El-Sawy, R., Elshaha, H., Agina, H., Mohamed, S., Rashad, H. (2021). Diagnostic Utility of BRCA1-Associated Protein 1 (BAP1) in Distinguishing Reactive and Neoplastic Mesothelial Proliferation. Benha Medical Journal, 38(Academic issue), 47-60. doi: 10.21608/bmfj.2020.126037
Rasha El-Sawy; Hadeer Elshaha; Hala Agina; Sahar Mohamed; Heba Rashad. "Diagnostic Utility of BRCA1-Associated Protein 1 (BAP1) in Distinguishing Reactive and Neoplastic Mesothelial Proliferation". Benha Medical Journal, 38, Academic issue, 2021, 47-60. doi: 10.21608/bmfj.2020.126037
El-Sawy, R., Elshaha, H., Agina, H., Mohamed, S., Rashad, H. (2021). 'Diagnostic Utility of BRCA1-Associated Protein 1 (BAP1) in Distinguishing Reactive and Neoplastic Mesothelial Proliferation', Benha Medical Journal, 38(Academic issue), pp. 47-60. doi: 10.21608/bmfj.2020.126037
El-Sawy, R., Elshaha, H., Agina, H., Mohamed, S., Rashad, H. Diagnostic Utility of BRCA1-Associated Protein 1 (BAP1) in Distinguishing Reactive and Neoplastic Mesothelial Proliferation. Benha Medical Journal, 2021; 38(Academic issue): 47-60. doi: 10.21608/bmfj.2020.126037
Diagnostic Utility of BRCA1-Associated Protein 1 (BAP1) in Distinguishing Reactive and Neoplastic Mesothelial Proliferation
1Department of Pathology, Benha faculty of medicine, Benha University, Egypt
2Department of Pathology, Benha faculty of medicine, Benha University, Egypt.
Abstract
Background: Malignant mesothelioma (MM) is an aggressive tumor which arises from the lining of serous cavities. Distinguishing between begnin and malignant mesothelial proliferation on effusions is a challenge. This study aims to evaluate the diagnostic utility of BAP1 in distinguishing MM from reactive mesothelial proliferation.Material and methods: This is a retrospective study on 61 cases; pleural biopsies (n=36) and pleural cell blocks (n=25). Included were synchronous cytology/ biopsy pair samples. All cases were stained with BAP-1antibody using avidin-biotin complex. BAP1 immunohistochemistry was evaluated using cut off value; negative staining indicate malignancy. Statistical analysis was done using SPSS (version 20), P value (P value Results: In MM cases 61.1% showed BAP1 negative nuclear expression. In reactive mesothelial proliferation cases; 20% showed BAP1 negative expression. In atypical mesothelial proliferation cases, 80% showed BAP1 negative nuclear expression. synchronous cytology/ biopsy pairs (13 cases) showed BAP1 matching results. There was a highly statistically significant correlation between BAP1 expression and the study groups (P-value <0.001). There was statistically significant correlation between BAP-1 expression and histological types of mesothelioma (P-value <0.05) and stage (P-value <0.05). In cell blocks; sensitivity was 80% and specificity was 80% for atypical mesothelial proliferation. In tissue biopsy; sensitivity was 61.1% and Specificity was 80% for mesothelioma.Conclusion: In effusions, negative BAP1 strongly support the diagnosis of malignant mesothelioma, so BAP1 may be included in immunohistochemical panels for malignant mesothelioma cytodiagnosis.