Value of PAX8, PAX2, claudin-4, and h-caldesmon immunostaining in distinguishing peritoneal epithelioid mesotheliomas from serous carcinomas
Distinguishing between peritoneal epithelioid mesotheliomas and papillary serous carcinomas involving the peritoneum can be difficult on routine histological preparations, but this differential diagnosis can be facilitated by the use of immunohistochemistry. Recent investigations have indicated that...
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| description | Distinguishing between peritoneal epithelioid mesotheliomas and papillary serous carcinomas involving the peritoneum can be difficult on routine histological preparations, but this differential diagnosis can be facilitated by the use of immunohistochemistry. Recent investigations have indicated that PAX8, PAX2, claudin-4, and h-caldesmon are immunohistochemical markers that can assist in distinguishing between these two malignancies; however, much of the information published on the value of these markers is either insufficient or contradictory. The purpose of this study is to resolve some of the existing controversies and to fully determine the practical value of these markers for assisting in the differential diagnosis between peritoneal mesotheliomas and serous carcinomas. In order to do so, a total of 40 peritoneal epithelioid mesotheliomas and 45 serous carcinomas (15 primary, 30 metastatic to the peritoneum) were investigated. PAX8 and PAX2 nuclear positivity was demonstrated in 42 (93%) and 25 (56%) of the serous carcinomas, respectively, whereas none of the mesotheliomas expressed either marker. Forty-four (98%) of the serous carcinomas exhibited claudin-4 reactivity along the cell membrane, whereas none of the mesotheliomas were positive for this marker. All of the serous carcinomas and mesotheliomas were negative for h-caldesmon. Based on these results, it is concluded that PAX8 and claudin-4 have a higher sensitivity and specificity for assisting in discriminating between peritoneal epithelioid mesotheliomas and serous carcinomas when compared with all of the other positive carcinoma markers that are, at present, recommended to be included in the immunohistochemical panels used in this differential diagnosis. Even though it is highly specific, PAX2 has little practical value in the diagnosis of peritoneal epithelioid mesotheliomas as its sensitivity is low. The h-caldesmon is not useful. |
| doi_str_mv | 10.1038/modpathol.2012.200 |
| format | Article |
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Recent investigations have indicated that PAX8, PAX2, claudin-4, and h-caldesmon are immunohistochemical markers that can assist in distinguishing between these two malignancies; however, much of the information published on the value of these markers is either insufficient or contradictory. The purpose of this study is to resolve some of the existing controversies and to fully determine the practical value of these markers for assisting in the differential diagnosis between peritoneal mesotheliomas and serous carcinomas. In order to do so, a total of 40 peritoneal epithelioid mesotheliomas and 45 serous carcinomas (15 primary, 30 metastatic to the peritoneum) were investigated. PAX8 and PAX2 nuclear positivity was demonstrated in 42 (93%) and 25 (56%) of the serous carcinomas, respectively, whereas none of the mesotheliomas expressed either marker. Forty-four (98%) of the serous carcinomas exhibited claudin-4 reactivity along the cell membrane, whereas none of the mesotheliomas were positive for this marker. All of the serous carcinomas and mesotheliomas were negative for h-caldesmon. Based on these results, it is concluded that PAX8 and claudin-4 have a higher sensitivity and specificity for assisting in discriminating between peritoneal epithelioid mesotheliomas and serous carcinomas when compared with all of the other positive carcinoma markers that are, at present, recommended to be included in the immunohistochemical panels used in this differential diagnosis. Even though it is highly specific, PAX2 has little practical value in the diagnosis of peritoneal epithelioid mesotheliomas as its sensitivity is low. The h-caldesmon is not useful.