肺癌组织中MOC-31和CD56的检测及其意义

背景与目的：国外多数研究发现,由于MOC－3在肺癌组织中的阳性率明显高于胸膜间皮瘤的阳性率,因此认为MOC－3对两者鉴别诊断有重要意义,但也有少数相反的报道。CD56（神经细胞粘附分子neural cell adhesion molecule)对小细胞肺癌的敏感性高,对非小细胞肺癌的敏感性则报道不五。本研究旨在探讨MOC－3及CD56检测在肺癌诊断中的意义。方法：采用免疫组织化学（S－P）方法对92例肺癌组织吕MOC－31及CD56进行同步检测。结果：MOC－31在肺癌中的阳性率为98．9％（91／92）,其中在非小细胞肺癌（non-small cell lung carcinoma NSCLC)中的阳性率为98．6％（72／73）,在小细胞肺癌（smal cell lung carcinoma,SCLC)中的阳性率为100％（19／19）。CD56在肺癌中的阳性表达率为30．4％（28／92）,其中在NSCLC中的阳性表达率为12．3％（9／73）,在SCLC中的阳性表达率为100％（19／19）,MOC－31及CD56在癌旁肺组织及正常肺组织中均未见阳性反应。结论：MOC－31是检测肺癌的一个敏感性高特异性较强抗体。而CD56仅对SCLC有敏感性。MOC－31与CD56联合检测,对诊断SCLC更有意义。     

恶性胸膜间皮瘤误诊分析

目的总结21例恶性胸膜间皮瘤误诊原因.方法分析21例恶性胸膜间皮瘤的临床资料,包括年龄、病史、确诊时间、误诊疾病、影象学检查、实验室检查等.结果确诊时间4-18个月,平均10个月;误诊为结核性胸膜炎的占71%(15/21),肺癌胸膜转移19%(4/21),肋软骨肿物4%(1/21),肝癌4%(1/21);平均查胸水脱落细胞7次,方见恶性间皮细胞.结论恶性胸膜间皮瘤因无典型的临床症状和特异的影象学征象,易误诊为其他疾病,因此结合临床和辅助检查,综合诊断是早期和正确诊断的重要方法.     

免疫组化在胸膜上皮性恶性肿瘤鉴别诊断中的价值

背景与目的 胸膜上皮性恶性肿瘤鉴别诊断难度较大,本文旨在探讨免疫组化在胸膜恶性间皮瘤与转移性肺腺癌鉴别诊断中的作用.方法 用免疫组化S-P法检测56例胸膜上皮性恶性肿瘤中波形蛋白、间皮细胞(MC)、钙结合蛋白(CR)、甲状腺转录因子-1(TTF-1)、癌胚抗原(CEA)、表面活性蛋白-B(Sp-B)、细胞角蛋白(CK)的表达情况.结果 用免疫组化方法确定56例胸膜上皮性恶性肿瘤中恶性间皮瘤24例,转移性肺腺癌22例.波形蛋白、MC、CR、TTF-1、CEA、Sp-B在恶性间皮瘤与转移性肺腺癌中表达差异具有显著性(P＜0.001或P＜0.002).结论 用免疫组化方法鉴别胸膜恶性间皮瘤与转移性肺腺癌,波形蛋白、MC、CR、TTF-1、CEA、Sp-B是较为理想的标志物.     

