Research Article

The Role of Napsin A, Caveolin-1, Type III Collagen and Tenascin-X Immunohistochemical Markers in the Differential Diagnosis of Primary Lung Adenocarcinomas and Pleural Epithelioid Mesotheliomas

Volume: 52 June 18, 2026
TR EN

The Role of Napsin A, Caveolin-1, Type III Collagen and Tenascin-X Immunohistochemical Markers in the Differential Diagnosis of Primary Lung Adenocarcinomas and Pleural Epithelioid Mesotheliomas

Abstract

The differential diagnosis between pleural epithelioid mesothelioma and peripheral lung adenocarcinoma remains a significant diagnostic challenge for pathologists. This study aimed to evaluate the diagnostic efficacy of a multi-antibody immunohistochemical (IHC) panel comprising Napsin A, Caveolin-1, Type III Collagen, and Tenascin-X. While Napsin A and Caveolin-1 are established markers, the diagnostic utility of Tenascin-X and Type III Collagen remains less explored in the current literature. A retrospective IHC analysis was performed on 70 paraffin-embedded tissue blocks, comprising 35 lung adenocarcinomas and 35 epithelioid mesotheliomas, diagnosed between 2005 and 2014. The expression patterns of Napsin A, Caveolin-1, Type III Collagen, and Tenascin-X were evaluated and compared between the two groups. Napsin A showed high sensitivity for adenocarcinoma (94.3%) with minimal expression in mesothelioma (2.9%). Conversely, Caveolin-1 and Tenascin-X emerged as strong markers for mesothelioma, with positivity rates of 97.2% and 88.6%, respectively (p < 0.001). Although Type III Collagen was exclusively expressed in mesothelioma (17.1%) and absent in all adenocarcinoma cases, its low sensitivity limits its standalone utility. Significant statistical differences were observed between the two tumor types for all markers evaluated. Our findings suggest that a panel including Napsin A, Caveolin-1, and Tenascin-X significantly aids in the differential diagnosis of lung adenocarcinoma and epithelioid mesothelioma. While Tenascin-X provides valuable supplementary data, the clinical application of Type III Collagen is constrained by its low sensitivity. Integrating these markers into diagnostic protocols can enhance diagnostic accuracy, though further validation in larger cohorts is recommended.

Keywords

References

  1. 1.Siegel RL, Giaquinto AN, Jemal A. Cancer statistics, 2024. CACancer J Clin. 2024;74(1):12-49.
  2. 2.WHO Classification of Tumours Editorial Board. ThoracicTumours. 5th ed. Lyon, France: International Agency forResearch on Cancer; 2021. WHO Classification of Tumours;vol 5.
  3. 3.Le Stang N, Burke L, Blaizot G, et al. Differential diagnosis ofepithelioid malignant mesothelioma with lung and breastpleural metastasis: a systematic review compared with astandardized panel of antibodies-a new proposal that mayinfluence pathologic practice. Arch Pathol Lab Med.2020;144(4):446-456.
  4. 4.Ordóñez NG. Napsin A expression in lung and kidneyneoplasia: a review and update. Adv Anat Pathol.2012;19(1):66-73.
  5. 5.Bishop JA, Sharma R, Illei PB. Napsin A and thyroidtranscription factor-1 expression in carcinomas of the lung,breast, pancreas, colon, kidney, thyroid, and malignantmesothelioma. Hum Pathol. 2010;41(1):20-25.
  6. 6.Anderson RG. The caveolae membrane system. Annu RevBiochem. 1998;67:199-225.
  7. 7.Amatya VJ, Takeshima Y, Kohno H, et al. Caveolin-1 is anovel immunohistochemical marker to differentiate epithelioidmesothelioma from lung adenocarcinoma. Histopathology.2009;55(1):10-19.
  8. 8.Bozdag Z, Tutar E, Dizibuyuk OF, Bakir K. Monoclonalcaveolin 1 expression in the differential diagnosis of malignantpleural mesothelioma and pulmonary adenocarcinoma: is ituseful? Pathol Oncol Res. 2020;26(3):1657-1658.

