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

December 29, 2006

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

Yasufumi Kato^1,2, Koji Tsuta¹, Kunihiko Seki¹, Akiko Miyagi Maeshima³, Shunichi Watanabe², Kenji Suzuki², Hisao Asamura², Ryosuke Tsuchiya² and Yoshihiro Matsuno¹

Clinical Laboratory, National Cancer Center Hospital, Tokyo, Japan
Thoracic Surgery Divisions, National Cancer Center Hospital, Tokyo, Japan
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: ymatsuno@ncc.go.jp

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

Abstract

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