OV 632 and MOC 31 in the diagnosis of mesothelioma and adenocarcinoma: an assessment of their use in formalin fixed and paraffin wax embedded material.

AIMS To investigate the reaction of antibodies OV 632 and MOC 31 in paraffin wax sections as opposed to frozen sections and cytological preparations; to evaluate their usefulness in the differential diagnosis of malignant mesothelioma and secondary adenocarcinoma of the pleura; and to assess the efficacy of microwave pretreatment of sections in unmasking their associated epitopes. METHODS Immunohistochemistry, using a standard avidin-biotin technique, with microwave pretreatment and trypsinisation in a certain proportion of cases. The material comprised 43 mesotheliomas, 44 adenocarcinomas and five reactive pleuras. RESULTS Epithelial mesotheliomas and the hyperplastic mesothelial cells reacted strongly with OV 632, the reaction with sarcomatoid and desmoplastic tumours was weak, and the reaction with adenocarcinomas was variable. An unequivocal but sometimes patchy positive reaction was obtained with MOC 31 in all but one of the adenocarcinomas; all but one of the mesotheliomas and all the reactive pleuras were negative. Review of the two apparently anomalous cases revealed that the original diagnoses had probably been incorrect. Reactions to both antibodies were abolished by microwave pretreatment, and also by prior trypsinisation in the case of OV 632. CONCLUSIONS OV 632 is unsuitable for routine clinical use in paraffin wax embedded material. MOC 31, however, would be a useful addition to a panel of antibodies in the differential diagnosis of mesothelioma and adenocarcinoma in large biopsy and resection specimens and necropsy material. Its value in small biopsy specimens remains to be assessed. Microwave pretreatment does not enhance the reactions with either antibody.