re-evaluation of histological diagnoses of malignant mesothelioma by immunohistochemistry重新评估的组织学诊断恶性间皮瘤的免疫组织化学.pdfVIP

Sandeck et al. Diagnostic Pathology 2010, 5:47 /content/5/1/47 RESEARCH Open Access Re-evaluation of histological diagnoses of malignant mesothelioma by immunohistochemistry 1* 2 3 4 4,5,6 Helmut P Sandeck , Oluf D Røe , Kristina Kjærheim , Helena Willén , Erik Larsson Abstract Background: In order to provide reliable tissue material for malignant mesothelioma (MM) studies, we re-evaluated biopsies and autopsy material from 61 patients with a diagnosis of MM from the period of 1980-2002. Methods: Basic positive (Calretinin, EMA, Podoplanin, Mesothelin) and negative (CEA, Ber-Ep4) immunohistochemical (IHC) marker reactions were determined. If needed, more markers were used. Histological diagnoses were made by three pathologists. Survival data were calculated. Results: 49 cases (80%) were considered being MM by a high degree of likelihood, five more cases possible MM. Of the remaining seven cases, three were diagnosed as adenocarcinoma, three as pleomorphic lung carcinoma, in one peritoneal case a clear entity diagnosis could not be given. One of the possible MM cases and two of the lung carcinoma cases had this already as primary diagnoses, but were registered as MM. With a sensitivity of 100%, Calretinin and CEA were the most reliable single markers. The amount of MM cells with positive immunoreactivity (IR) for Podoplanin and Mesothelin showed most reliable inverse relation to the degree of atypia. In the confirmed MM cases, there had been applied either no IHC or between one and 18 markers. The cases not confirmed by us had either lacked IHC (n = 1), non-specific markers were used (n = 4), IR was different (n = 1), or specific markers had not shown positive IR in the right part of the tumour cells (n = 3).