Reference

Summary17

sensitivity

specificity

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

34bE12

O

O

44-3A6

O

Amylase

O

AUA1

O

B72.3

A ,=1(positive in adenocarcinoma; recommended as a first-line marker with BerEP4 or MOC1 as alternatives)

80%

91%

1

O

1

1

2

O

O

O

O

 =1

=1

BerEP4

A ,=1(positive in adenocarcinoma; recommended as a first-line marker with B72.3 or MOC1 as alternatives)

80%

88%

1

1

O

1

=1

1

O

2

O

1

O

2

=1

=1

Ber-H2

O

BG-8

A ,2(positive in adenocarcinoma; recommended as a second-line marker)

 88%

89%

1

2

Blood-group related antigens A, B &H

3

BMA-120

O

Ca 125

O

O

Ca 19.9

A ,2(positive in adenocarcinoma; recommended as a second-line marker)

 56%

99.5%

1

2

Calretinin

M,1(positive in epithelioid mesothelioma; recommended as a first-line marker)

 80%

86%

O

O

O

1

1

1

O

=1

O

2

1

=1

Cam 5.2

O

CD 44H

O

O

CD44S

M,O(positive in epithelioid mesothelioma, but not recommended)

 66%

61%

O

CD138

A(positive in adenocarcinoma: not of proven value as a marker)

55%

92%

CEA

A ,1(positive in adenocarcinoma; recommended as a first-line marker)

 84%

97.5%

1

4

1

1

1

1

1

O

O

1

1

=1

O

O

2

1

=1

CK4

O

CK5/6

M,=1(positive in epithelioid mesothelioma; recommended as a first-line marker with WT1 as an alternative)

 80%

83%

O

1

 2

=1

=1

CK7

O

O

CK8

O

CK8/18/19

O

CK10

O

CK13

O

CK13/16

O

CK14

O

CK16

O

CK18

O

O

CK19

O

CK20

O

D2-40

  M,=1(positive in epithelioid mesothelioma; recommended as a first-line marker with podoplanin as an alternative; more studies are needed.)

=1

Desmin

O

O

E-cadherin

A ,O(positive in adenocarcinoma, but not recommended)

 89%

66%

1

1

O

EMA

A ,O(positive in adenocarcinoma, but not recommended)

O

O

O

1

O

O

 O

HBME-1

M,O(positive in epithelioid mesothelioma, but not recommended)

 78%

51%

O

O

O

2

O

O

1

O

O

O

HEA125

2

O

HMFG-2

2

IOB3

1

LeuM1

A ,2(positive in adenocarcinoma; recommended as a second-line marker)

 67%

93%

2

O

O

1

2

O

O

O

1

1

O

O

O

2

2

mesothelin

M,2(positive in epithelioid mesothelioma; recommended as a second-line marker)

 97%

53%

2

MNF116

O

MOC-31

A ,=1(positive in adenocarcinoma; recommended as a first-line marker with B72.3 or BerEP4 as alternatives)

 91%

88%

=1

O

1

O

1

=1

=1

N-cadherin

M,O(positive in epithelioid mesothelioma, but not recommended)

 77%

65%

2

O

p-170gp

O

p53

O

PDGFR-beta 

O

PLAP

O

Podoplanin

  M,=1(positive in epithelioid mesothelioma; recommended as a first-line marker with D2-40 as an alternative; more studies are needed.)

=1

Secretory component

O

Sialosyl-TN

2

SP-A

O

SM3

O

thrombomodulin

M,2(positive in epithelioid mesothelioma; recommended as a second-line marker)

 62%

81%

O

1

O

O

2

1

O

O

2

2

TTF-1

A ,2(positive in adenocarcinoma; recommended as a second-line marker)

 75%

100%

1

2

vimentin

M ,O(positive in mesothelioma, but not recommended)

66%

72%

O

O

O

O

O

O

1

1

O

O

O

O

WT1

M,=1(positive in epithelioid mesothelioma; recommended as a first-line marker with CK5/6 as an alternative)

 76%

97%

1

=1

=1

See also:

• TTF-1 is positive in most adenocarcinomas but negative in mesothelioma. 

• CD56 is more often positive in mesothelioma than in non small cell lung carcinoma

• Calretinin is usually positive in mesothelioma and negative in adenocarcinoma.

• HBME-1 is of low specificity for mesothelioma, 

• MOC-31 is usually expressed by adenocarcinomas, but is usually negative in mesotheliomas.

• MNF116 positivity in fibrous cells is reported to be more frequent in mesothelioma than in adenocarcinoma

• Sialosyl-TN

• CD 44H.

