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Immunohistochemistry in the diagnosis of malignant pleural mesothelioma: Trends in A ustralia and a literature review
Author(s) -
Linton Anthony,
Kao Steven,
Vardy Janette,
Clarke Stephen,
Zandwijk Nico,
Klebe Sonja
Publication year - 2013
Publication title -
asia‐pacific journal of clinical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.73
H-Index - 29
eISSN - 1743-7563
pISSN - 1743-7555
DOI - 10.1111/ajco.12043
Subject(s) - mesothelioma , medicine , immunohistochemistry , extrapleural pneumonectomy , context (archaeology) , pathology , surgical pathology , decortication , pathological , pneumonectomy , lung cancer , biology , paleontology
Aims The accurate diagnosis of malignant pleural mesothelioma ( MPM ) is essential for therapeutic and legal reasons. In 2006 the I nternational M esothelioma P anel advocated the use of a panel, including two mesothelial and two non‐mesothelial immunohistochemical ( IHC ) markers. We assessed the changing use of IHC for the diagnosis of MPM in A ustralia over two decades in the context of current best practice. Methods Patients with a confirmed clinico‐pathological diagnosis of MPM who underwent extrapleural pneumonectomy or pleurectomy and/or decortication between 1988 and 2006 were identified from the cardiothoracic database at R oyal P rince A lfred H ospital and combined with consecutive patients reviewed by the D ust D iseases B oard between M arch 2007 and M arch 2009. Initial diagnostic pathology reports were reviewed. Results A total of 289 patients were identified. A median of six IHC stains per sample was performed (range 0–18): two (range 0–5) mesothelial markers, two (0–6) carcinoma markers and two epithelial markers. A trend to the higher usage of antibodies in epithelioid tumors versus biphasic and sarcomatoid tumors was noted ( P = 0.148 and 0.389, respectively). Testing increased from a median of three stains per sample (1988–1997) to seven (2006–2009). Labeling specimens with > 2 mesothelial markers and > 2 carcinoma markers increased to 72 and 67 percent, respectively, after 2006. Conclusion Reflecting the acceptance of diagnostic panels and increased availability of antibodies, an increase in the use of IHC stains for MPM diagnosis has occurred over the past two decades although uncertainty persists as to the optimal panel composition.