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Challenges and Limitation of Mtap Immunohistochemistry in Diagnosing Desmoplastic Mesothelioma/Sarcomatoid Pleural Mesothelioma with Desmoplastic Features
- Source :
- SSRN Electronic Journal.
- Publication Year :
- 2022
- Publisher :
- Elsevier BV, 2022.
-
Abstract
- Genomic-based ancillary assays including immunohistochemistry (IHC) for BRCA-1 associated protein-1 (BAP1) and methylthioadenosine phosphorylase (MTAP), and fluorescence in situ hybridization (FISH) for CDKN2A are effective for differentiating pleural mesothelioma (PM) from reactive mesothelial proliferations. We previously reported a combination of MTAP and BAP1 IHC effectively distinguishes sarcomatoid PM from fibrous pleuritis (FP). Nevertheless, cases of sarcomatoid PM with desmoplastic features (desmoPM) are encountered where the IHC assessment is unclear.We evaluated assessment of MTAP IHC, BAP1 IHC, and CDKN2A FISH in 20 desmoPM compared to 24 FP. MTAP and BAP1 IHC could not be assessed in 11 (55 %) and 10 (50 %) cases, respectively, due to loss or faint immunoreactivity of internal positive control cells, while CDKN2A FISH could be evaluated in all cases. The sensitivities for MTAP loss, BAP1 loss, and CDKN2A homozygous deletion in desmoPM were 40 %, 10 %, and 100 %. A combination of MTAP loss and BAP1 loss yielded 45 % of sensitivity.MTAP IHC is a useful surrogate diagnostic marker in differentiating ordinary sarcomatoid PM from FP, but its effectiveness is limited in desmoPM. CDKN2A FISH is the most effective diagnostic assays with 100 % sensitivity and specificity in discriminating desmoPM from FP in the facilities where the FISH assay is available.
- Subjects :
- Mesothelioma
History
Lung Neoplasms
Polymers and Plastics
Pleural Neoplasms
Homozygote
Mesothelioma, Malignant
Sarcoma
Soft Tissue Neoplasms
General Medicine
Immunohistochemistry
Industrial and Manufacturing Engineering
Pathology and Forensic Medicine
Purine-Nucleoside Phosphorylase
Biomarkers, Tumor
Humans
Business and International Management
Ubiquitin Thiolesterase
Cyclin-Dependent Kinase Inhibitor p16
In Situ Hybridization, Fluorescence
Sequence Deletion
Subjects
Details
- ISSN :
- 15565068
- Database :
- OpenAIRE
- Journal :
- SSRN Electronic Journal
- Accession number :
- edsair.doi.dedup.....0eaf236bcfa81a3d8df81f2473bc76bf