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Diagnostic utility of BAP 1 and EZH 2 expression in malignant mesothelioma
Author(s) -
ShinozakiUshiku Aya,
Ushiku Tetsuo,
Morita Shigeki,
Anraku Masaki,
Nakajima Jun,
Fukayama Masashi
Publication year - 2017
Publication title -
histopathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.626
H-Index - 124
eISSN - 1365-2559
pISSN - 0309-0167
DOI - 10.1111/his.13123
Subject(s) - mesothelioma , immunohistochemistry , pathology , mesothelial cell , medicine , peritoneal mesothelioma , mesothelium , mesothelin , cancer
Aims Malignant mesothelioma is a highly aggressive cancer that is usually diagnosed at advanced stages; thus, highly sensitive and specific markers are necessary for its early definitive diagnosis. The aim of this study was to evaluate the diagnostic utility and prognostic significance of BAP 1 and EZH 2 in malignant mesothelioma. Methods and results The expression of BAP 1 and EZH 2 was investigated by immunohistochemistry in 32 malignant mesotheliomas and 44 benign mesothelial proliferative lesions, including well‐differentiated papillary mesothelioma ( n = 4), mesothelial inclusion cyst ( n = 22), and reactive mesothelial hyperplasia ( n = 18). BAP 1 loss and high EZH 2 expression were observed in 17 (53%) and 22 (66%) malignant mesothelioma cases, respectively, whereas none of the benign lesions showed BAP 1 loss or high EZH 2 expression. The combination of BAP 1 loss and high EZH 2 expression as markers to differentiate epithelioid/biphasic malignant mesothelioma from benign mesothelial lesions was highly sensitive (90%) and specific (100%). There were no statistically significant associations between parameters such as age and sex of patients, tumour location, asbestos exposure, treatment, histology, and BAP 1 or EZH 2 expression. Survival analysis revealed that BAP 1 loss, but not high EZH 2 expression, was associated with a better prognosis. Conclusions BAP 1 loss and high EZH 2 expression were highly specific to malignant mesothelioma in differentiating it from benign mesothelial proliferations, and the combination of these two markers improved the diagnostic accuracy.