Immunohistochemical Detection of GLUT-1 Can Discriminate Between Reactive Mesothelium and Malignant Mesothelioma

Mod Pathol. 2007 Feb;20(2):215-20. doi: 10.1038/modpathol.3800732. Epub 2006 Dec 22.

Abstract

The separation of benign reactive mesothelium (RM) from malignant mesothelial proliferation can be a major challenge. A number of markers have been proposed, including epithelial membrane antigen, p53 protein, and P-glycoprotein. To date, however, no immunohistochemical marker that allows unequivocal discrimination of RM from malignant pleural mesothelioma (MPM) has been available. A family of glucose transporter isoforms (GLUT), of which GLUT-1 is a member, facilitate the entry of glucose into cells. GLUT-1 is largely undetectable by immunohistochemistry in normal epithelial tissues and benign tumors, but is expressed in a variety of malignancies. Thus, the expression of GLUT-1 appears to be a potential marker of malignant transformation. Recently, in fact, some studies have shown that GLUT-1 expression is useful for distinguishing benign from malignant lesions. The purpose of the present study was to evaluate the diagnostic utility of GLUT-1 expression for diagnostic differentiation between RM and MPM. Immunohistochemical staining for GLUT-1 was performed in 40 cases of RM, 48 cases of MPM, and 58 cases of lung carcinoma. Immunohistochemical GLUT-1 expression was seen in 40 of 40 (100%) MPMs, and in all cases the expression was demonstrated by linear plasma membrane staining, sometimes with cytoplasmic staining in addition. GLUT-1 expression was also observed in 56 out of 58 (96.5%) lung carcinomas. On the other hand, no RM cases were positive for GLUT-1. GLUT-1 is a sensitive and specific immunohistochemical marker enabling differential diagnosis of RM from MPM, whereas it cannot discriminate MPM from lung carcinoma.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adenocarcinoma / metabolism
  • Adenocarcinoma / pathology
  • Biomarkers, Tumor / metabolism*
  • Cell Membrane / metabolism
  • Cell Membrane / pathology
  • Diagnosis, Differential
  • Glucose Transporter Type 1 / metabolism*
  • Humans
  • Immunoenzyme Techniques*
  • Lung Neoplasms / metabolism
  • Lung Neoplasms / pathology
  • Mesothelioma / diagnosis
  • Mesothelioma / metabolism*
  • Pleural Neoplasms / diagnosis
  • Pleural Neoplasms / metabolism*
  • Pleurisy / diagnosis
  • Pleurisy / metabolism*

Substances

  • Biomarkers, Tumor
  • Glucose Transporter Type 1