CAL、VIM、CEA、EMA在胸(腹)水癌细胞诊断中应用

目的:探讨胸(腹)水疑难病例的病理诊断.方法:采用免疫细胞化学方法,分析130个病例.以诊断为癌的31例和仅有间皮细胞的30例为研究样本,相互对照,找出规律,再以此规律分析诊断为异型间皮细胞/可疑癌细胞的69例,鉴别出癌细胞和间皮细胞.结果:30例间皮细胞组CAL 28例(+)(93.33%),VIM 27例(+)(90.00%),而CEA无1例阳性(0),EMA 2例(+)(6.67%).31例癌细胞组,CAL 5例(+)(16.13%),VIM 7例(+)(22.58%),CEA 29例(+)(93.55%),EMA 26例(+)(83.89%).经χ2检测P＜0.01有显著差异.结合临床情况,CAL或CAL+VIM阳性为间皮源细胞;CEA或CEA+ EMA阳性为上皮源性细胞.69例异型间皮细胞/可疑癌细胞组4种抗体标记后,56例可确定其中的细胞是否为癌细胞,另有7例,结合HE涂片及临床资料,也能诊断.诊断率达81.16%～91.30%.结论:ICC技术是解决胸(腹)水疑难病例病理诊断的重要手段;依据形态学确定"异型间皮细胞”不妥,提倡ICC标记;CAL+CEA或CAL+VIM+CEA+EMA的联合应用,对癌细胞与间皮细胞的鉴别有重要意义.     

肺癌患者胸水中MOC-31 mRNA的表达及临床意义

目的探讨MOC-31mRNA在肺癌患者胸水中的表达及临床意义。方法应用逆转录-聚合酶链反应（RT—PCR），检测74例肺癌和40例肺良性疾病患者胸水中MOC-31mRNA的表达，并与常规细胞学诊断进行对比。结果肺癌组胸水中MOC-31mRNA的阳性表达率为91．9％（68／74），肺良性疾病组胸水中MOC-31mRNA的阳性表达率为10．0％（4／40），差异有统计学意义（Χ^2=74．83，P〈0．01）：肺癌组胸水中MOC-31mRNA的表达与病理分型无关（P〉0．05）；MOC-31mRNA的检测对恶性胸水诊断的敏感度和准确度均明显高于常规细胞学检查（P〈0．01），但两种诊断方法的特异度差异却无统计学意义（P〉0．05）。结论MOC-31mRNA可作为检测肺癌患者胸膜微转移的分子标志物，是判断肺癌患者胸水中是否存在脱落癌细胞和肺癌临床分期的辅助参考指标。     

间皮细胞检查对良、恶性胸水的诊断价值

目的　为了探讨胸腔积液中的间皮细胞含量的改变对良、恶性胸水的鉴别诊断价值。方法　用定量的胸水沉渣涂片法对 5 0例结核性胸腔积液和 30例恶性胸腔积液的胸水进行间皮细胞含量的测定。结果　两者的间皮细胞含量存在显著差异 (P <0 .0 1)。结论　提示胸水中的间皮细胞含量的改变 ,对良、恶性胸腔积液的鉴别诊断有重要意义。     

54例恶性胸水发病与细胞学诊断的分析

 本文收集了珠海地区最近七年内总共54例恶性胸水病例。从本地区恶性胸水发病趋势以及形态学观察得出结论：1.本地阳性胸水高发组在50～79岁（>85%）;2.特高发组（60～69岁）中存在着显着的性别上的差异，男女之比为1:10.女性占有绝对的性别优势；3.54例阳性胸水中腺癌占90.7%（49例）,鳞癌占5.6%（3例）,未分化癌占3.7%（2例）;4.阳性胸水中不但见到癌细胞脱落，还可以观察到癌组织的脱落，后者仅见于腺癌一类中，甚而可以见到正常胸膜组织脱落；5.对高分化小细胞性腺癌中粘液性印戒细胞癌应与间皮细胞增生时印戒样变鉴别诊断；6.对血性或非血性胸水沉渣作组织切片应列为常规诊断，方法学上的对比研究可以互补不足，尤其在追踪不典型高分化腺癌，间皮细胞不典型增生等鉴别诊断与确诊上，有实质性的意义。     