</description><identifier>ISSN: 0893-3952</identifier><identifier>EISSN: 1530-0285</identifier><identifier>DOI: 10.1038/modpathol.2012.200</identifier><identifier>PMID: 23196794</identifier><identifier>CODEN: MODPEO</identifier><language>eng</language><publisher>New York: Elsevier Inc</publisher><subject>631/67/1857 ; 692/699/67 ; 692/700/139 ; Antibodies ; Antigens ; Biomarkers, Tumor - analysis ; Calmodulin-Binding Proteins - analysis ; Cancer ; claudin-4 ; Claudin-4 - analysis ; Cystadenocarcinoma, Serous - diagnosis ; Diagnosis, Differential ; Female ; h-caldesmon ; Humans ; Immunohistochemistry ; Laboratory Medicine ; Male ; Medicine ; Medicine & Public Health ; Mesothelioma ; Mesothelioma - diagnosis ; Metastasis ; original-article ; Paired Box Transcription Factors - analysis ; Pathology ; PAX2 ; PAX2 Transcription Factor - analysis ; PAX8 ; PAX8 Transcription Factor ; peritoneal mesothelioma ; Peritoneal Neoplasms - diagnosis ; Sensitivity and Specificity ; serous carcinoma</subject><ispartof>Modern pathology, 2013-04, Vol.26 (4), p.553-562</ispartof><rights>2013 United States & Canadian Academy of Pathology</rights><rights>United States and Canadian Academy of Pathology, Inc. 2013</rights><rights>Copyright Nature Publishing Group Apr 2013</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c472t-d18e53e0a4e51e4cb7f901a84cb034c81b02aa0117da19bc356a5586aa7e455c3</citedby><cites>FETCH-LOGICAL-c472t-d18e53e0a4e51e4cb7f901a84cb034c81b02aa0117da19bc356a5586aa7e455c3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23196794$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ordóñez, Nelson G</creatorcontrib><title>Value of PAX8, PAX2, claudin-4, and h-caldesmon immunostaining in distinguishing peritoneal epithelioid mesotheliomas from serous carcinomas</title><title>Modern pathology</title><addtitle>Mod Pathol</addtitle><addtitle>Mod Pathol</addtitle><description>Distinguishing between peritoneal epithelioid mesotheliomas and papillary serous carcinomas involving the peritoneum can be difficult on routine histological preparations, but this differential diagnosis can be facilitated by the use of immunohistochemistry. Recent investigations have indicated that PAX8, PAX2, claudin-4, and h-caldesmon are immunohistochemical markers that can assist in distinguishing between these two malignancies; however, much of the information published on the value of these markers is either insufficient or contradictory. The purpose of this study is to resolve some of the existing controversies and to fully determine the practical value of these markers for assisting in the differential diagnosis between peritoneal mesotheliomas and serous carcinomas. In order to do so, a total of 40 peritoneal epithelioid mesotheliomas and 45 serous carcinomas (15 primary, 30 metastatic to the peritoneum) were investigated. PAX8 and PAX2 nuclear positivity was demonstrated in 42 (93%) and 25 (56%) of the serous carcinomas, respectively, whereas none of the mesotheliomas expressed either marker. Forty-four (98%) of the serous carcinomas exhibited claudin-4 reactivity along the cell membrane, whereas none of the mesotheliomas were positive for this marker. All of the serous carcinomas and mesotheliomas were negative for h-caldesmon. Based on these results, it is concluded that PAX8 and claudin-4 have a higher sensitivity and specificity for assisting in discriminating between peritoneal epithelioid mesotheliomas and serous carcinomas when compared with all of the other positive carcinoma markers that are, at present, recommended to be included in the immunohistochemical panels used in this differential diagnosis. Even though it is highly specific, PAX2 has little practical value in the diagnosis of peritoneal epithelioid mesotheliomas as its sensitivity is low. The h-caldesmon is not useful.</description><subject>631/67/1857</subject><subject>692/699/67</subject><subject>692/700/139</subject><subject>Antibodies</subject><subject>Antigens</subject><subject>Biomarkers, Tumor - analysis</subject><subject>Calmodulin-Binding Proteins - analysis</subject><subject>Cancer</subject><subject>claudin-4</subject><subject>Claudin-4 - analysis</subject><subject>Cystadenocarcinoma, Serous - diagnosis</subject><subject>Diagnosis, Differential</subject><subject>Female</subject><subject>h-caldesmon</subject><subject>Humans</subject><subject>Immunohistochemistry</subject><subject>Laboratory Medicine</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Mesothelioma</subject><subject>Mesothelioma - diagnosis</subject><subject>Metastasis</subject><subject>original-article</subject><subject>Paired Box Transcription Factors - analysis</subject><subject>Pathology</subject><subject>PAX2</subject><subject>PAX2 Transcription Factor - analysis</subject><subject>PAX8</subject><subject>PAX8 Transcription Factor</subject><subject>peritoneal mesothelioma</subject><subject>Peritoneal Neoplasms - diagnosis</subject><subject>Sensitivity and Specificity</subject><subject>serous carcinoma</subject><issn>0893-3952</issn><issn>1530-0285</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp9kc9u1DAQxi0EotvCC3BAlrhw2LT-E28ciUtVUUCqRA-AuEWz9qTrKraDnSDxDn1oHKVUFYdexjPj3zce-SPkDWennEl95qMdYTrE4VQwLkpgz8iGK8kqJrR6TjZMt7KSrRJH5DjnW8Z4rbR4SY6E5O2uaesNufsBw4w09vT6_KfeLlFsqRlgti5U9ZZCsPRQGRgsZh8Ddd7PIeYJXHDhhrpArctTSWeXD0tnxOSmGBAGiqObDji46Cz1mONaeMi0T9HTjCnOmRpIxoWl_Yq86GHI-Pr-PCHfLz9-u_hcXX399OXi_KoydSOmynKNSiKDGhXH2uybvmUcdMmYrI3meyYAGOeNBd7ujVQ7UErvABqslTLyhLxf544p_poxT5132eAwQMCyUcelEI3kQqqCvvsPvY1zCmW7heKac93UhRIrZVLMOWHfjcl5SH86zrrFq-7Bq27xqgRWRG_vR897j_ZB8s-cAsgVyOUq3GB69PZTYz-sKiw_-NsVVTYOg0HrEpqps9E9Jf8LdBe5sA</recordid><startdate>20130401</startdate><enddate>20130401</enddate><creator>Ordóñez, Nelson G</creator><general>Elsevier Inc</general><general>Nature Publishing Group US</general><general>Elsevier Limited</general><scope>6I.