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. 2018 Jan 9;8(1):134.
doi: 10.1038/s41598-017-18545-x.

MUC4 immunohistochemistry is useful in distinguishing epithelioid mesothelioma from adenocarcinoma and squamous cell carcinoma of the lung

Amany Sayed Mawas  1   2 , Vishwa Jeet Amatya  1 , Kei Kushitani  1 , Yuichiro Kai  1   3 , Yoshihiro Miyata  3 , Morihito Okada  3 , Yukio Takeshima  4
Affiliations

MUC4 immunohistochemistry is useful in distinguishing epithelioid mesothelioma from adenocarcinoma and squamous cell carcinoma of the lung

Amany Sayed Mawas et al. Sci Rep. .

Abstract

The differential diagnosis of epithelioid mesothelioma from lung adenocarcinoma and squamous cell carcinoma requires the positive and negative immunohistochemical markers of mesothelioma. The IMIG guideline has suggested the use of Calretinin, D2-40, WT1, and CK5/6 as mesothelial markers, TTF-1, Napsin-A, Claudin 4, CEA as lung adenocarcinoma markers p40, p63, CK5/6, MOC-31 as squamous cell markers. However, use of other immunohistochemical markers is still necessary. We evaluated 65 epithelioid mesotheliomas, 60 adenocarcinomas, and 57 squamous cell carcinomas of the lung for MUC4 expression by immunohistochemistry and compared with the previously known immunohistochemical markers. MUC4 expression was not found in any of 65 cases of epithelioid mesothelioma. In contrast, MUC4 expression was observed in 50/60(83.3%) cases of lung adenocarcinoma and 50/56(89.3%) cases of lung squamous cell carcinoma. The negative MUC4 expression showed 100% sensitivity, 86.2% specificity and accuracy rate of 91.2% to differentiate epithelioid mesothelioma from lung carcinoma. The sensitivity, specificity, and accuracy of MUC4 are comparable to that of previously known markers of lung adenocarcinoma and squamous cell carcinoma, namely CEA, Claudin 4 and better than that of MOC-31. In conclusion, MUC4 immunohistochemistry is useful for differentiation of epithelioid mesothelioma from lung carcinoma, either adenocarcinoma or squamous cell carcinoma.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Figure 1
Figure 1
Representative cases of epithelioid mesothelioma with papillo-tubular (A) and solid (C) growth showing no MUC4 expression (B,D). Note: normal bronchial epithelium as internal control showing MUC4 expression. (A,C) H & E stain × 40 high power field; (B,D) MUC4 immunohistochemistry).
Figure 2
Figure 2
Representative cases of lung adenocarcinomas, papillary (2 A) or solid (2 C) growth and non-keratinizing squamous cell carcinoma (E,G) showing MUC4 expression. (A,C,E,G): H & E stain × 40 high power field, (B,D,F,H): MUC4 immunohistochemistry).
See this image and copyright information in PMC

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