CAL，VIM，CEA，EMA在胸（腹）水癌细胞诊断中应用

目的：探讨胸（腹）水疑难病例的病理诊断。方法：采用免疫细胞化学方法，分析130个病例。以诊断为癌的31例和仅有间皮细胞的30例为研究样本，相互对照，找出规律，再以此规律分析诊断为异型间皮细胞／可疑癌细胞的69例，鉴别出癌细胞和间皮细胞。结果：30 间皮细胞组CAL28例（＋）（93.33%)，VIM27例（＋）（90.00%)，而CEA无1例阳性（0），EMA2例（＋）（6.67%)。31例癌细胞 组，CAL5例（＋）（16.13%)，VIM7例（＋）（22.58%)，CEA29例（＋）（93.55%)，EMA26例（＋）（83.89%)。经X^2检测P＜0.01有显著差异。结合临床情况，CAL或CAL＋VIM阳性为间皮源细胞；CEA或EMA阳性为皮皮源性细胞。69例异型间皮细胞／可疑癌细胞组4种抗体标记后，56例可确定其中的细胞是否为癌细胞，另有7例，结果HE涂片及临床资料，也能诊断。诊断率达81.16%-91.30%。结论：ICC技术是解决胸（腹）水疑难病例病理诊断的重要手段。依据形态学确定“异型间皮细胞”不妥，提介ICC标记；CAL＋CEA或CAL＋VIM＋CEA＋EMA的联合应用，对癌细胞与间皮细胞的鉴别有重要意义。     

胸腔积液脱落细胞免疫组化染色对肿瘤来源鉴别诊断价值的探讨

目的:评估波形蛋白(VIM)、神经特异度钙结合蛋白(CR)、间皮细胞(MC),细胞角蛋白7(CK7)和甲状腺转录因子-1(TTF-1)免疫组化染色在转移性肺腺癌和恶性间皮瘤鉴别诊断中的价值.方法:收集经病理学确诊的恶性胸腔积液患者82例,选取其中的胸膜转移性肺腺癌和恶性胸膜间皮瘤患者纳入分析.评估TTF-1、CK7、Vimentin、MC和Calretinin 5项指标对胸膜转移性肺腺癌和恶性胸膜间皮瘤的诊断灵敏度和特异度.结果:VIM(x2 =4.99,P=0.014)、CR(x2 =23.74,P=0.01)和MC(x2 =13.08,P=0.001)的表达在恶性胸膜间皮瘤的表达高于胸膜转移性肺腺癌.而TTF-1(x2 =21.67,P＜0.01)和CK7(x2 =18.12,P＜0.01)在胸膜转移性肺腺癌表达高于恶性胸膜间皮瘤.对于恶性间皮瘤的诊断,VIM的灵敏度为72.7％(8/11),特异度为64.4％ (29/45);CR的灵敏度为90.9％ (10/11),特异度为84.4％(38/45);MC的灵敏度为72.7％ (8/11),特异度为82.2％ (37/45).对于胸膜转移性肺腺癌的诊断,CK7的灵敏度为95.6％ (43/45),特异度为54.5％ (6/11);TTF-1的灵敏度为82.2％(37/45),特异度为90.9％(10/11).结论:胸腔积液脱落细胞的TTF-1、CK7、Vimentin、MC和Calretinin免疫组化染色对恶性胸膜间皮瘤和胸膜转移性肺腺癌的鉴别具有较高价值.     

检测痰脱落细胞p16基因甲基化对周围型肺癌的诊断价值

目的　探讨检测痰脱落细胞p16基因甲基化对周围型肺癌的诊断价值。方法　应用甲基化特异性PCR(methylation specificPCR ,MSP)对 5 0例周围型肺结节患者及 2 0例正常人痰脱落细胞p16基因甲基化改变进行检测 ,将检测结果与术后病理报告相对照。结果　周围型肺癌痰脱落细胞 p16MSP阳性率( 2 7/ 44 ,61.4%)明显高于良性周围型肺结节 ( 1/ 6,16.7%)及正常人 ( 3 / 2 0 ,15 .0 %) ( χ2 值分别为 4.2 81和11.869,P <0 .0 5 ) ,良性周围型肺结节 p16MSP阳性率与正常人无显著性差异 ( χ2 =0 .13 6,P >0 .0 5 )。鳞癌和腺癌患者痰脱落细胞 p16MSP阳性率无显著性差异 ( χ2 =3 .416,P >0 .0 5 )。如果以痰脱落细胞 p16MSP阳性作为判断肺结节恶性的标准 ,其诊断周围型肺癌的阳性预测值为 96.4%,阴性预测值 2 2 .7%,灵敏度 61.4%,特异度 83 .0 %。结论　检测痰脱落细胞 p16基因甲基化对周围型肺癌具有辅助诊断价值     

Use of the monoclonal antibody MOC-31 as an immunomarker for detecting metastatic adenocarcinoma in effusion cytology

BACKGROUND:

MOC‐31 is an established immunologic marker with which to detect adenocarcinomas. The objective of the current study was to evaluate the use of MOC‐31 in the diagnosis of metastatic adenocarcinoma in effusion specimens.

