Expression of mesothelin as a potential diagnostic marker in mesothelioma

Nihon Kokyuki Gakkai Zasshi. 2008 Jan;46(1):3-9. [Link]

Kuribayashi K, Fukuoka K, Nakajima T, Miyake M, Miyata S, Tamura K, Iida S, Yamada S, Murakami A, Hirano H, Nakano T.

Division of Respiratory Medicine, Department of Internal Medicine, Hyogo College of Medicine.


Histological discrimination of mesothelioma from adenocarcinoma is often difficult, therefore, many investigators have tried immunohistochemical, ultrastructual, and molecular methods. Economically, immunohistological studies are more excellent, compared with ultrastractual and molecular biological methods. Immunohistologically, many well known markers are divided into two category; adenocarcinoma-related markers, which expressed by adenocarcinoma, and mesothelioma-related makers, which are positive for mesothelioma. CEA, TTF-1, and Ber-Ep4 are well known adenocarcinoma-related markers, mesothelin, TM, HBME-1 and calretinin, have been used as mesothelioma-related markers. Most previous reports associated with discrimination of adenocarcinoma and mesothelioma mentioned that a diagnosis of epithelioid mesothelioma would be excluded by the presence of adenocarcinoma-related antibody. The positive ratio of mesothelioma-related antibodies is lower than that of adenocarcinoma-related antibodies. Only a single mesothelioma-related marker cannot lead to a diagnosis of epithelioid mesothelioma and a correct diagnosis can be made by combination of several makers, which contain both mesothelioma-related markers and adenocarcinoma-related markers. We immunohistologically examined 41 cases of mesothelioma and 16 cases of adenocarcinoma of the lung, and re-evaluated the use of immunohistochemical markers, compared with previous reports. Reactivity for mesothelin was obtained in 19 (73%) of the epithelioid mesotheliomas, but none (0%) of the lung adenocarcinomas. None of the sarcomatoid mesotheliomas exhibited positivity for this marker, nor was any reactivity seen in the spindle cell component of the biphasic mesotheliomas. These findings indicate that, in some instances, mesothelin immunostaining can assist in the diagnosis of mesothelioma.