Mesothelioma Diagnosis

Another interesting study is called, Value of the Ber-EP4 antibody in differentiating epithelial pleural mesothelioma from adenocarcinoma : The M.D. Anderson experience and a critical review of the literature – American Society of Clinical Pathologists, Chicago, IL, ETATS-UNIS (1931) (Revue) by ORDONEZ N. G. (1) ; 1998, vol. 109, no1, pp. 85-89 (21 ref.) Here is an excerpt: Abstract – Although most studies have indicated that Ber-EP4 immunostaining can assist in differentiating epithelial pleural mesotheliomas from adenocarcinomas that metastasize to the pleura, the percentage of positive cases has varied greatly among different studies. Authors of a recent publication concluded that Ber-EP4 has no diagnostic utility in separating these conditions. To determine whether Ber-EP4 has any value in distinguishing mesothelioma from adenocarcinoma, 70 formalin-fixed epithelial pleural mesotheliomas, 20 pulmonary adenocarcinomas, 59 nonpulmonary adenocarcinomas, 4 squamous cell carcinomas of the lung, 6 transitional cell carcinomas, and 31 adenocarcinomas of unknown origin that metastasized to the pleura were stained with this antibody. Reactivity was observed in 18 (26%) of 70 mesotheliomas and in all 20 (100%) of the pulmonary adenocarcinomas, in 55 (93%) of the 59 nonpulmonary adenocarcinomas, in 4 (100%) of 4 squamous cell carcinomas of the lung, in 4 (67%) of 6 transitional cell carcinomas, and in 26 (84%) of 31 adenocarcinomas of unknown origin that metastasized to the pleura. The staining in the mesotheliomas was focal and restricted to a limited number of cells, in contrast with staining in the pulmonary adenocarcinomas in which it was invariably diffuse. The extent of the staining in the nonpulmonary adenocarcinomas and the metastatic adenocarcinomas of unknown origin was less consistent-negative or focal in some cases and diffuse in others. Therefore, while Ber-EP4 seems to be helpful in separating epithelial pleural mesotheliomas from lung adenocarcinomas, its value in distinguishing mesotheliomas from other tumors metastatic to the pleura is more limited and depends largely on the site of origin of the metastatic tumor.

Another interesting study is called, Pleurectomy/decortication in the setting of multimodality treatment for diffuse malignant pleural mesothelioma. By Rusch VW. Memorial Sloan-Kettering Cancer Center, Department of Surgery and Cornell University Medical College, New York, NY 10021. Semin Thorac Cardiovasc Surg. 1997 Oct;9(4):367-72. Here is an excerpt: Abstract – Pleurectomy/decortication is a frequently performed operation for patients with diffuse malignant pleural mesothelioma (DMPM). It has a low surgical mortality rate (less than 5%), but is associated with a significant risk of local recurrence. To date, intensive adjuvant radiation or chemotherapy has not diminished that risk. Despite these disappointing results, pleurectomy/decortication may still be the best treatment option for some patients, particularly those with early stage disease whose medical condition precludes pneumonectomy. The role of pleurectomy/decortication in conjunction with newer treatment strategies such as neoadjuvant therapy or gene therapy warrants investigation.

Another interesting study is called, “Antisense therapy for malignant mesothelioma with oligonucleotides targeting the bcl-xl gene product” by W. Roy Smythe, MD, Imran Mohuiddin, MD, Mustafa Ozveran, MD, Xiaobo X. Cao – J Thorac Cardiovasc Surg 2002;123:1191-1198.  Here is an excerpt: “Objective: Malignant pleural mesothelioma is resistant to conventional therapies and to apoptosis. The bcl-2 family genes are major determinants of apoptotic homeostasis. Malignant pleural mesothelioma lines and tumors rarely express the antiapoptotic Bcl-2 protein but routinely express the antiapoptotic protein Bcl-xl and the proapoptotic proteins Bax and Bak. We have previously shown pharmacologic inhibition of bcl-xl expression in malignant pleural mesothelioma can lead to apoptosis, so we sought to determine whether antisense oligonucleotides directed at bcl-xl messenger RNA would engender apoptosis, possibly through a “forced imbalance” of bcl-2 family proteins.

Methods: Malignant pleural mesothelioma lines REN (epithelial) and I-45 (sarcomatous) were exposed to modified bcl-xl antissense oligonecleotides directed near the messenger RNA initiation sequence with and without a liposomal delivery system.

According to researchers and well known healthcare providers, mesothelioma is a type of cancer which attacks those who use asbestos blended materials randomly. The health of the victim gets destroyed due to over exposure to asbestos. Therefore, proper pre-emptive measures need to be taken to safeguard the body from the onset of this deadly disease. Mesothelioma affected patients must be well taken care of. Researchers have found out that when the disease is in its final stages it can prove to be deadly for the patient. It takes at least 30 years to destroy a person as it spreads very slowly in the body.

Reasons of Occurrence of Mesothelioma