METHODS:

The authors evaluated cytologic specimens of effusions/washings in which MOC‐31 immunostaining was performed on unstained cell block sections or Papanicolaou‐stained cytospin preparations. Membranous staining with or without cytoplasmic staining was considered to be positive. The immunostaining results were correlated with the cytologic diagnoses and clinical follow‐up data.

RESULTS:

A total of 215 effusions and washings were identified (cell blocks in 162 cases, cytospin preparations in 53 cases, and both in 2 cases in which MOC‐31 immunostaining was performed). A total of 94 (44%) of the 215 cases were found to be positive for malignancy, including 87 metastatic adenocarcinomas. Specimens were positive for MOC‐31 in 76 (87%; 55 cell blocks and 21 cytospin preparations) of 87 cases of metastatic adenocarcinoma. Eleven cases of metastatic adenocarcinoma were found to be negative for MOC‐31 (4 cases from lung tumors, 2 from stomach tumors, 2 from colon tumors, 2 from breast tumors, and 1 from a renal tumor). Minimal and/or focal cytoplasmic staining for MOC‐31 was noted in 13% of cases of reactive mesothelial cells/mesothelioma. The sensitivity of MOC‐31 for metastatic adenocarcinoma was 89%, the specificity was 100%, the negative predictive value was 92%, and the positive predictive value was 100%.

CONCLUSIONS:

MOC‐31 alone was found to be highly sensitive for distinguishing reactive mesothelial cells/mesothelioma from metastatic adenocarcinoma in effusion specimens. Interpreting membranous MOC‐31 staining as positive can help prevent confusion between reactive mesothelial cells/mesothelioma and metastatic adenocarcinoma. Cancer (Cancer Cytopathol) 2011;. © 2011 American Cancer Society     

Utility of anti-L523S antibody in the diagnosis of benign and malignant serous effusions

BACKGROUND: Immunohistochemistry is helpful in distinguishing metastatic carcinoma from atypical mesothelial cells; however, it is not useful in differentiating atypical mesothelial cells from malignant mesothelial cells. K homolog domain containing protein overexpressed in cancer (KOC), a member of the insulin-like growth factor mRNA-binding protein (IMP) family, also known as L523S and IMP3, is expressed during embryogenesis and in various malignancies. Using a mouse monoclonal antibody (L523S) against KOC, KOC expression was investigated in malignant tumors and reactive mesothelial cells in serous effusions. METHODS: Seventy-six cases with paraffin-embedded pleural, pericardial, and peritoneal serous effusion cell blocks including 60 malignant serous effusions (11 malignant pleural mesotheliomas and 49 metastatic carcinomas) and benign pleural effusions (14 cases with reactive mesothelial cells and 2 cases with atypical cells with uncertain significance) were selected for immunohistochemical analysis with L523S, calretinin, and CK5/6. RESULTS: Immunohistochemical studies showed that positive staining for KOC of variable degrees of intensity was observed in 47 of 60 cases in malignant serous effusions including 10 of 11 mesotheliomas and 36 of 49 metastatic carcinomas. The associated reactive mesothelial cells were negative for KOC but positive for calretinin and CK5/6. All 11 malignant mesotheliomas exhibited positivity for calretinin, and 9 of 11 cases had CK5/6 staining. In addition, 16 cases that were originally diagnosed either as pleural effusions with reactive mesothelial cells (14) or atypical cells with uncertain significance (2) were also tested for KOC expression. Interestingly, 3 of 16 cases exhibited various degrees of positivity for KOC, 2 of which were diagnosed as lung adenocarcinoma with a recurrence after tumor resection and 1 as malignant pleural mesothelioma. CONCLUSIONS: Anti-L523S antibody is a useful marker for the detection of malignant cells in serous effusions and it can have significant utility in differentiating reactive mesothelial cells from malignant mesothelioma and metastatic carcinoma in combination with calretinin and CK5/6 staining.     

