Expression And Significance Of EZH2、IMP3、GLUT-1 Protein In Malignant Mesothelioma

Part One: Expression and significance of EZH2,IMP3,GLUT-1 protein in MM tissueObjective:Malignant mesotheliomais(MM)is a rare mesotheliogenic tumor with an increasing incidence in recent years.It is difficult to distinguish MM from reactive mesothelial cell hyperplasia(RMH)and metastatic carcinoma,especially in biopsy and cytological specimens where interstitial infiltration can not be evaluated.It is a great challenge for pathologists to identification MM and RMH.The diagnosis of MM is relatively single,mainly assisted by morphology and immunohistochemical staining,but the sensitivity and specificity of the first-line antibodies are difficult to satisfied the needs of daily work.This paper studies the expression of EZH2,IMP3,GLUT-1protein in MM and its clinicopathological significance,to explore the role of abnormal expression of histone in the occurrence of MM and its application value in judging the prognosis of patients,to provide a new antibody combination for the diagnosis and differential diagnosis of MM,and to provide theoretical basis for clinical judgment of prognosis of patients.Method:Retrospective analysis of 50 MM and 20 RMH cases and their follow-up data.The expression of EZH2,IMP3,GLUT-1 protein in MM and RMH was detected by immunohistochemical SP method,the correlation between abnormal expression of EZH2,IMP3,GLUT-1 protein and MM clinicopathological parameters was analyzed by chi-square test,the Kaplan-Meier method was used to analyze the survival of single factor,and the Log-rank method was used to compare the difference,and to explore the relationship with the prognosis of MM patients.The difference was statistically significant with P<0.05.Results:1.The positive expression rates of EZH2,IMP3 and GLUT-1 in 50 cases were88%(44/50),60%(30/50),68%(34/50),significant higher than10%(2/20),5%(1/20),0%(0/20)in RMH,difference was statistically significant(all P<0.05).2.When compared with EZH2,IMP3,GLUT-1 test MM alone,the sensitivity and specificity of EZH2 combined IMP3 were 90% and 85% respectively,EZH2 combined GLUT-1were 98% and 90%,IMP3 combined GLUT-1 were 84% and 95%,differences were statistically significant(P<0.05);the diagnostic sensitivity of EZH2 combination GLUT-1in the three antibody combinations was the highest,differences were statistically significant(P<0.05).3.The positive expression rate of IMP3 in MM peritoneum group was higher than that in pleural group,the difference was significant(P<0.05),there was no significant correlation between the expression of EZH2,GLUT-1 protein and MM clinic(P>0.05).4.Kaplan-Meier survival curve was analyzed by single factor survival.The results showed that the survival time of MM patients in IMP3 positive expression group was significantly lower than that in negative expression group(P<0.05).Conclusion:1.The positive rate of EZH2,IMP3,GLUT-1 expression in MM was significantly higher than that in RMH,suggesting that it may play a certain role in the occurrence of MM,and that it can be used as a diagnostic index.2.Combined detection EZH2,IMP3 and GLUT-1,especially EZH2 combination GLUT-1,can improve the sensitivity of diagnostic MM.3.IMP3 can be used as an important biological index to evaluate the prognosis of MM patients.Meaning:This paper first proposes that the combined detection EZH2 and GLUT-1,can be used as the differential diagnosis index with strong sensitivity of MM and RMH,which provides a new antibody combination for the differential diagnosis of the two.Part Two: Value of EZH2,GLUT-1 combined with DNA-ICM in differentiating benign and malignant mesotheliosis from serosal effusionObjective:The early symptoms of malignant mesothelioma were not obvious,including serous cavity effusion,chest pain,abdominal distension,with or without weight loss,and most patients were treated with serous cavity effusion.It is difficult for some patients to obtain sufficient tissue samples,and then to determine the nature of the lesions by pleural and abdominal water exfoliation cytology,and it is more difficult to diagnose malignant mesothelioma by cytology alone.In particular,the differential diagnosis of highly differentiated malignant mesothelioma and reactive proliferative mesothelioma is lack of reproducibility.This study was based on the high sensitivity and specificity of the combination of EZH2 and GLUT-1 antibodies in the first part of histopathology.To explore the value of cell block section combined with immunocytochemistry(EZH2,GLUT-1)staining in differentiating MM from RMH,and to explore the clinical value of immunocytochemistry(EZH2,GLUT-1)staining combined with cytosolic DNA-ICM in the diagnosis of mesodermal lesions in serous effusion.Method:Collect 50 cases of pleural and abdominal water confirmed by histology between January 2014~ December 2019,MM 30 of them,RMH 20 example.The expression of EZH2 and GLUT-1 was detected by cell block combined with immunocytochemistry,and the significance of differential MM and RMH of antibody in serous cavity effusion was discussed.The sensitivity and specificity of immunocytochemistry,DNA-ICM and combined detection MM were compared.Results:1.EZH2 positive expression was 83% in 30 MM,25% positive expression rate in20 RMH,expression differences were statistically significant(P<0.05);GLUT-1 was70% positive in 30 MM,no positive expression in 20 RMH(P<0.05).2.The sensitivity of EZH2,GLUT-1 to MM diagnosis was 83%,70%,and the specificity was 75% and 100%,respectively.When EZH2,GLUT-1 combined detection,the sensitivity to the diagnosis was 90% and the specificity was 75%,which was statistically significant compared with the single antibody(P<0.05).3.The sensitivity of combined immunocytochemistry and DNA ploidy analysis was 97,which was significantly higher than that of single method(P<0.05),and the specificity was 75,which was not statistically significant compared with that of single method(P>0.05).Conclusion:The combined detection EZH2 and GLUT-1,can be used as the differential diagnostic index with strong sensitivity to MM and RMH in serous cavity effusion,and the sensitivity of differential diagnosis can be further improved by combining cell DNA-ICM technology.Meaning:the first application of EZH2 and GLUT-1 immunocytochemical markers can be used as the differential diagnostic index of MM and RMH sensitivity in plasma cavity effusion,and cell DNA-ICM can further improve the sensitivity of differential diagnosis.