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American Journal of Pathology, Vol 133, 30-38, Copyright © 1988 by American Society for Investigative Pathology

REGULAR ARTICLES

Differentiation of adenocarcinoma of the lung from mesothelioma. Periodic acid-Schiff, monoclonal antibodies B72.3, and Leu M1

ML Warnock, A Stoloff and A Thor
Department of Pathology, University of California, San Francisco 94143- 0506.

The immunohistochemical reactivity of 38 mesotheliomas and 44 adeno- carcinomas or large cell carcinomas of the lung with monoclonal antibodies (MAb) B72.3 and Leu M1 was compared with their reactivity with the routine histochemic stains periodic acid-Schiff with diastase digestion (PAS-D) and alcian blue +/- hyaluronidase. Both MAbs reacted selectively with carcinomas when a positive test was set at greater than or equal to 10% reactive tumor cells. However, MAb B72.3 reacted with significantly more of the carcinomas (86%, chi-square test, P less than 0.01) and bound to a greater percentage of tumor cells (47 +/- 28%; mean +/- SD, t-test, P less than 0.001) than Leu M1 (57% and 25 +/- 28%, respectively). The similar reactivities of surgically resected tumor specimens and post mortem tissues with both antibodies confirmed antigen stability and suggested broad clinical utility. PAS-D stained 61% of the carcinomas. Using the markers for carcinomas (PAS-D, B72.3, and Leu M1), the tumors were classified into the correct group in 80 of 82 (98%) cases (95% confidence level: greater than 92% accuracy). The alcian blue stain was useful to confirm a diagnosis of dimorphic or epithelial mesothelioma (48% were positive).


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Copyright © 1988 by the American Society for Investigative Pathology.