{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T09:53:47Z","timestamp":1781776427675,"version":"3.54.5"},"reference-count":35,"publisher":"BMJ","issue":"7","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["J Clin Pathol"],"accepted":{"date-parts":[[2026,4,30]]},"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Distinguishing epithelioid malignant mesothelioma (EMM) from poorly differentiated lung adenocarcinoma (PD-LUAD) remains challenging, particularly when 21.7% of PD-LUADs lack lineage-specific markers (thyroid transcription factor-1 (TTF-1)\/Napsin A), creating a diagnostic blind spot. While GATA-binding protein 3 (GATA3) is established in sarcomatoid mesothelioma, its complementary diagnostic value and prognostic relevance in EMM are not well defined.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective study analysed 115 tissue specimens (55 EMMs; 60 PD-LUADs). Immunohistochemistry for GATA3, calretinin, Wilms\u2019 tumour gene 1 (WT-1), TTF-1, Napsin A and pan-cytokeratin was performed. Results were correlated with clinicopathological parameters and overall survival (OS) using Kaplan\u2013Meier and multivariate Cox regression analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>GATA3 was expressed in 78.2% of EMM but only 6.7% of PD-LUAD cases (p&lt;0.001). Although not specific enough for standalone diagnosis, GATA3 provided meaningful complementary value: in TTF-1\/Napsin A\u2013negative PD-LUAD, GATA3 remained negative in 92.3%, helping to exclude EMM when used within a broader panel. Incorporating GATA3 with calretinin and WT-1 improved panel sensitivity to 96.4% while maintaining 100% specificity.<\/jats:p>\n                    <jats:p>High GATA3 expression in EMM correlated significantly with advanced T stage, higher International Mesothelioma Interest Group stage and poor functional status (Karnofsky performance status\/Eastern Cooperative Oncology Group). Multivariate analysis identified GATA3 expression (p=0.037), smoking (p=0.041) and clinical T stage (p&lt;0.001) as independent predictors of shorter OS. A qualitative inverse relationship between tumorous GATA3 and GATA3-positive tumour-infiltrating lymphocytes was also noted.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>GATA3 serves as a useful adjunct within established immunohistochemical panels, particularly in resolving ambiguity in double-negative PD-LUAD. Beyond its supportive diagnostic role, GATA3 demonstrates independent prognostic significance and may reflect underlying immune-microenvironmental features, meriting further exploration in biomarker-guided therapeutic stratification.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/jcp-2026-210673","type":"journal-article","created":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T17:20:28Z","timestamp":1778779228000},"page":"475-485","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical utility and prognostic value of GATA3 in epithelioid malignant mesothelioma: a practical and cost-effective approach for resource-limited settings"],"prefix":"10.1136","volume":"79","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-0429-755X","authenticated-orcid":false,"given":"Dina Moustafa","family":"Thabit","sequence":"first","affiliation":[{"name":"Department of Pathology, Faculty of Medicine, Minia University, Minia, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dalia M","family":"Thabet","sequence":"additional","affiliation":[{"name":"Department of Pathology, Faculty of Medicine, Minia University, Minia, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,5,14]]},"reference":[{"key":"2026061802100681000_79.7.475.1","doi-asserted-by":"crossref","DOI":"10.1148\/rg.220128","article-title":"Mesotheliomas and Benign Mesothelial Tumors: Update on Pathologic and Imaging Findings","volume":"43","author":"Bonde","year":"2023","journal-title":"Radiographics"},{"key":"2026061802100681000_79.7.475.2","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1038\/s41379-021-00895-7","article-title":"Pleural mesothelioma classification-update and challenges","volume":"35","author":"Dacic","year":"2022","journal-title":"Mod Pathol"},{"key":"2026061802100681000_79.7.475.3","doi-asserted-by":"publisher","DOI":"10.1016\/j.prp.2020.152817"},{"key":"2026061802100681000_79.7.475.4","doi-asserted-by":"publisher","DOI":"10.1016\/j.humpath.2018.01.017"},{"key":"2026061802100681000_79.7.475.5","doi-asserted-by":"crossref","first-page":"119893","DOI":"10.1016\/j.bbamcr.2024.119893","article-title":"GATA3: Orchestrating cellular fate through differentiation and proliferation","volume":"1872","author":"Bacha","year":"2025","journal-title":"Biochimica et Biophysica Acta (BBA) - 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