Utility of anti‐L523S antibody in the diagnosis of benign and malignant serous effusions

BACKGROUND.

Immunohistochemistry is helpful in distinguishing metastatic carcinoma from atypical mesothelial cells; however, it is not useful in differentiating atypical mesothelial cells from malignant mesothelial cells. K homolog domain containing protein overexpressed in cancer (KOC), a member of the insulin‐like growth factor mRNA‐binding protein (IMP) family, also known as L523S and IMP3, is expressed during embryogenesis and in various malignancies. Using a mouse monoclonal antibody (L523S) against KOC, KOC expression was investigated in malignant tumors and reactive mesothelial cells in serous effusions.

METHODS.

Seventy‐six cases with paraffin‐embedded pleural, pericardial, and peritoneal serous effusion cell blocks including 60 malignant serous effusions (11 malignant pleural mesotheliomas and 49 metastatic carcinomas) and benign pleural effusions (14 cases with reactive mesothelial cells and 2 cases with atypical cells with uncertain significance) were selected for immunohistochemical analysis with L523S, calretinin, and CK5/6.

RESULTS.

Immunohistochemical studies showed that positive staining for KOC of variable degrees of intensity was observed in 47 of 60 cases in malignant serous effusions including 10 of 11 mesotheliomas and 36 of 49 metastatic carcinomas. The associated reactive mesothelial cells were negative for KOC but positive for calretinin and CK5/6. All 11 malignant mesotheliomas exhibited positivity for calretinin, and 9 of 11 cases had CK5/6 staining. In addition, 16 cases that were originally diagnosed either as pleural effusions with reactive mesothelial cells (14) or atypical cells with uncertain significance (2) were also tested for KOC expression. Interestingly, 3 of 16 cases exhibited various degrees of positivity for KOC, 2 of which were diagnosed as lung adenocarcinoma with a recurrence after tumor resection and 1 as malignant pleural mesothelioma.

CONCLUSIONS.

Anti‐L523S antibody is a useful marker for the detection of malignant cells in serous effusions and it can have significant utility in differentiating reactive mesothelial cells from malignant mesothelioma and metastatic carcinoma in combination with calretinin and CK5/6 staining. Cancer (Cancer Cytopathol) 2008. © 2007 American Cancer Society.     

胸腹水细胞块的免疫细胞化学研究

[目的]行多项胸腹水细胞块的免疫细胞化学检测,探索一组鉴别良恶性及肿瘤起源的有价值的常规一抗试剂组.[方法]收集胸腹水标本制成细胞块,HE染色筛检出间皮细胞反应性增生及可疑恶性或查见恶性细胞的病例59例.免疫细胞化学方法采用SP法,一抗用HBME-1、钙网膜蛋白(CR)、E-cad、CD44、CK7、CK20,腹水加做CA19-9(女性加做CA125),胸水加做TTF-1.[结果]HBME-1在间皮瘤中表达57.1%(4/7)、转移腺癌中表达51.1%(23/45);钙网膜蛋白在间皮瘤中表达100%、腺癌中未表达;E-cad( )见于96.4%(53/55)恶性肿瘤;CD44( )见于反应性增生及恶性间皮瘤;TTF-1在肺癌中表达80.6%(25/31)、非肺源性未见表达;CK7( )在转移腺癌中表达86.7%(39/45),无特异性;CK20( )在肠癌中表达100%,CK7(-)/CK20( )具肠源性特异性;CA19-9在胃肠癌中表达100%,间皮瘤中亦表达2/7;CA125在卵巢癌表达75.0%(3/4),特异性100%.[结论]E-cad鉴别良恶性胸腹水;CR鉴别是否间皮起源、TTF-1鉴别肺源性、CK7/CK20鉴别肠源性转移癌具有特异性及敏感性特点,它们可作为常规一抗鉴别良恶性及肿瘤起源.CA125鉴别卵巢癌具有相同特点,可作为女性患者腹水常规一抗.     