</scope><scope>AAFTH</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QP</scope><scope>7RV</scope><scope>7TK</scope><scope>7X7</scope><scope>7XB</scope><scope>88A</scope><scope>88E</scope><scope>8AO</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB0</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M7P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20130401</creationdate><title>Value of PAX8, PAX2, claudin-4, and h-caldesmon immunostaining in distinguishing peritoneal epithelioid mesotheliomas from serous carcinomas</title><author>Ordóñez, Nelson G</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c472t-d18e53e0a4e51e4cb7f901a84cb034c81b02aa0117da19bc356a5586aa7e455c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>631/67/1857</topic><topic>692/699/67</topic><topic>692/700/139</topic><topic>Antibodies</topic><topic>Antigens</topic><topic>Biomarkers, Tumor - 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Academic</collection><jtitle>Modern pathology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ordóñez, Nelson G</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Value of PAX8, PAX2, claudin-4, and h-caldesmon immunostaining in distinguishing peritoneal epithelioid mesotheliomas from serous carcinomas</atitle><jtitle>Modern pathology</jtitle><stitle>Mod Pathol</stitle><addtitle>Mod Pathol</addtitle><date>2013-04-01</date><risdate>2013</risdate><volume>26</volume><issue>4</issue><spage>553</spage><epage>562</epage><pages>553-562</pages><issn>0893-3952</issn><eissn>1530-0285</eissn><coden>MODPEO</coden><abstract>Distinguishing between peritoneal epithelioid mesotheliomas and papillary serous carcinomas involving the peritoneum can be difficult on routine histological preparations, but this differential diagnosis can be facilitated by the use of immunohistochemistry. Recent investigations have indicated that PAX8, PAX2, claudin-4, and h-caldesmon are immunohistochemical markers that can assist in distinguishing between these two malignancies; however, much of the information published on the value of these markers is either insufficient or contradictory. The purpose of this study is to resolve some of the existing controversies and to fully determine the practical value of these markers for assisting in the differential diagnosis between peritoneal mesotheliomas and serous carcinomas. In order to do so, a total of 40 peritoneal epithelioid mesotheliomas and 45 serous carcinomas (15 primary, 30 metastatic to the peritoneum) were investigated. PAX8 and PAX2 nuclear positivity was demonstrated in 42 (93%) and 25 (56%) of the serous carcinomas, respectively, whereas none of the mesotheliomas expressed either marker. Forty-four (98%) of the serous carcinomas exhibited claudin-4 reactivity along the cell membrane, whereas none of the mesotheliomas were positive for this marker. All of the serous carcinomas and mesotheliomas were negative for h-caldesmon. Based on these results, it is concluded that PAX8 and claudin-4 have a higher sensitivity and specificity for assisting in discriminating between peritoneal epithelioid mesotheliomas and serous carcinomas when compared with all of the other positive carcinoma markers that are, at present, recommended to be included in the immunohistochemical panels used in this differential diagnosis. Even though it is highly specific, PAX2 has little practical value in the diagnosis of peritoneal epithelioid mesotheliomas as its sensitivity is low. The h-caldesmon is not useful.</abstract><cop>New York</cop><pub>Elsevier Inc</pub><pmid>23196794</pmid><doi>10.1038/modpathol.2012.200</doi><tpages>10</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | 631/67/1857 692/699/67 692/700/139 Antibodies Antigens Biomarkers, Tumor - analysis Calmodulin-Binding Proteins - analysis Cancer claudin-4 Claudin-4 - analysis Cystadenocarcinoma, Serous - diagnosis Diagnosis, Differential Female h-caldesmon Humans Immunohistochemistry Laboratory Medicine Male Medicine Medicine & Public Health Mesothelioma Mesothelioma - diagnosis Metastasis original-article Paired Box Transcription Factors - analysis Pathology PAX2 PAX2 Transcription Factor - analysis PAX8 PAX8 Transcription Factor peritoneal mesothelioma Peritoneal Neoplasms - diagnosis Sensitivity and Specificity serous carcinoma |
| title | Value of PAX8, PAX2, claudin-4, and h-caldesmon immunostaining in distinguishing peritoneal epithelioid mesotheliomas from serous carcinomas |
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