Details

Primary Language

English

Subjects

Pathology

Journal Section

Research Article

Publication Date

June 18, 2026

Submission Date

February 6, 2026

Acceptance Date

May 5, 2026

Published in Issue

Year 2026 Volume: 52

APA
Kabul, S., Akyıldız, E. Ü., & Bayram, A. (2026). The Role of Napsin A, Caveolin-1, Type III Collagen and Tenascin-X Immunohistochemical Markers in the Differential Diagnosis of Primary Lung Adenocarcinomas and Pleural Epithelioid Mesotheliomas. Journal of Uludağ University Medical Faculty, 52. https://doi.org/10.32708/uutfd.1883265
AMA
1.Kabul S, Akyıldız EÜ, Bayram A. The Role of Napsin A, Caveolin-1, Type III Collagen and Tenascin-X Immunohistochemical Markers in the Differential Diagnosis of Primary Lung Adenocarcinomas and Pleural Epithelioid Mesotheliomas. Journal of Uludağ University Medical Faculty. 2026;52. doi:10.32708/uutfd.1883265
Chicago
Kabul, Selva, Elif Ülker Akyıldız, and Ahmet Bayram. 2026. “The Role of Napsin A, Caveolin-1, Type III Collagen and Tenascin-X Immunohistochemical Markers in the Differential Diagnosis of Primary Lung Adenocarcinomas and Pleural Epithelioid Mesotheliomas”. Journal of Uludağ University Medical Faculty 52 (June). https://doi.org/10.32708/uutfd.1883265.
EndNote
Kabul S, Akyıldız EÜ, Bayram A (June 1, 2026) The Role of Napsin A, Caveolin-1, Type III Collagen and Tenascin-X Immunohistochemical Markers in the Differential Diagnosis of Primary Lung Adenocarcinomas and Pleural Epithelioid Mesotheliomas. Journal of Uludağ University Medical Faculty 52
IEEE
[1]S. Kabul, E. Ü. Akyıldız, and A. Bayram, “The Role of Napsin A, Caveolin-1, Type III Collagen and Tenascin-X Immunohistochemical Markers in the Differential Diagnosis of Primary Lung Adenocarcinomas and Pleural Epithelioid Mesotheliomas”, Journal of Uludağ University Medical Faculty, vol. 52, June 2026, doi: 10.32708/uutfd.1883265.
ISNAD
Kabul, Selva - Akyıldız, Elif Ülker - Bayram, Ahmet. “The Role of Napsin A, Caveolin-1, Type III Collagen and Tenascin-X Immunohistochemical Markers in the Differential Diagnosis of Primary Lung Adenocarcinomas and Pleural Epithelioid Mesotheliomas”. Journal of Uludağ University Medical Faculty 52 (June 1, 2026). https://doi.org/10.32708/uutfd.1883265.
JAMA
1.Kabul S, Akyıldız EÜ, Bayram A. The Role of Napsin A, Caveolin-1, Type III Collagen and Tenascin-X Immunohistochemical Markers in the Differential Diagnosis of Primary Lung Adenocarcinomas and Pleural Epithelioid Mesotheliomas. Journal of Uludağ University Medical Faculty. 2026;52. doi:10.32708/uutfd.1883265.
MLA
Kabul, Selva, et al. “The Role of Napsin A, Caveolin-1, Type III Collagen and Tenascin-X Immunohistochemical Markers in the Differential Diagnosis of Primary Lung Adenocarcinomas and Pleural Epithelioid Mesotheliomas”. Journal of Uludağ University Medical Faculty, vol. 52, June 2026, doi:10.32708/uutfd.1883265.
Vancouver
1.Selva Kabul, Elif Ülker Akyıldız, Ahmet Bayram. The Role of Napsin A, Caveolin-1, Type III Collagen and Tenascin-X Immunohistochemical Markers in the Differential Diagnosis of Primary Lung Adenocarcinomas and Pleural Epithelioid Mesotheliomas. Journal of Uludağ University Medical Faculty. 2026 Jun. 1;52. doi:10.32708/uutfd.1883265

ISSN: 1300-414X, e-ISSN: 2645-9027

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