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Written by Karen Selby, RN | Medically Reviewed By Dr. Raja Michael Flores | Edited By Walter Pacheco | Last Update: November 14, 2024
Proteins are essential building blocks for your body’s cells. Different organs and tissues in your body are made of different types of proteins. These proteins give doctors critical clues when trying to diagnose cancer.
Doctors need to know the cancer’s origin to pick the right treatment. This can be tough because cancer spreads to different tissues before symptoms appear.
For example, when doctors find cancer in the lung and the nearby membrane (mesothelium), they must determine its type. It could be lung cancer, mesothelioma, or cancer from elsewhere in the body.
Immunohistochemical tumor markers help doctors find out what cancer is present.
Immunohistochemistry is a method pathologists use to study mesothelioma cancer tissue samples. It employs antibodies to make certain proteins in cells visible under a microscope.
An antibody is a molecule that binds to another type of molecule. Pathologists use antibodies designed to stain specific proteins in a color that is easy to see.
If a pathologist suspects mesothelioma, they will check for specific proteins. These proteins are typically in mesothelioma cells and indicate cancer.
The pathologist will also use other antibodies to check for proteins not typically found in mesothelioma cells. These proteins are markers for other cancers but not for mesothelioma.
After staining the cancer tissue sample with the antibodies, the pathologist looks at it through a microscope. They look for which antibodies stuck to the cells and which did not. If the pathologist finds many positive markers but few for other cancers, it suggests mesothelioma.
Immunohistochemistry is just one step in diagnosing mesothelioma. Pathologists also need to look at the tumor’s pattern and the cancer cells’ characteristics.
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The International Mesothelioma Interest Group identified calretinin, cytokeratin 5/6, WT-1 protein, podoplanin and mesothelin as some of the most helpful markers.
A 2021 study suggests that newly found markers may help doctors distinguish between pleural sarcomatoid mesothelioma and pulmonary sarcomatoid carcinoma. These markers are MUC4 and GATA 3.
Immunohistochemistry for mesothelioma is still developing as a science. Different pathologists have experience with using different antibodies. Because of this, there is no standard set of markers for mesothelioma.
Calretinin is a calcium-binding protein that occurs in various types of cells in the body. It is found in almost all mesothelioma cases and sometimes occurs in other types of cancer. It is beneficial for diagnosing sarcomatoid mesothelioma.
Cytokeratins are proteins that give cells support. Different body parts use various types. They’re numbered by their locations in the body. Cytokeratin 5 or 5/6 is found in over 75% of pleural mesothelioma cases. However, it is also present in some lung cancers. Its value in diagnosing peritoneal mesothelioma is limited. Similarly, it may not be reliable for sarcomatoid mesothelioma.
The WT-1 protein regulates genes to help some cells grow and mature. Most pleural mesothelioma cases have WT-1, while most lung cancer cases do not. WT-1 is not very useful for diagnosing peritoneal or sarcomatoid mesothelioma.
Pathologists use a tissue stain for podoplanin. It helps to tell apart epithelioid mesothelioma and adenocarcinoma, a cancer in mucus-secreting membranes.
The exact function of this protein is still unknown. Yet, it is a helpful marker for several cancers. Notably, it is highly present in squamous cell carcinomas, mesothelioma and brain tumors.
Mesothelin is a protein on the surface of mesothelial and some cancer cells. It’s found in all mesothelioma cells. Therefore, it helps rule out certain cancers, such as kidney cancer that has spread to the lungs.
You can’t rule out other cancers with just positive mesothelioma markers. Pathologists need to check for rare immunohistochemical tumor markers as well.
Common Negative Mesothelioma Markers
If negative mesothelioma markers appear, the tumor may be a different type of cancer.
The sources on all content featured in The Mesothelioma Center at Asbestos.com include medical and scientific studies, peer-reviewed studies and other research documents from reputable organizations.
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Selby, K. (2024, November 14). Immunohistochemical Markers for Mesothelioma. Asbestos.com. Retrieved November 20, 2024, from https://www.asbestos.com/mesothelioma/diagnosis/immunohistochemical-markers/
Selby, Karen. "Immunohistochemical Markers for Mesothelioma." Asbestos.com, 14 Nov 2024, https://www.asbestos.com/mesothelioma/diagnosis/immunohistochemical-markers/.
Selby, Karen. "Immunohistochemical Markers for Mesothelioma." Asbestos.com. Last modified November 14, 2024. https://www.asbestos.com/mesothelioma/diagnosis/immunohistochemical-markers/.
A medical doctor who specializes in mesothelioma or cancer treatment reviewed the content on this page to ensure it meets current medical standards and accuracy.
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Dr. Raja Flores is chairman of the Department of Thoracic Surgery at Mount Sinai Hospital and a professor of surgery at the Icahn School of Medicine in New York City. He is a world leader in the treatment of pleural mesothelioma.
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