<i>p16/CDKN2A</i> FISH in Differentiation of Diffuse Malignant Peritoneal Mesothelioma From Mesothelial Hyperplasia and Epithelial Ovarian Cancer

  • Tomohiro Ito
    1Department of Pathology, Fukuoka University School of Medicine and Hospital, Fukuoka, Japan
  • Makoto Hamasaki
    1Department of Pathology, Fukuoka University School of Medicine and Hospital, Fukuoka, Japan
  • Shinji Matsumoto
    1Department of Pathology, Fukuoka University School of Medicine and Hospital, Fukuoka, Japan
  • Kenzo Hiroshima
    3Department of Pathology, Tokyo Women’s Medical University Yachiyo Medical Center, Yachiyo, Japan
  • Tohru Tsujimura
    4Department of Pathology, Hyogo College of Medicine, Hyogo, Japan
  • Toshiaki Kawai
    5Department of Pathology and Laboratory Medicine, National Defense Medical College, Tokorozawa, Japan
  • Yoshiya Shimao
    6Department of Pathology, Miyazaki Prefectural Miyazaki Hospital, Miyazaki, Japan
  • Kousuke Marutsuka
    7Department of Pathology, Miyazaki University School of Medicine, Miyazaki, Japan
  • Sayaka Moriguchi
    7Department of Pathology, Miyazaki University School of Medicine, Miyazaki, Japan
  • Riruke Maruyama
    8Laboratory of Surgical Pathology, Shimane University School of Medicine, Izumo, Japan.
  • Shingo Miyamoto
    2Department of Obstetrics and Gynecology, Fukuoka University School of Medicine and Hospital, Fukuoka, Japan
  • Kazuki Nabeshima
    1Department of Pathology, Fukuoka University School of Medicine and Hospital, Fukuoka, Japan

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<jats:title>Abstract</jats:title> <jats:sec> <jats:title>Objectives:</jats:title> <jats:p>It can be difficult to differentiate diffuse malignant peritoneal mesothelioma (DMPM) from reactive mesothelial hyperplasia (RMH) or peritoneal dissemination of gynecologic malignancies, such as epithelial ovarian cancer (EOC), which cause a large amount of ascites. Detection of the homozygous deletion of p16/CDKN2A (p16) by fluorescence in situ hybridization (FISH) is an effective adjunct in the diagnosis of malignant pleural mesothelioma. The aim of this study was to investigate the ability of the p16 FISH assay to differentiate DMPM from RMH and EOC.</jats:p> </jats:sec> <jats:sec> <jats:title>Methods:</jats:title> <jats:p>p16 FISH was performed in 28 DMPMs (successful in 19), 30 RMHs, and 40 EOC cases. The cutoff values of p16 FISH were more than 10% for homozygous deletion and more than 40% for heterozygous deletion.</jats:p> </jats:sec> <jats:sec> <jats:title>Results:</jats:title> <jats:p>According to the above criteria, nine (47.4%) of 19 successful DMPM cases were homozygous deletion positive, and three (15.8%) of 19 were heterozygous deletion positive, whereas all RMH cases were negative for the p16 deletion. In all four major histologic subtypes of EOC, neither p16 homozygous nor heterozygous deletions were detected. To differentiate DMPM from RMH or EOC, the sensitivity of the p16 homozygous deletion was 32% (9/28), and the specificity was 100%.</jats:p> </jats:sec> <jats:sec> <jats:title>Conclusions:</jats:title> <jats:p>Our study suggests that p16 FISH analysis is useful in differentiating DMPM from RMH and EOC when homozygous deletion is detected.</jats:p> </jats:sec>

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