{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T21:40:08Z","timestamp":1789767608096,"version":"4.0.1"},"reference-count":27,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2022,10,19]],"date-time":"2022-10-19T00:00:00Z","timestamp":1666137600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2023,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Pleural mesothelioma (PM) is typically diagnosed late during the disease. Earlier detection can increase the chance of effective therapy. Recurrent pleural effusions are the earliest symptoms displaying an array of cytomorphological changes from reactive atypia to malignancy. Diagnosis is possible on effusion cytology by applying molecular and immunocytochemical markers, the main difficulty being when to suspect PM and to differentiate PM from metastatic adenocarcinoma and reactive mesothelial proliferations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We evaluated the diagnostic performance of two immunocytochemical dual stains (BerEp4\/Calretinin and Desmin\/Epithelial Membrane Antigen (EMA)) on 149 ethanol\u2010fixed cytospin preparation as an initial step to solve the mentioned diagnostic difficulty. The immunocytochemical reactivity pattern was evaluated by two independent investigators. The final diagnosis corresponded to PM (<jats:italic>n<\/jats:italic>\u00a0=\u00a020), metastatic adenocarcinoma (<jats:italic>n<\/jats:italic>\u00a0=\u00a083), and mesotheliosis (<jats:italic>n<\/jats:italic>\u00a0=\u00a046) in these cases.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Calretinin had 99% specificity and 98% sensitivity for indicating a mesothelial phenotype, while BerEp4 distinguished the adenocarcinoma cases with 98% specificity and 99% sensitivity. EMA displayed 96% specificity and 99% sensitivity in malignant cases, while Desmin without EMA present showed 99% specificity and 96% sensitivity for indicating benign mesothelial proliferation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Interpretation of the four immunoreactions is improved when performed as dual stains. The dual staining is a useful tool in the initial handling of atypical effusions and guides the subsequent choice of antibody panels for more detailed subclassification of malignant effusions.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cam4.5353","type":"journal-article","created":{"date-parts":[[2022,10,19]],"date-time":"2022-10-19T07:30:35Z","timestamp":1666164635000},"page":"5334-5340","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Utility of BerEp4\/calretinin and desmin\/epithelial membrane antigen (EMA) dual immunocytochemical staining in effusion cytology"],"prefix":"10.1002","volume":"12","author":[{"given":"Anders","family":"Hjerpe","sequence":"first","affiliation":[{"name":"Division of Pathology, Department of Laboratory Medicine Karolinska Institutet  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enes","family":"Demir","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Eskisehir Osmangazi University  Eskisehir Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sulaf","family":"Abd\u2010Own","sequence":"additional","affiliation":[{"name":"Division of Pathology, Department of Laboratory Medicine Karolinska Institutet  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0207-6733","authenticated-orcid":false,"given":"Katalin","family":"Dobra","sequence":"additional","affiliation":[{"name":"Division of Pathology, Department of Laboratory Medicine Karolinska Institutet  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,10,19]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.lungcan.2016.12.017"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1038\/modpathol.2008.45"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.lungcan.2009.05.004"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1159\/000377697"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.5858\/arpa.2018-0020-RA"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1038\/bjc.2017.20"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/dc.24395"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/JTO.0b013e31815608d9"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1038\/bjc.2011.104"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1159\/000339586"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/cyt.12738"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0107741"},{"issue":"5","key":"e_1_2_11_14_1","first-page":"205","article-title":"Expression of mesothelial markers in malignant mesotheliomas: an immunohistochemical evaluation of 173 cases","volume":"55","author":"Soomro IN","year":"2005","journal-title":"J Pak Med Assoc"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1136\/jcp.55.9.662"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2559.2003.01686.x"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1053\/hupa.2001.24329"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2559.1998.00405.x"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/dc.23683"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/dc.23837"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/dc.10039"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/dc.21489"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1038\/srep09507"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1002\/dc.21398"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0072030"},{"issue":"3","key":"e_1_2_11_26_1","first-page":"219","article-title":"The distinction of mesothelioma from adenocarcinoma in malignant effusions by electron microscopy","volume":"29","author":"Kobzik L","year":"1985","journal-title":"Acta Cytol"},{"key":"e_1_2_11_27_1","first-page":"409","article-title":"The use of electron microscopy in the diagnosis of diffuse mesotheliomas using human pleural effusions","volume":"30","author":"Butler EB","year":"1980","journal-title":"IARC Sci Publ"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.1080\/01913123.2016.1195469"}],"container-title":["Cancer Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/cam4.5353","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/cam4.5353","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/cam4.5353","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,21]],"date-time":"2023-08-21T16:20:11Z","timestamp":1692634811000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/cam4.5353"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,10,19]]},"references-count":27,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2023,3]]}},"alternative-id":["10.1002\/cam4.5353"],"URL":"https:\/\/doi.org\/10.1002\/cam4.5353","archive":["Portico"],"relation":{},"ISSN":["2045-7634","2045-7634"],"issn-type":[{"value":"2045-7634","type":"print"},{"value":"2045-7634","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,10,19]]},"assertion":[{"value":"2022-08-29","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-10-04","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-10-19","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}