Mezotelyoma ve akciğer adenokarsinomunun ayırıcı tanısında immünohistokimyasal belirteçlerden calretinin, D2-40, p63 ve tiroid transkripsiyon faktör-1'in rolü

Yıl 2023, Cilt: 9 Sayı: 2, 125 - 132, 30.08.2023

Mehmet Mustafa Erdoğan , Songül Yerlikaya Kavak

https://doi.org/10.30569/adiyamansaglik.1225533

Öz

Amaç: Mezotelyoma ile akciğer adenokarsinomunun ayırıcı tanısında morfolojik bulgular yetersizdir. İmmünohistokimyasal inceleme en iyi yardımcı yöntemdir. Çalışmada mezotelyoma ile akciğer adenokarsinomunun ayırıcı tanısında uygun belirteçlerin belirlenmesi amaçlanmıştır.
Gereç ve Yöntem: Bu çalışmada hastanemizde tanı almış akciğer adenokarsinomu ile mezotelyoma olgularına ait patoloji arşivi incelenerek bu olgularda ayırıcı tanıya giderken kullanılan calretinin, D2-40, p63 ve tiroid transkripsiyon faktör-1 (TTF-1) immünhistokimyasal belirteçleri değerlendirilmiştir.
Bulgular: Elde edilen bulgulara göre, 45 mezotelyoma olgusunun 43’ünde D2-40 belirteç pozitifliği, 44’ünde calretinin belirteç pozitifliği, 45 akciğer adenokarsinom olgusunun ise tamamında TTF-1 belirteç pozitifliği bulundu.
Sonuç: Mezotelyoma açısından calretinin ve D2-40 belirteçlerinin, akciğer adenokarsinomu açısından ise TTF-1 immünhistokimyasal belirteçlerinin olgularda yüksek oranda doğru tanı sağladığını tespit ettik.

Anahtar Kelimeler

Akciğer adenokarsinom, Mezotelyoma, D2-40, Calretinin, TTF-1

The role of immunohistochemical antibodies calretinin, D2-40, p63 and thyroid transcription factor-1 in the differential diagnosis of mesothelioma and lung adenocarcinoma

Öz

Aim: Morphological findings are insufficient in the differential diagnosis of mesothelioma and lung adenocarcinoma. Immunohistochemical examination is the best auxiliary method. In this study, it was aimed to determine the appropriate antibodies in the differential diagnosis of mesothelioma and lung adenocarcinoma.
Materials and Methods: In this study, the pathology archive of lung adenocarcinoma and mesothelioma cases diagnosed in our hospital was examined, and the immunohistochemical markers of calretinin, D2-40, p63 and thyroid transcription factor-1 (TTF-1), which were used for differential diagnosis in these cases, were evaluated.
Results: According to the findings obtained, 43 of 45 mesothelioma cases had D2-40 antibody positivity, 44 cases had calretinin antibody positivity, and 45 lung adenocarcinoma cases had antibody positivity. TTF-1 antibody positivity was found in all of them.
Conclusion: We found that calretinin and D2-40 markers for mesothelioma and TTF-1 immunohistochemical markers for lung adenocarcinoma provided a high rate of accurate diagnosis in cases.