Utility of paired box gene 8 (PAX8) expression in fluid and fine‐needle aspiration cytology

BACKGROUND:

Metastases from ovarian neoplasms are commonly encountered in peritoneal fluids. In addition, reactive mesothelial cells in effusion specimens can mimic ovarian serous carcinoma, making the diagnosis difficult. Calretinin has been recognized as a reliable immunohistochemical marker for mesothelial cells, whereas WT1 has proven useful in the diagnosis of ovarian serous carcinoma. This can present a diagnostic pitfall in effusion cytology, because mesothelial cells can demonstrate immunoreactivity for WT1. Recently, paired box gene 8 (PAX8) has been used in distinguishing ovarian from mammary carcinoma. To the authors' knowledge, no studies using PAX8 have been performed on peritoneal cytology specimens to date, and its expression in metastatic ovarian serous carcinoma has not been studied.

METHODS:

These markers, along with BerEP4 and MOC‐31, were evaluated in cytology cell block preparations from 30 fluid cytology specimens and 11 fine‐needle aspiration specimens.

RESULTS:

PAX8 was found to be positive in 37 of 41 (90%) ovarian carcinoma cases studied, and was a sensitive (90%) and specific (100%) marker for the detection of metastatic ovarian carcinoma. In addition, calretinin was found to be useful for identifying mesothelial cells in fluid cytology. Furthermore, although PAX8 and WT1 have demonstrated comparable sensitivity (90% and 93%, respectively) in diagnosing metastatic ovarian carcinoma, PAX8 appears to have superior specificity because staining is not observed in mesothelial cells. BerEP4 and MOC‐31 were found to have a lower sensitivity and specificity compared with PAX8.

CONCLUSIONS:

PAX8‐positive, calretinin‐negative staining appears to be highly specific and sensitive for detecting metastatic ovarian serous carcinoma in cytologic preparations and can be useful in distinguishing it from mesothelial cells in fluid cytology. Cancer (Cancer Cytopathol) 2010. © 2010 American Cancer Society.     

Stimulatory effects of pleural fluids from mesothelioma patients on CD44 expression,hyaluronan production and cell proliferation in primary cultures of normal mesothelial and transformed cells

Cell lines established from human malignant mesotheliomas, but not from normal mesothelial cells, have been shown possess hyaluronan receptors, and to secrete factors that stimulate hyaluronan production by fibroblasts and normal mesothelial cells. In the present study we investigated the generality of this observation, namely the presence of hyaluro nan receptors and factors which induce stimulation of hyaluronan synthesis in primary mesothelioma and mesothelial cell cultures. Functionally active hyaluronan-binding sites on the surface of malignant mesothelioma cells in primary cultures, established from pleural effusions of 3 different patients, were demonstrated using 3H-hyaluronan. Primary cultures of normal mesothelial cells from non-mesothelioma effusions did not exhibit any binding ability. Pleural fluids from mesothelioma patients both stimulated hyaluronan synthesis and promoted proliferation of normal mesothelial cells to a larger extent than non-mesothelioma fluids. The hyaluronan-stimulatory activity was only slightly neutralized by antibodies against PDGF-BB TGF-8; antibodies against bFGF had no effect. Although the concentration of hyaluronan was much higher in pleural fluids from mesothelioma than from non-mesothelioma patients, molecular weight was almost the same. The hyaluronan-binding capacity of early-passage mesothelioma cells derived from pleural effusions can be an additional marker, in combination with other diagnostic tools, to distinguish between mesothelioma and mesothelial cells.     

