悪性胸膜中皮腫の基本組織型における中皮腫抗原発現の免疫組織化学的検討

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  • Immunohistochemical Studies of Malignant Pleural Mesothelioma using the Mesothelium-related Antigens.

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Objectives: We examined immunoreactivity for mesothelium-related antigens and cadherin-family antigens in different histological types of malignant mesothelioma of the pleura.<BR>Methods: In 28 cases (19 epithelial type, 5 biphasic type and 4 sarcomatous type) these antibodies were investigated in terms of efficiency of diagnosis of mesothelioma. Controls consisted of 12 cases of pulmonary adenocarcinoma and 5 cases of solitary fibrous tumor. Results: The immunoreactivity rates in mesothelioma for each antigen were as follows: 22 /28 (78.6%) for calretinin, 10/28 (35.7%) for thrombomodulin, 16/28 (57.1%) for vimentin, 28/28 (100%) for CAM 5.2, 26/28 (92.9%) for N-cadherin, 2/28 (7.1%) for E-cadherin and 1/28 (3.6%) for Ber-Ep4. Sixteen cases of the epithelial type were positive for calretinin, and, in particular cases of tubulopapillary pattern were strongly positive. On the other hand, only four cases of the epithelial type were positive for thrombomodulin. All of biphasic and sarcomatous type cases were strongly positive for vimentin, whereas only 7 cases of the epithelial type were positive. In adenocarcinoma, the positivity rate was low for calretinin, thrombomodulin and vimentin, whereas it was high for E-cadherin and Ber-Ep4 a significant difference in the positivity rate for calretinin, thrombomodulin, vimentin., E-cadherin and Ber-Ep4 being clearly observed between adenocarcinoma and mesothelioma. However, both mesothelioma and adenocarcinoma were highly positive for CAM5.2 and N-cadherin, suggesting little diagnostic efficiency. All cases of solitary fibrous tumor were positive for vimentin and two of these cases were weakly positive for calretinin. However, all cases of solitary fibrous tumor were negative for CAM5.2, thrombomodulin and Ber-Ep4.<BR>Conclusion: Our results suggested that not only positive immunoreactivity for calretinin but also negative immunoreactivity for Ber-Ep4 and E-cadherin were important for the diagnosis of malignant mesothelioma.

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  • 肺癌

    肺癌 40 (7), 711-717, 2000

    特定非営利活動法人 日本肺癌学会

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