Anahtar Kelimeler

Lung adenocarcinoma, Mesothelioma, D2-40, Calretinin, TTF-1

Kaynakça

• Haber SE, Haber JM. Malignant mesothelioma: a clinical study of 238 cases. Industrial health. 2011;49(2):166-72.
• Kabul S. Primer akciğer adenokarsinomlari ile plevra yerleşimli epiteloid tip malign mezotelyomalarin ayirici tanisinda napsin A, caveolin-1, tip III kollajen ve tenascin-x immünohistokimyasal antikorlarin rolü. [Uzmanlık tezi]. Bursa, Türkiye: Uludag Universitesi; 2015.
• Sternberg SS, Mills SE, Carter D. Sternberg's diagnostic surgical pathology. vol 1. Lippincott Williams & Wilkins; 2004.
• Kaplan S. Determining the position of CEA, HBME-1 and thrombomodülin markers in the differential diagnosis of malign mesothelioma and lung adenocarcinoma. [Uzmanlık tezi]. Elazig, Türkiye: Fırat Universitesi; 2005.
• Akyildiz EÜ, Öz B, Aki H, Demirkaya A. Plevral Epiteloid Malign Mezotelyoma ile Adenokarsinom Ayirici Tanisinda Immünhistokimya; Bir Panel Önerisi. Turk Toraks Dergisi. 2010;11(4):144.
• Aydiner F, Yerci Ö. Differential Diagnosis of Malignant Mesothelioma Versus Primary Pulmonary Adenocarcinoma: An Immunohistoc-Hemical Analysis. Turk Patoloji Derg 2004;20(3-4):60-5.
• King J, Hasleton P. Immunohistochemistry and the diagnosis of malignant mesothelioma. Histopathology. 2001;38(5):471-6.
• Rogers JH. Calretinin: a gene for a novel calcium-binding protein expressed principally in neurons. J Cell Biol. 1987;105(3):1343-53.
• Doglioni C, Dei AP, Laurino L, et al. Calretinin: a novel immunocytochemical marker for mesothelioma. Am J Surg Path. 1996;20(9):1037-46.
• Fetsch PA, Abati A. Immunocytochemistry in effusion cytology: a contemporary review. Cancer. 2001;93(5):293-308.
• Leers M, Aarts M, Theunissen P. E-cadherin and calretinin: a useful combination of immunochemical markers for differentiation between mesothelioma and metastatic adenocarcinoma. Histopathology. 1998;32(3):209-16.
• Dei Tos AP, Doglionit C. Calretinin: a novel tool for diagnostic immunohistochemistry. Adv Anat Pathol. 1998;5(1):61.
• Deniz H, Kibar Y, Güldür ME, Bakır K. Is D2-40 a useful marker for distinguishing malignant mesothelioma from pulmonary adenocarcinoma and benign mesothelial proliferations? Pathol Res Pract. 2009;205(11):749-52.
• Bhalla R, Siddiqui MT, Mandich D, et al. Diagnostic utility of D2‐40 and podoplanin in effusion cell blocks. Diagn Cytopathol. 2007;35(6):342-7.
• Saad RS, Lindner JL, Lin X, Liu YL, Silverman JF. The diagnostic utility of D2‐40 for malignant mesothelioma versus pulmonary carcinoma with pleural involvement. Diagn Cytopathol. 2006;34(12):801-6.
• Karadeniz C. Küçük Hücre Dışı Akciğer Karsinomu Tanısı Alan Hastalarda Patolojik Alt Grup Analizi ve Sağkalım Üzerine Olan Etkileri. Yandal Uzmanlık Tezi. Ankara, Türkiye: Başkent Üniversitesi; 2013.
• Barletta JA, Perner S, Iafrate AJ, et al. Clinical significance of TTF‐1 protein expression and TTF‐1 gene amplification in lung adenocarcinoma. J Cell Mol Med. 2009;13(8b):1977-86.
• Zhao Q, Xu S, Liu J, et al. Thyroid transcription factor-1 expression is significantly associated with mutations in exon 21 of the epidermal growth factor receptor gene in Chinese patients with lung adenocarcinoma. Onco Targets Ther. 2015;8:2469.
• Mutlu S. Seröz Effüzyonlarda Malign Mezotelyoma, Reaktif Mezotel Hücreleri ve Adenokarsinoma Ayırımında Calretinin, Glut-1 ve E-Cadherin Ekspresyonunun Değeri. [Yüksek lisans tezi]. İstanbul, Türkiye: İstanbul Üniversitesi; 2010.
• World Health Organization Classification of Tumours. Thoracic Tumours. 5th Edition. Volume 5. 2021:202-4.
• Kushitani K, Takeshima Y, Amatya VJ, Furonaka O, Sakatani A, Inai K. Immunohistochemical marker panels for distinguishing between epithelioid mesothelioma and lung adenocarcinoma. Pathol Int. 2007;57(4):190-9.
• Wick MR. Immunophenotyping of malignant mesothelioma. Am J Surg Pathol. 1997;21(12):1395-8.
• Ozardalı Hİ, Yildiz F, Terzi A, ve ark. Kolon Adenokarsinomlarında D2-40 İmmünreaktivitesi. Duzce Medical Journal. 13(2):1-5.
• Seyhan EC, Çetinkaya E, Altın S, Ürer N, Timur S. Akciğer adenokarsinomu ve malign mezotelyoma ayırıcı tanısında immünhistokimyasal analiz. Toraks Dergisi. 2007;8(4):202-6.
• Rogers J, Khan M, Ellis J. Calretinin and other CaBPs in the nervous system. Adv Exp Med Biol. 1990;269:195-203.
• Oates J, Edwards C. HBME-1, MOC-31, WT1 and calretinin: an assessment of recently described markers for mesothelioma and adenocarcinoma. Histopathology. 2000;36(4):341-7.
• Gomaa AH, Yaar M, Bhawan J. Cutaneous immunoreactivity of D2-40 antibody beyond the lymphatics. Am J Dermatopathol. 2007;29(1):18-21.
• Pereira TC, Saad RS, Liu Y, Silverman JF. The diagnosis of malignancy in effusion cytology: a pattern recognition approach. Adv Anat Pathol. 2006;13(4):174-84.
• Pu RT, Pang Y, Michael CW. Utility of WT-1, p63, MOC31, mesothelin, and cytokeratin (K903 and CK5/6) immunostains in differentiating adenocarcinoma, squamous cell carcinoma, and malignant mesothelioma in effusions. Diagn Cytopathol. 2008;36(1): 20-5.
• Travis WD, Brambilla E, Noguchi M, et al. International association for the study of lung cancer/american thoracic society/european respiratory society international multidisciplinary classification of lung adenocarcinoma. J Thorac Oncol. 2011;6(2):244-85.
• Urer N. Patolojik Tanı ve Ayırıcı Tanı da Yaklaşımlar. TTD Plevra Bülteni 2009;3:7-10.
• King J, Thatcher N, Pickering C, Hasleton P. Sensitivity and specificity of immunohistochemical antibodies used to distinguish between benign and malignant pleural disease: a systematic review of published reports. Histopathology. 2006;49(6):561-8.
• Ozbudak İH, Ozbudak Ö, Arslan G, Erdoğan A, Ozbilim G. Metachronous malignant mesothelioma and pulmonary adenocarcinoma. Turk Patoloji Derg. 2013;1:4.
• Yaziji H, Battifora H, Barry TS, et al. Evaluation of 12 antibodies for distinguishing epithelioid mesothelioma from adenocarcinoma: identification of a three-antibody immunohistochemical panel with maximal sensitivity and specificity. Mod Pathol. 2006;19(4):514-23.
• Marchevsky AM. Application of immunohistochemistry to the diagnosis of malignant mesothelioma. Arch Pathol Lab Med. 2008;132(3):397-401.