• Ca 19.9

• Caveolin

• Mesothelin is of limited value

• Tenascin-X:  one study indicates usefulness, particularly in the differentiation of mesothelioma from ovarian / primary peritoneal serous carcinoma.

References

1 Brown, R. W., G. M. Clark, et al. (1993). "Multiple-marker immunohistochemical phenotypes distinguishing malignant pleural mesothelioma from pulmonary adenocarcinoma [see comments]." Hum Pathol 24(4): 347-54.

2 Moch, H., M. Oberholzer, et al. (1993). "Diagnostic tools for differentiating between pleural mesothelioma and lung adenocarcinoma in paraffin embedded tissue. Part I: Immunohistochemical findings." Virchows Arch A Pathol Anat Histopathol 423(1): 19-27.

3 Skov, B. G., A. F. Lauritzen, et al. (1994). "Differentiation of adenocarcinoma of the lung and malignant mesothelioma: predictive value and reproducibility of immunoreactive antibodies." Histopathology 25(5): 431-7.

4 Kortsik, C. S., P. Werner, et al. (1995). "Immunocytochemical characterization of malignant mesothelioma and carcinoma metastatic to the pleura: IOB3--a new tumor marker." Lung 173(2): 79-87.

5 Ordonez, N. G. (1997). "The value of antibodies 44-3A6, SM3, HBME-1, and thrombomodulin in differentiating epithelial pleural mesothelioma from lung adenocarcinoma: a comparative study with other commonly used antibodies [see comments]." Am J Surg Pathol 21(12): 1399-408.

6 Riera, J. R., C. Astengo-Osuna, et al. (1997). "The immunohistochemical diagnostic panel for epithelial mesothelioma: a reevaluation after heat-induced epitope retrieval [see comments]." Am J Surg Pathol 21(12): 1409-19.

7 Chenard-Neu, M. P., A. Kabou, et al. (1998). "[Immunohistochemistry in the differential diagnosis of mesothelioma and adenocarcinoma. Evaluation of 5 new antibodies and 6 traditional antibodies]." Ann Pathol 18(6): 460-5.

8 Garcia-Prats, M. D., C. Ballestin, et al. (1998). "A comparative evaluation of immunohistochemical markers for the differential diagnosis of malignant pleural tumours." Histopathology 32(5): 462-72.

9 Leers, M. P., M. M. Aarts, et al. (1998). "E-cadherin and calretinin: a useful combination of immunochemical markers for differentiation between mesothelioma and metastatic adenocarcinoma." Histopathology 32(3): 209-16.

10 Brockstedt, U., M. Gulyas, et al. (2000). "An optimized battery of eight antibodies that can distinguish most cases of epithelial mesothelioma from adenocarcinoma." Am J Clin Pathol 114(2): 203-9.

11 Comin, C. E., L. Novelli, et al. (2001). "Calretinin, thrombomodulin, CEA, and CD15: a useful combination of immunohistochemical markers for differentiating pleural epithelial mesothelioma from peripheral pulmonary adenocarcinoma." Hum Pathol 32(5): 529-36.

12 Oates, J. and C. Edwards (2000). "HBME-1, MOC-31, WT1 and calretinin: an assessment of recently described markers for mesothelioma and adenocarcinoma." Histopathology 36(4): 341-7.

13 Carella, R., G. Deleonardi, et al. (2001). "Immunohistochemical panels for differentiating epithelial malignant mesothelioma from lung adenocarcinoma: a study with logistic regression analysis." Am J Surg Pathol 25(1): 43-50.

14 Gonzalez-Lois, C., C. Ballestin, et al. (2001). "Combined use of novel epithelial (MOC-31) and mesothelial (HBME-1) immunohistochemical markers for optimal first line diagnostic distinction between mesothelioma and metastatic carcinoma in pleura." Histopathology 38(6): 528-34.

15 Roberts, F., McCall, A. E., Burnett, R. A. Malignant mesothelioma: a comparison of biopsy and postmortem material by light microscopy and immunohistochemistry. J Clin Pathol 2001;54:766-70.

16 Abutaily, A.S., Addis, B.J. and Roche, W.R. Immunohistochemistry in the distinction between malignant mesothelioma and pulmonary adenocarcinoma: a critical evaluation of new antibodies. J Clin Pathol 2002;55:662-8.

17 Ordonez, N. G. (2003). "The immunohistochemical diagnosis of mesothelioma: a comparative study of epithelioid mesothelioma and lung adenocarcinoma." Am J Surg Pathol 27(8): 1031-51.

18 Ordonez NG. Immunohistochemical diagnosis of epithelioid mesothelioma: an update. Arch Pathol Lab Med 2005; 129:1407-14

Dail and Hammar, 2nd ed., p 1516-1526

This page last revised 7.8.06.

©SMUHT/PW Bishop