Usefulness of methylthioadenosine phosphorylase and BRCA‐associated protein 1 immunohistochemistry in the diagnosis of malignant mesothelioma in effusion cytology specimens
| Autor: | Simon Cheung, Kyra B. Berg, Sanja Dacic, Andrew Churg |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Mesothelioma
Cancer Research Pathology medicine.medical_specialty Lung Neoplasms Biopsy Malignancy Cytology Biomarkers Tumor medicine Humans Cyclin-Dependent Kinase Inhibitor p16 In Situ Hybridization Fluorescence Pleural Cavity medicine.diagnostic_test business.industry Tumor Suppressor Proteins Mesothelioma Malignant medicine.disease Immunohistochemistry Pleural Effusion Malignant Staining Purine-Nucleoside Phosphorylase Oncology Effusion Differential diagnosis business Ubiquitin Thiolesterase Gene Deletion Fluorescence in situ hybridization |
| Zdroj: | Cancer Cytopathology. 128:126-132 |
| ISSN: | 1934-6638 1934-662X |
| Popis: | Background The separation of benign from malignant mesothelial proliferations on effusion cytology can be difficult. Loss of methylthioadenosine phosphorylase (MTAP) by immunohistochemistry is an established marker of malignancy in mesothelial proliferations, but to the authors' knowledge largely has been applied only to biopsies. The current study was conducted to determine the usefulness of MTAP immunohistochemistry in the diagnosis of malignant mesothelioma in effusion cytology specimens. Methods A total of 21 effusion cytology cases of malignant mesothelioma were stained for MTAP and BRCA-associated protein 1 (BAP1), with 15 reactive mesothelial cytology cases used as a control. Fourteen cases had a paired surgical specimen for comparison, and 7 cases were run for CDKN2A deletion by fluorescence in situ hybridization. Results Complete loss of MTAP cytoplasmic staining was noted in 7 of 21 effusion samples (33%), and no loss was observed in 11 effusion samples (52%); 11 of these cases had a matching surgical specimen and all 11 specimens demonstrated the same MTAP pattern. Partial loss was observed in 3 effusion specimens (80%, 40%, and 40% intact staining, respectively), but in all 3 the surgical specimen demonstrated 100% staining. None of the 15 reactive mesothelial cytology specimens demonstrated MTAP cytoplasmic loss. CDKN2A FISH demonstrated concordance in 5 of 7 cases (71%). MTAP immunohistochemistry had a sensitivity of 33% and a specificity of 100% for this differential diagnosis. Conclusions MTAP staining demonstrated generally good concordance between the cytologic and surgical specimens and appears to be useful in the diagnosis of mesothelioma on effusion specimens. Complete loss of MTAP is a reliable marker of malignancy, but the significance of partial loss of MTAP staining is unclear. |
| Databáze: | OpenAIRE |
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