Elsevier

Pathology

Volume 38, Issue 1, February 2006, Pages 10-15
Pathology

Cell proliferation rate and telomerase activity in the differential diagnosis between benign and malignant mesothelial proliferations

https://doi.org/10.1080/00313020500456017Get rights and content

Summary

Aims

The differential diagnosis of malignant mesothelioma (MM) from benign mesothelial lesions (BML) based on histopathological criteria is sometimes not satisfying and causes diagnostic problems for histopathologists. We aimed to investigate whether the immunohistochemically determined cell proliferation rate and telomerase activity, using Ki-67 and human telomerase reverse transcriptase (hTERT) immunohistochemistry, respectively, are useful in the differential diagnosis of MM from BML.

Methods

Sixty-six cases of MM (33 epithelioid, 30 biphasic and 3 sarcomatoid) and 22 cases of BML (15 reactive mesothelial proliferations and 7 fibrous pleuritis/pericarditis) were included in this study. We evaluated the proliferative activity by Ki-67 and telomerase activity by hTERT immuno-histochemistries for each case.

Results

The mean value of the Ki-67 proliferation index (PI) in MMs was significantly higher than that of BMLs. Biphasic MMs have higher a Ki-67 PI than epithelioid and sarcomatoid types. Ki-67 immunohistochemistry has a sensitivity of 74%, specificity of 86% and positive predictive value of 94% in detecting MM. hTERT immunohistochemistry detected MM with sensitivity and specificity of 68%.

Conclusion

As a result, being cheap and simple methods, Ki-67 and hTERT immunohistochemistries can be used in differentiating malignant and benign mesothelial lesions in routine formalin-fixed, paraffin-embedded material.

References (47)

  • MoranC.A. et al.

    The role of immunohistochemistry in the diagnosis of malignant mesothelioma

    Semin Diagn Pathol

    (2000)
  • HerbertA. et al.

    Pleural biopsy in the diagnosis of malignant mesothelioma

    Thorax

    (1982)
  • HendersonD.W. et al.

    Reactive mesothelial hyperplasia vs. mesothelioma including mesothelioma in situ. A brief review

    Am J Clin Pathol

    (1998)
  • ChurgA. et al.

    US-Canadian Mesothelioma Reference Panel, The separation of benign and malignant mesothelial proliferations

    Am J Surg Pathol

    (2000)
  • MayallF.G. et al.

    p53 immunostaining in the distinction between benign and malignant mesothelial proliferations using formalin-fixed paraffin sections

    J Pathol

    (1992)
  • WolanskiK.D. et al.

    The use of epithelial membrane antigen and silver-stained nucleolar organizer regions testing in the differential diagnosis of mesothelioma from benign reactive mesothelioses

    Cancer

    (1998)
  • CasalotsJ. et al.

    Utility of epithelial membrane antigen and p53 in the differential diagnosis of benign reactive processes from malignancy in pleural biopsy specimens

    Virchows Arch

    (1999)
  • ScoonesD.J. et al.

    Expression of desmin and smooth muscle actin in mesothelial hyperplasia and mesothelioma

    J Pathol

    (1998)
  • AttanoosR.L. et al.

    The use of immunohistochemistry in distinguishing reactive from neoplastic mesothelium. A novel use for desmin and comparative evaluation with epithelial membrane antigen, p53, platelet-derived growth factor-receptor, P-glycoprotein and Bcl-2

    Histopathology

    (2003)
  • SingtonJ.D. et al.

    Assessment of cell cycle state may facilitate the histopathological diagnosis of malignant mesothelioma

    Histopathology

    (2003)
  • GerdesJ. et al.

    Immunobiochemical and molecular biologic characterization of the cell proliferation associated nuclear antigen that is defined by monoclonal antibody Ki-67

    Am J Pathol

    (1991)
  • CominC.E. et al.

    MIB-1 proliferation index correlates with survival in pleural malignant mesothelioma

    Histopathology

    (2000)
  • BongiovanniM. et al.

    p27kip1 immunoreactivity correlates with long-term survival in pleural malignant mesothelioma

    Cancer

    (2001)
  • Cited by (17)

    • Diagnostic value of p53 and ki67 immunostaining for distinguishing benign from malignant serous effusions

      2011, Journal of the Egyptian National Cancer Institute
      Citation Excerpt :

      Taheri et al. [31] in another work evaluated the diagnostic value of ki67 and repp86 in differentiation of benign mesothelial proliferation from malignancy and reported 88% sensitivity and 92% specificity for ki67. Cakir et al. [9] evaluated telomerase activity and ki67 immunostaining to differentiate malignant from mesothelial proliferation and reported 74% sensitivity and 86% specificity for ki67. Kimura et al. [37] studied three proliferative markers (MCM7, Topo IIα, and ki67) to differentiate malignant from mesothelial proliferation and reported 64.3% sensitivity and 92.9% specificity for ki67 using 30% labeling index as cutoff point.

    • Telomere length variations in 6 mucosal cell types of gastric tissue observed using a novel quantitative fluorescence in situ hybridization method

      2007, Human Pathology
      Citation Excerpt :

      This finding is contrary to that of previous studies, perhaps because of the fact that all the noncancerous mucosal specimens we used for comparison were obtained from cancer-bearing stomachs. Both Ki-67 and h-TERT activities are reported to indicate proliferative activity in benign or malignant tumors [18] and to show mutual correlation in thyroid and esophageal tumors [19,20]. Overexpression of Ki-67 in tumors is considered to be a marker of proliferation and the metastatic potential of gastric cancer [21].

    • Epithelioid lesions of the serosa

      2012, Archives of Pathology and Laboratory Medicine
    View all citing articles on Scopus
    View full text