Journal of Pathology and Translational Medicine

Original Articles

Can BAP1 expression loss in mesothelial cells be an indicator of malignancy?: Hanife Gulnihal Ozdemir, Sermin Coban Kokten, Nagehan Ozdemir Barisik; J Pathol Transl Med. 2020;54(6):497-503. Published online November 9, 2020; DOI: https://doi.org/10.4132/jptm.2020.09.14

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Background
Malignant mesothelioma is a highly aggressive tumor that can be confused with a benign mesothelial lesion, especially cytomorphologic lesions. BRCA1-associated protein 1 (BAP1) acts as a tumor suppressor. In this study, we aim to investigate the value of BAP1 staining of malignant mesothelioma cases with expression loss and diagnosis in cell block and biopsy tissue.
Methods
Between January 2009 and March 2017, 64 mesotheliomas, 117 reactive mesothelial hyperplasias, and 20 fibrinous pleuritis/pericarditis were diagnosed with morphologic and immunohistochemical findings in our pathology clinic and were included in the study. Formalin-fixed, paraffin-embedded tissues were immunohistochemically examined for BAP1. Inflammatory and stromal cells were used as positive internal controls. BAP1 was assessed for nuclear staining in mesothelial cells.
Results
Examinations of the relationship between patient diagnosis and BAP1 biopsy status showed that the BAP1 loss rate (76.6%) was significantly higher in malignant mesothelioma cases than in other benign diseases (0%) (p<.001). Sensitivity and specificity were 76.56% and 100%, respectively, for biopsy tissue from malignant mesothelioma. Sensitivity and specificity were both 100% for BAP1 test on cell block tissue. Furthermore, the consistency between BAP1 cell block and biopsy results was excellent (ĸ=0.90) and the correlation was significant (p<.001).
Conclusions
This study shows that BAP1 expression loss in both cytology and biopsy tissue in biopsy-confirmed malignant mesothelioma cases is an essential parameter for malignant mesothelioma diagnosis.

Citations

Citations to this article as recorded by

Diagnostic Challenges in the Pathological Approach to Pleural Mesothelioma
Stefano Lucà, Giovanna Pignata, Alessandro Cioce, Cecilia Salzillo, Rossella De Cecio, Gerardo Ferrara, Carminia Maria Della Corte, Floriana Morgillo, Alfonso Fiorelli, Marco Montella, Renato Franco
Cancers.2025; 17(3): 481. CrossRef
Thrombocytosis as a paraneoplastic syndrome in metastatic malignant peritoneal mesothelioma of biphasic morphology mimicking ovarian adenocarcinoma: A case report
Moustafa S. Alhamadh, Rakan B. Alanazi, Osama Mohaamad Wadaan, Abdulrahman Yousef Alhabeeb, Mohammad Alkaiyat, Ohoud Zaid Aljarbou, Fouad Sabatin
Clinical Case Reports.2023;[Epub] CrossRef
Primary cardiac mesothelioma presenting with fulminant recurrent pericarditis: a case report
Shmuel Schwartzenberg, Yaron Shapira, Victor Rubachevski, Ram Sharony, Harry Klimis, Domenico Filomena, Edgar Francisco Carrizales Sepulveda, Nikolaos Spinthakis, Jonathan Senior
European Heart Journal - Case Reports.2023;[Epub] CrossRef

Loss of Nuclear BAP1 Expression Is Associated with High WHO/ISUP Grade in Clear Cell Renal Cell Carcinoma: Young Chan Wi, Ahrim Moon, Min Jung Jung, Yeseul Kim, Seong Sik Bang, Kiseok Jang, Seung Sam Paik, Su-Jin Shin; J Pathol Transl Med. 2018;52(6):378-385. Published online October 1, 2018; DOI: https://doi.org/10.4132/jptm.2018.09.21

8,490 View
214 Download
13 Web of Science
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Abstract PDF

Background
BRCA1-associated protein 1 (BAP1) mutations are frequently reported in clear cell renal cell carcinoma (ccRCC); however, very few studies have evaluated the role of these mutations in other renal cell carcinoma (RCC) subtypes. Therefore, we analyzed BAP1 protein expression using immunohistochemistry in several RCC subtypes and assessed its relationship with clinicopathological characteristics of patients.
Methods
BAP1 expression was immunohistochemically evaluated in tissue microarray blocks constructed from 371 samples of RCC collected from two medical institutions. BAP1 expression was evaluated based on the extent of nuclear staining in tumor cells, and no expression or expression in < 10% of tumor cells was defined as negative.
Results
Loss of BAP1 expression was observed in ccRCC (56/300, 18.7%), chromophobe RCC (6/26, 23.1%), and clear cell papillary RCC (1/4, 25%), while we failed to detect BAP1 expression loss in papillary RCC, acquired cystic disease-associated RCC, or collecting duct carcinoma. In ccRCC, loss of BAP1 expression was significantly associated with high World Health Organization (WHO)/International Society of Urological Pathology (ISUP) grade (p = .002); however, no significant correlation was observed between loss of BAP1 expression and survival in ccRCC. Loss of BAP1 expression showed no association with prognostic factors in chromophobe RCC.
Conclusions
Loss of BAP1 nuclear expression was observed in both ccRCC and chromophobe RCC. In addition, BAP1 expression loss was associated with poor prognostic factors such as high WHO/ISUP grade in ccRCC.

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