Immunohistochemical detection of GLUT-1 can discriminate between reactive mesothelium and malignant mesothelioma

Modern Pathology (2007) 20, 215–220. [Link]

Yasufumi Kato1,2, Koji Tsuta1, Kunihiko Seki1, Akiko Miyagi Maeshima3, Shunichi Watanabe2, Kenji Suzuki2, Hisao Asamura2, Ryosuke Tsuchiya2 and Yoshihiro Matsuno1

  1. Clinical Laboratory, National Cancer Center Hospital, Tokyo, Japan
  2. Thoracic Surgery Divisions, National Cancer Center Hospital, Tokyo, Japan
  3. Pathology Division, National Cancer Center Research Institute, Tokyo, Japan

Correspondence: Dr Y Matsuno, MD, Clinical Laboratory Division, National Cancer Center Hospital, 1-1, Tsukiji 5-chome, Chuo-ku, Tokyo 104-0045, Japan. E-mail:

Received 30 August 2006; Accepted 23 October 2006; Published online 22 December 2006.


The separation of benign reactive mesothelium (RM) from malignant mesothelial proliferation can be a major challenge. A number of markers have been proposed, including epithelial membrane antigen, p53 protein, and P-glycoprotein. To date, however, no immunohistochemical marker that allows unequivocal discrimination of RM from malignant pleural mesothelioma (MPM) has been available. A family of glucose transporter isoforms (GLUT), of which GLUT-1 is a member, facilitate the entry of glucose into cells. GLUT-1 is largely undetectable by immunohistochemistry in normal epithelial tissues and benign tumors, but is expressed in a variety of malignancies. Thus, the expression of GLUT-1 appears to be a potential marker of malignant transformation. Recently, in fact, some studies have shown that GLUT-1 expression is useful for distinguishing benign from malignant lesions. The purpose of the present study was to evaluate the diagnostic utility of GLUT-1 expression for diagnostic differentiation between RM and MPM. Immunohistochemical staining for GLUT-1 was performed in 40 cases of RM, 48 cases of MPM, and 58 cases of lung carcinoma. Immunohistochemical GLUT-1 expression was seen in 40 of 40 (100%) MPMs, and in all cases the expression was demonstrated by linear plasma membrane staining, sometimes with cytoplasmic staining in addition. GLUT-1 expression was also observed in 56 out of 58 (96.5%) lung carcinomas. On the other hand, no RM cases were positive for GLUT-1. GLUT-1 is a sensitive and specific immunohistochemical marker enabling differential diagnosis of RM from MPM, whereas it cannot discriminate MPM from lung carcinoma.

Keywords: Glut-1, reactive methothelium, malignant pleural mesothelioma, immunohistochemistry, lung carcinoma