Ber-EP4 and Anti-Calretinin Antibodies: A Useful Combination for Differential Diagnosis of Various Histological Types of Ovarian Cancer Cells and Mesothelial Cells

Abstract

The differential diagnosis between reactive mesothelial cells and ovarian carcinoma cells is often difficult in cytologic specimens. Immunocytochemical procedures have been utilized in assisting this differential diagnosis, with limitations. Furthermore, previous studies examined only serous type but not other histological types of ovarian carcinoma cases. Therefore, we evaluated the practical value of various epithelial and mesothelial markers in differential diagnosis of these two types of cells. Various types of ovarian carcinoma (serous, n = 22; mucinous, n = 10; endometrioid, n = 7; clear cell, n = 10) and benign mesothelial tissues (n = 15) were studied by immunohistochemistry. We then studied effective panels of antibodies by immunohistochemistry in 43 cytologic specimens of ascites or peritoneal lavage fluid consisting of 20 reactive mesothelium and 23 adenocarcinomas of the ovary. In the tissue specimens, Ber-EP4, a monoclonal antibody of epithelial antigen, and a polyclonal antibody against calretinin, which is expressed in mesothelium, are used in differentiating reactive mesothelial cells from ovarian carcinoma. In cytologic specimens, the sensitivity and specificity of Ber-EP4 were 100% and 90%, respectively. The sensitivity and specificity of the anti-calretinin antibody were 90% and 91%, respectively. Using multiple regression analysis, the correlation coefficient between epithelial antigen and calretinin reactivity was r = 0.938, with a significance level of p < 0.0001. In conclusion, the combined immunostaining of cytologic specimens for Ber-EP4 and the anti-calretinin antibody is helpful for the differential diagnosis between mesothelial cells and not only serous type, but also mucinous, endometrioid and clear cell types of ovarian cancer cells.peritoneal cytology; reactive mesothelial cell; ovarian carcinoma; Ber-EP4; calretinin

Specific expression of hepatocyte nuclear factor‐1β in the ovarian clear cell adenocarcinoma and its application to cytological diagnosis

“…Ber‐EP4, B72.3, anticarcinoembryonic antigen antibody, anti‐CA125 antibody, antiepithelial membrane antigen and LeuM1 are markers sensitive to cancer cells, ( 31–33 ) whereas HBME‐1 ( 21 ) and calretinin ( 34 ) are applied as mesothelium‐sensitive markers. In ovarian cancer, a novel monoclonal antibody, ( 35 ) a combination of Ber‐EP4 and calretinin, and so forth, ( 36,37 ) had been applied. We consider HNF‐1β applicable to clinical specimens, and evaluations of the sensitivity and specificity of the above‐mentioned markers to be necessary.…”

Pyloric Metastases from Primary Breast Cancer- A Case Report and Literature Review

“…It is useful to differentiate between reactive mesothelial cells (positive) and carcinomas (negative) in effusion cytology of ascites fluid (23)(24)(25) . The typical management of primary breast cancer with gut metastases is systemic chemotherapy.…”

Routes of Delivery for Biological Drug Products

“…The EPCAM specificity targets EPCAM-expressing epithelial tumor cells that have invaded the peritoneal cavity. Importantly, EPCAM expression is found in 70-100% of cases of malignant ascites, and the (non-tumor) peritoneal cavity itself is lined with EPCAM-negative mesothelial cells, enabling a high level of specificity of tumor binding [48,49]. Furthermore, preclinical pharmacokinetic studies confirmed that intraperitoneal (IP) administration of catumaxomab produced high local concentrations of the antibody in the ascites fluid while significantly limiting systemic exposure (<5% detectable in plasma), a critical finding given the potential toxicity of systemic anti-CD3 stimulation [50,51].…”