GLUT-1 Aids in Differentiating Mesothelioma From Reactive Mesothelial Lesions

By Reuters Staff

February 03, 2014

NEW YORK (Reuters Health) - GLUT-1 can help distinguish mesothelioma from benign reactive lesions of the mesothelium, a retrospective study suggests.

Mesothelial hyperplasia and fibrosing pleuritis can be hard to differentiate from epithelioid (MM-E) and sarcomatoid (MM-S) malignant pleural mesotheliomas, especially in small biopsy specimens. Multiple potential markers have been evaluated and failed to distinguish the benign from the malignant lesions.

Dr. Aliya N. Husain from The University of Chicago Medical Center and colleagues evaluated the usefulness of GLUT-1 immunoreactivity in differentiating these conditions in a retrospective study of biopsy specimens from 31 mesothelioma hyperplasia cases, 29 fibrosing pleuritis cases, 41 MM-E cases, and 29 MM-S cases.

Nearly 60% of the malignant mesotheliomas (45/78, 58% overall) showed GLUT-1 positivity, compared with none of the cases of reactive pleural mesothelial proliferation.

GLUT-1 expression was more common in MM-S (21/29, 72%) than in MM-E (21/41, 50%).

The overall sensitivity of GLUT-1 positivity for mesothelioma was 58%, with a specificity of 100%, according to the authors' report online December 30th Lung Cancer.

"Our results showed all reactive pleural mesothelial proliferations to be negative for GLUT-1 expression, with GLUT-1 immunoreactivity supporting a diagnosis of malignancy," the researchers conclude. "However, a negative GLUT-1 stain did not rule out malignancy."

"It is likely that the value of GLUT-1 could be improved if combined with other markers such as IMP-3 or p16 deletion," they note.

"When dealing with limited biopsy material where the differential is between benign and malignant mesothelial proliferation, demonstration of homozygous p16 deletion provides the only definitive evidence of malignancy," the authors say. "When FISH is not available or diagnostic, immunostaining for GLUT-1 in conjunction with IMP-3 and desmin (which in our experience strongly supports a benign diagnosis) is likely to be the optimal diagnostic panel."

Dr. Husain did not respond to a request for comments.


Lung Cancer 2014.


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