Utility of GLUT-1 and KOC in differential diagnosis of reactive mesothelial hyperplasia, malignant mesothelioma and lung adenocarcinoma

Malignant mesothelioma is a primary malignant tumour, which develops from the mesothelial cells lining serosal surfaces, especially the pleura, and which has a very poor prognosis. As malignant mesothelioma may display a variety of histological patterns and has a wide spectrum of cytomorphologic characteristics, there may be problems in its differential diagnosis from lung adenocarcinomas and sometimes from benign mesothelial proliferations. Immunohistochemical examination is the most useful method in this distinction. In the present study, we aimed to determine the value of glucose transporter isoform-1 (GLUT-1) and K homology domain containing protein (KOC) markers in the differential diagnosis of reactive mesothelial hyperplasia, malignant mesothelioma and lung adenocarcinoma.The study included 30 samples of malignant mesothelioma, 30 samples of lung adenocarcinoma and 30 samples of reactive mesothelial hyperplasia selected from the archives of the Fırat University Hospital, Pathology Department Laboratory. The samples were applied GLUT-1 and KOC markers by immunohistochemistry and the place of these markers in differential diagnosis was examined.GLUT-1 was found positive in 80% of malignant mesothelioma cases, 83.3% of adenocarcinoma cases and 6.6% of reactive mesothelial hyperplasia cases. KOC was positive in 83.3% of malignant mesothelioma cases, 76.6% of adenocarcinoma cases and 46.6% of reactive mesothelial hyperplasia cases.There was no statistically significant difference between malignant mesothelioma and lung adenocarcinoma cases in terms of the prevalence and severity of staining with GLUT-1, whereas a significant difference was established when these groups were compared with reactive mesothelial hyperplasia cases. The results obtained from the comparison of groups with regard to the prevalence and severity of staining with KOC were similar to those obtained with GLUT-1.Consequently, it was concluded that GLUT-1 and KOC markers were not useful in the differentiation between malignant mesothelioma and lung adenocarcinomas, but could be quite useful in the distinction between reactive mesothelial hyperplasia on one hand and malignant mesothelioma and lung adenocarcinoma on the other.