多标志物免疫组化在间皮瘤鉴别诊断中的应用价值OA

Objective To evaluate the utility of BAP1 loss,p16 loss,MTAP loss,and moderate-to-strong Cy-clin D1 expression in differentiating mesothelioma from well-differentiated papillary mesothelial tumor(WDPMT),ad-enomatoid tumor(AT),and reactive mesothelial hyperplasia(RMH).Methods Clinical data were collected from 28 cases of mesothelioma,2 cases of WDPMT,5 cases of AT,and 20 cases of RMH.The expression of Cyclin D1,BAP1,p16,and MTAP proteins was examined using the EnVision two-step immunohistochemical method.The differ-ences in marker expression among various lesions were analyzed,and the sensitivity and specificity of each marker in diagnosing mesothelioma were calculated.Results In the mesothelioma group,the rates of BAP1 loss(35.7%,10/28),p16 loss(64.3%,18/28),MTAP loss(28.6%,8/28),and moderate-to-strong nuclear positivity for Cyclin D1(35.7%,10/28)were significantly higher compared to the control group(combined WDPMT,AT and RMH;n=27)(P values 0.001,<0.001,0.004,0.001,respectively).None of these markers showed the respective loss or moderate-to-strong positivity pattern in the 27 control cases,corresponding to a specificity with a 95%confidence inter-val of 87.5%to 100%.While the overall Cyclin D1 positivity rate showed no difference between the mesothelioma group(64.3%,18/28)and the control group(55.6%,15/27)(P=0.587),moderate-to-strong positivity was ob-served exclusively in mesotheliomas.Conclusion Based on the confirmation of classical mesothelial markers,the com-bined detection of the expression of BAP1,p16,MTAP,and Cyclin D1 holds significant auxiliary diagnostic value in differentiating mesothelioma from WDPMT,AT,and RMH.