Calretinin staining pattern aids in the differentiation of mesothelioma from adenocarcinoma in serous effusions

BACKGROUND: The differentiation between malignant mesothelioma and adenocarcinoma based on morphology alone can be a diagnostic challenge. The majority of the available antibodies recognize molecules expressed by adenocarcinoma whereas to the authors' knowledge specific markers for mesothelial cells are lacking. Calretinin, a calcium-binding protein, has been reported to be a selective marker for mesothelioma and largely is absent from adenocarcinoma on histologic material. The results with cytologic preparations have been inconsistent. METHODS: To evaluate the specificity of calretinin in differentiating mesothelioma from adenocarcinoma in cytologic preparations, 21 paraffin embedded cells blocks of serous effusions from 15 patients with metastatic adenocarcinoma and 16 cell blocks from 9 patients with malignant mesothelioma were stained with a monoclonal antibody against calretinin. The immunoreactivity was evaluated blindly by two observers. Positive staining was defined as nuclear and cytoplasmic staining with or without intense membranous decoration. The former resulted in a characteristic "fried egg" appearance. RESULTS: Calretinin staining was positive in all but 2 cases of mesothelioma (14 of 16 cases; 87.5%). The latter contained predominantly spindle-shaped neoplastic mesothelial cells in the cell block preparations. All adenocarcinoma specimens were classified as negative for calretinin staining; 9 (42.9%) lacked any immunoreactivity and 12 (57.1%) showed weak, sparse, coarse, granular cytoplasmic staining without nuclear or membranous staining. Benign reactive mesothelial cells, when observed in association with adenocarcinoma, also showed the characteristic "fried egg" appearance. The difference in the staining pattern of calretinin between cells of mesothelial origin and adenocarcinoma cells was statistically significant. CONCLUSIONS: Calretinin is a useful marker in differentiating mesothelioma of the epithelial type from adenocarcinoma in serous effusions. The "fried-egg" appearance or cytoplasmic and nuclear staining pattern is characteristic of cells of mesothelial origin.     

Tnp-alpha determination in serum and pleural effusion in patients with lung-cancer

The relationship between Tumor Necrosis Factor-alpha (TNF-alpha) in the serum and pleural fluid of lung cancer patients and the extent and the histological cell type was studied. TNF-(a)lpha level was determined in the serum of 68 patients with lung cancer [51 non-small cell lung cancer (NSCLC) and 17 small cell lung cancer (SCLC)] and in pleural fluid of 30 patients with lung cancer (22 NSCLC, 11 of them positive for neoplastic cells and 8 SCLC, 7 of them positive). Sera of 31 healthy subjects and the pleural fluid of 15 non-malignant pleural effusions were tested as controls. TNF-alpha serum level was increased in patients with lung cancer (healthy subjects 7.8+/-3.3 pg/ml; lung cancer 16.2+/-9.1 pg/ml), in NSCLC as well as SCLC and a relationship with the extent of the disease was found in both the histological types. In pleural fluid, no differences of TNF-alpha level were observed between neoplastic and benign inflammatory effusion, between SCLC and NSCLC or between cases positive and negative for the presence of neoplastic cells. Serum TNF-alpha may be an indicator of tumour burden; conversely, TNF-alpha in pleural fluid, was unable to discriminate between neoplastic and benign effusion.     

Verification of the histologic diagnosis of malignant mesothelioma in relation to the binding of an antimesothelial cell antibody

The diagnostic value of a recently developed polyclonal antibody to mesothelial cells has been tested by means of an immunoperoxidase technique to differentiate mesothelioma from lung carcinoma. All 16 unequivocal mesotheliomas reacted with the antibody, whereas none of the 31 lung carcinomas did, thus confirming the high specificity and the high sensitivity of the antibody. Furthermore, 20 cases of serous membranes tumor, in which major diagnostic disagreement was present when reviewed by the members of the Commission of the European Communities Mesothelioma Panel, were examined. Sixteen of the 20 cases were immunoreactive to the antimesothelial cell antibody, thus establishing their mesothelial origin. Given conventionally fixed and processed tissues, it appears that this antibody may be used as an appropriate diagnostic adjunct to increase the accuracy of the diagnosis of mesothelioma.