Peritoneal Malignant Mesothelioma with Epithelioid Type, Demonstrating High Serum and Ascitic KL-6 Levels: Immunohistochemical Analyses

Our plain-English summary of Peritoneal Malignant Mesothelioma with Epithelioid Type, Demonstrating High Serum and Ascitic KL-6 Levels: Immunohistochemical Analyses, by S. Nahar, M. Nakamoto, A. Hokama, et al (Rare Tumors, 2015).

The study

• Authors: S. Nahar, M. Nakamoto, A. Hokama, C. Kobashigawa, M. Kaida, T. Kinjo, T. Hirata, N. Kinjo, M. Saio, N. Yoshimi, Y. Ohtsuki, J. Fujita
• Journal: Rare Tumors
• Published: 2015;7(3):5947
• Type of article: Case report
• Cited by: 2 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

We report a case of KL-6 producing peritoneal malignant mesothelioma. A 56-year-old woman was referred to our hospital on November 2005 with severe abdominal distention. Peritoneal malignant mesothelioma with epithelioid type was diagnosed by clinical symptoms, laboratory investigations, imaging studies, and immunohistochemical examination of known tumor markers. In addition, high serum and ascitic KL-6 levels were observed and the immunostaining of the tumor for KL-6 was evident. We thus consider KL-6 to be a potential novel marker for peritoneal malignant mesothelioma with epithelioid type.

In plain English

This article is a case report about one patient, a 56-year-old woman treated at a university hospital in Japan for peritoneal malignant mesothelioma of the epithelioid type. She had had abdominal swelling since September 2005 and was referred to the hospital in November 2005. She had worked at an iron factory for 4 years without known exposure to asbestos. Several standard blood tumor markers were within normal limits. Her blood level of KL-6, a protein used as a marker of interstitial lung disease, was 9000 IU/mL (normal up to 500 IU/mL), and KL-6 in her abdominal fluid was 7500 U/mL. A biopsy taken during laparoscopy, with tissue staining, was consistent with epithelioid peritoneal mesothelioma. The tumor cells also stained positive for KL-6 on their surface. She received four chemotherapy regimens. Her KL-6 levels fell once after the first regimen and later rose as the disease worsened. She died 32 months after diagnosis. The authors concluded that KL-6 can be regarded as a potential tumor marker for this cancer. They said more cases are needed to establish its usefulness.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: case report (single patient)
• Who was studied: One 56-year-old woman referred to the University of the Ryukyus hospital, Japan, in November 2005 with abdominal distention since September 2005
• Exposure: Worked at an iron factory for 4 years; no known asbestos exposure
• Main results:
  • The patient's serum KL-6 was 9000 IU/mL (normal up to 500 IU/mL)
  • The patient's serum CEA, AFP, CA19-9, CA125 and CYFRA were within normal limits
  • In the ascites fluid, CA125 was 86 U/L and KL-6 was 7500 U/mL (units as printed)
  • Hyaluronic acid was 60 ng/mL in serum and 11,900 ng/mL in peritoneal fluid
  • Microscopic features of the peritoneal biopsy were consistent with epithelioid peritoneal mesothelioma
  • Tumor cells were negative for CEA, MOC-31, Ber-EP4 and TTF-1
  • Immunostaining for KL-6 showed distinct surface positivity of the mesothelioma cells
  • After gemcitabine plus cisplatin, serum and ascitic KL-6 dropped once, then rose as the disease worsened
  • The patient died 32 months after initial diagnosis despite four chemotherapy regimens
• The authors' conclusion: The authors concluded that serum KL-6 can be regarded as a potential tumor marker in epithelioid peritoneal malignant mesothelioma
• Limitations the authors state:
  • Electron microscopy was not done, so the authors could not confirm whether the surface KL-6 staining reflects surface microvilli
  • The usefulness of KL-6 for monitoring tumor progression needs to be established in more cases

Topics

Medical terms in this study, explained in our Lexicon: Mesothelioma, Epithelioid, Tumor Marker.

Related studies

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• Peritoneal malignant mesothelioma (PMM), and primary peritoneal serous carcinoma (PPSC) and reactive mesothelial hyperplasia (RMH) of the peritoneum. Immunohistochemical and fluorescence in situ hybridisation (FISH) analyses — T. Kawai, S. Tominaga, et al. (2016)
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