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Validation of a minimal panel of antibodies for the diagnosis of malignant pleural mesothelioma

Kao, S.C-H, Griggs, K., Lee, K., Armstrong, N., Clarke, S., Vardy, J., van Zandwijk, N., Burn, J., McCaughan, B.C., Henderson, D.W. and Klebe, S. (2011) Validation of a minimal panel of antibodies for the diagnosis of malignant pleural mesothelioma. Pathology, 43 (4). pp. 313-317.

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We previously established the use of a minimal panel of antibodies as sufficient to diagnose most epithelial malignant mesothelioma (MPM). We aimed to validate this approach and investigate the utility of a D2-40 antibody.

A series of 80 MPM patients selected for surgery and 21 consecutive patients with pleural metastatic carcinoma were included. A minimal panel of antibodies, consisting of calretinin, BG8 and CD15, and D2-40 was investigated.

There were 61 epithelial and 19 biphasic MPM as well as 12 metastatic lung, six breast (5 ductal adenocarcinomas, 1 mixed ductal/lobular adenocarcinoma), two serous papillary ovarian carcinomas and one moderately differentiated colorectal adenocarcinoma. The sensitivity of positive calretinin labelling to confirm the diagnosis of MPM was 97.5%, while the 'diagnostic sensitivities' of lack of labelling for BG8 and CD15 were 91.3% and 97.5%, respectively. The use of calretinin, BG8 and CD15 resulted in correct classification in 97.5% of all MPMs. All MPM cases investigated showed at least focal positive D2-40 labelling.

We have validated the usefulness of a minimal panel of antibodies with calretinin, BG8 and CD15 as the initial step to the diagnosis of MPM. D2-40 emerged as a helpful diagnostic tool for cases where our initial approach failed to conclusively diagnose MPM.

Publication Type: Journal Article
Publisher: Lippincott Williams and Wilkins
Copyright: © 2011 Royal College of Pathologists of Australasia
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