16 patients either BAP1 or p16 were noncontributory to the diagnosis of mesothelioma. However, we were able to detect a better survival rate in those patients in whom BAP1 was lost and p16 showed homozygous deletion. Our findings showed that even though the use of BAP1 and p16 are important tools in the diagnosis of mesothelioma, a proportion of cases still remains negative with approximately 30 % of the cases in which the concordance of BAP1 loss and p16 homozygous deletion will not be present. We consider that the final diagnosis of mesothelioma is best accomplished by a global interpretation of clinical, radiographic, and pathological features including immunohistochemistry and molecular studies.
53 例肉瘤样胸膜间皮瘤患者进行了 CDKN2A（p16）纯合缺失评估，并通过免疫组织化学法与 BRCA 相关蛋白-1（BAP1）表达相关联。这些患者为 45 名男性和 8 名女性，年龄在 37 岁至 79 岁之间（平均年龄：58 岁），表现为胸痛、咳嗽和体重减轻等症状。诊断性影像学显示所有病例均存在弥漫性胸膜增厚，并伴有肺实质包绕。所有患者均接受了胸膜外全肺切除术的手术治疗。49 例肿瘤存在 BAP1 反应缺失，41 例肿瘤存在 p16 纯合缺失，而在 16 例患者中，无论是 BAP1 还是 p16 对间皮瘤的诊断都没有帮助。然而，我们发现那些 BAP1 缺失和 p16 显示纯合缺失的患者的生存率更好。我们的研究结果表明，尽管 BAP1 和 p16 的使用是间皮瘤诊断的重要工具，但仍有一部分病例呈阴性，大约 30%的病例中 BAP1 缺失和 p16 纯合缺失的一致性将不存在。我们认为，通过对临床、影像学和病理学特征（包括免疫组织化学和分子研究）的全面解释，才能得出间皮瘤的最终诊断。
