Online citations, reference lists, and bibliographies.
← Back to Search

Utility Of Claudin-4 Versus BerEP4 And B72.3 In Pleural Fluids With Metastatic Lung Adenocarcinoma.

A. Patel, A. Borczuk, Momin T Siddiqui
Published 2020 · Medicine

Cite This
Download PDF
Analyze on Scholarcy
Share
INTRODUCTION Lung adenocarcinoma (LADC) is the most common occult primary in patients presenting with a malignant pleural effusion. Distinguishing metastatic LADC from reactive mesothelial cells (RMC) and malignant mesothelioma (MM) based on morphology alone has been a persistent diagnostic challenge in cytopathology. Claudin-4, a major functional constituent of tight junctions, has been shown to help distinguish LADC from RMC and MM in surgical specimens. Our goal was to further validate and assess the utility of Claudin-4 in comparison to BerEP4 and B72.3 in malignant effusions with a focus on metastatic LADC. MATERIALS AND METHODS We evaluated 58 pleural effusions (40 LADC, 10 RCM, and 8 MM). Immunohistochemistry was performed using Claudin-4, Ber-EP4, and B72.3 on cell blocks. Staining patterns, quantity of tumor cells, and intensity of staining (weak, moderate, or strong) were assessed. RESULTS All cases of LADC were positive for Claudin-4 with an overall sensitivity of 100% (40 of 40) and specificity of 100% (18 of 18). In addition, Claudin-4 showed the highest quantity and quality of staining with 3+ staining intensity in 73% (29 of 40) of cases, compared with 35% (14 of 40) of cases using BerEP4 and 52% (21 of 40) of cases using B72.3. The sensitivity and specificity for BerEP4 were 90% and 78%, respectively. The sensitivity and specificity for B72.3 were 87.5% and 100%, respectively. CONCLUSIONS In this study, Claudin-4 performed superiorly compared to BerEP4 and B72.3 in distinguishing lung adenocarcinoma from RMC or MM in pleural effusions. Our results show Claudin-4 is a useful marker for distinguishing RMC and MM from lung adenocarcinoma, with high sensitivity (100%) and specificity (100%), compatible with studies shown in the literature.
This paper references
10.1002/DC.2840100207
Monoclonal antibody Ber‐EP4: Its use in the differential diagnosis of malignant mesothelioma and carcinoma in cell blocks of malignant effusions and FNA specimens
B. Maguire (1994)
10.1002/cncy.22021
Ancillary studies in pleural, pericardial, and peritoneal effusion cytology
K. Sundling (2018)
10.1007/s00428-007-0448-x
Claudin 4 identifies a wide spectrum of epithelial neoplasms and represents a very useful marker for carcinoma versus mesothelioma diagnosis in pleural and peritoneal biopsies and effusions
F. Facchetti (2007)
10.1002/dc.21380
Usefulness of Claudin 4 in the cytological diagnosis of serosal effusions
S. Lonardi (2011)
10.1371/journal.pone.0107741
Diagnostic Accuracy of Ber-EP4 for Metastatic Adenocarcinoma in Serous Effusions: A Meta-Analysis
B. Wang (2014)
10.1038/modpathol.3800544
The diagnostic utility of immunohistochemistry in distinguishing between epithelioid mesotheliomas and squamous carcinomas of the lung: a comparative study
N. Ordóñez (2006)
10.1002/(SICI)1097-0339(199708)17:2<115::AID-DC6>3.0.CO;2-F
Complementary value of five carcinoma markers for the diagnosis of malignant mesothelioma, adenocarcinoma metastasis, and reactive mesothelium in serous effusions
M. Delahaye (1997)
10.1159/000333982
Ber-EP4 for differentiating adenocarcinoma from reactive and neoplastic mesothelial cells in serous effusions. Comparison with carcinoembryonic antigen, B72.3 and Leu-M1.
M. E. Bailey (1996)
10.1002/DC.2840110309
Markers for metastatic adenocarcinoma in serous effusion specimens
P. Shield (1994)
10.4103/2277-9175.138888
Diagnostic value of claudin-4 marker in pleural and peritoneal effusion cytology: Does it differentiate between metastatic adenocarcinoma and reactive mesothelial cells?
N. Afsharmoghaddam (2014)
10.1002/dc.23659
Pleural fluid cytology samples in cases of suspected lung cancer: An experience from a tertiary care centre
G. Kaur (2017)
10.1093/AJCP/109.1.85
Value of the Ber-EP4 antibody in differentiating epithelial pleural mesothelioma from adenocarcinoma. The M.D. Anderson experience and a critical review of the literature.
N. Ordóñez (1998)
10.29271/jcpsp.2019.01.33
Diagnostic Accuracy of a Limited Immuno-panel of Calretinin and Ber-EP4 for Diagnosis of Malignant Effusions.
Nosheen Khurram (2019)
Diagnostic immunohistochemistry : theranostic and genomic applications
D. Dabbs (2010)
10.1016/j.lungcan.2018.11.020
Measurement and immunophenotyping of pleural fluid EpCAM-positive cells and clusters for the management of non-small cell lung cancer patients.
J. C. Thompson (2019)
10.1002/dc.23476
Immunocytochemical utility of claudin‐4 versus those of Ber‐EP4 and MOC‐31 in effusion cytology
T. Oda (2016)
10.1309/AJCP0B3YJBXWXJII
Value of claudin-4 immunostaining in the diagnosis of mesothelioma.
N. Ordóñez (2013)
10.5858/arpa.2017-0124-RA
Guidelines for Pathologic Diagnosis of Malignant Mesothelioma 2017 Update of the Consensus Statement From the International Mesothelioma Interest Group.
A. Husain (2018)
10.1016/j.anndiagpath.2015.03.007
Claudin 3, 4, and 15 expression in solid tumors of lung adenocarcinoma versus malignant pleural mesothelioma.
Siham Chaouche-Mazouni (2015)
10.1002/DC.2840090509
Utility of BER‐EP4 in the diagnosis of adenocarcinoma in effusions: An immunocytochemical study of 232 cases
A. A. Diaz-Arias (1993)
10.1097/01.pai.0000213148.62525.9a
Evidence-based Guidelines for the Utilization of Immunostains in Diagnostic Pathology: Pulmonary Adenocarcinoma Versus Mesothelioma
A. Marchevsky (2007)
Kosss diagnostic cytology and its histopathologic bases
L. Koss (2006)
10.1136/jcp.2005.028589
Claudins in differential diagnosis between mesothelioma and metastatic adenocarcinoma of the pleura
Y. Soini (2006)
10.1002/cncy.21392
Claudin‐4 immunohistochemistry is highly effective in distinguishing adenocarcinoma from malignant mesothelioma in effusion cytology
V. Jo (2014)



This paper is referenced by
Semantic Scholar Logo Some data provided by SemanticScholar