Diagnostic Challenges of Malignant Pleural Mesothelioma

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Pathology and Molecular Diagnostics".

Deadline for manuscript submissions: closed (30 November 2022) | Viewed by 6094

Special Issue Editors

1. Division of Thoracic Surgery, Ospedale Maggiore della Carità di Novara, Novara, Italy.
2. Department of Health Sciences, Università del Piemonte Orientale, Via Solaroli 17, Novara, Italy
Interests: lung cancer; mesothelioma; mediastinal tumors; thymoma; myasthenia gravis; pleural diseases; robotic surgery; video-assisted thoracic surgery; tracheal surgery; chest wall diseases; surgery of the diaphragm
Division of Thoracic Surgery, Ospedale Maggiore della Carità di Novara, Novara, Italy
Interests: lung cancer; mesothelioma; mediastinal tumors; thymoma; myasthenia gravis; pleural diseases; robotic surgery; video-assisted thoracic surgery

Special Issue Information

Dear Colleagues, 

Mesothelioma is a subtle and insidious disease, with a poor prognosis. Expected survival at diagnosis is between 12 and 24 months, and the 5-year relative survival rate is about 10%.

More than 80% of cases are caused by prior asbestos exposure, with a long latency, as the exposure and the onset of cancer may be separated by 40–50 years. Other known risk factors include inhalation of erionite (a fibrous silicate similar to asbestos) and genetic aberrations such as BAP1 germline mutation.

Mesothelioma is a rare cancer, for which there are no recommended screening tests in people who are not at increased risk. For people who have been exposed to asbestos, there is no agreed screening protocol. The role of several serum biomarkers is still under debate. Regular imaging tests are of unclear usefulness. Most cases are still diagnosed at the onset of symptoms. 

Diagnosis of mesothelioma is challenging, as it can be suspected with imaging, but it has to be confirmed with biopsy. Conventional cytology has several limitations, although immunohistochemistry has enhanced its accuracy. Immunohistochemistry is crucial in differentiating mesothelioma from neoplastic mimics.  

An interdisciplinary approach involving a team of healthcare professionals including molecular biologists, pathologists, radiotherapists, oncologists, and surgeons is essential to diagnose mesothelioma, and to evaluate the benefits and burdens of various therapies in order to provide the best care for this disease.

Accordingly, this Special Issue is intended for researchers cooperate to evaluate and discuss new research developments of diagnostic methods that may lead to a prompt and precise diagnosis, which may help physicians deal with this disease.

In this Special Issue, the following topics will be presented: histopathology, cytopathology, genetics of malignant pleural mesothelioma, mesothelioma biomarkers, pleural mesothelial hyperplasia, invasive and non-invasive staging and surgical diagnosis of malignant mesothelioma.

Prof. Dr. Ottavio Rena
Dr. Sara Parini
Guest Editors

Manuscript Submission Information

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Keywords

  • mesothelioma histopathology
  • mesothelioma immunohistochemistry
  • mesothelioma cytopathology
  • mesothelioma genetics
  • mesothelioma biomarkers
  • pleural mesothelial hyperplasia
  • non-invasive staging of malignant mesothelioma
  • invasive diagnosis of malignant mesothelioma

Published Papers (3 papers)

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Review

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15 pages, 972 KiB  
Review
Diagnostic and Therapeutic Challenges of Malignant Pleural Mesothelioma
by Jacopo Moro, Simona Sobrero, Carlotta Francesca Cartia, Simona Ceraolo, Roberta Rapanà, Federico Vaisitti, Stefano Ganio, Federica Mellone, Stefano Rudella, Federico Scopis, Danilo La Paglia, Carola Crystel Cacciatore, Enrico Ruffini and Francesco Leo
Diagnostics 2022, 12(12), 3009; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics12123009 - 01 Dec 2022
Cited by 2 | Viewed by 2211
Abstract
Malignant pleural mesothelioma is a rare cancer characterized by a very poor prognosis. Exposure to asbestos is the leading cause of malignant pleural mesothelioma. The preinvasive lesions, the mesothelial hyperplasia and its possible evolution are the focus of the majority of the studies [...] Read more.
Malignant pleural mesothelioma is a rare cancer characterized by a very poor prognosis. Exposure to asbestos is the leading cause of malignant pleural mesothelioma. The preinvasive lesions, the mesothelial hyperplasia and its possible evolution are the focus of the majority of the studies aiming to identify the treatable phase of the disease. The role of BAP-1 and MTAP in the diagnosis of mesothelioma in situ and in the prognosis of malignant pleural mesothelioma is the main topic of recent studies. The management of preinvasive lesions in mesothelioma is still unclear and many aspects are the subject of debate. The diagnosis, the disease staging and the accurate, comprehensive assessment of patients are three key instants for an appropriate management of patients/the disease. Full article
(This article belongs to the Special Issue Diagnostic Challenges of Malignant Pleural Mesothelioma)
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14 pages, 565 KiB  
Review
New Insights in Pleural Mesothelioma Classification Update: Diagnostic Traps and Prognostic Implications
by Maria Giovanna Mastromarino, Alessandra Lenzini, Vittorio Aprile, Greta Alì, Diana Bacchin, Stylianos Korasidis, Marcello Carlo Ambrogi and Marco Lucchi
Diagnostics 2022, 12(12), 2905; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics12122905 - 22 Nov 2022
Cited by 4 | Viewed by 1570
Abstract
The 2021 WHO Classification of Tumors of the Pleura has introduced significant changes in mesothelioma codification beyond the three current histological subtypes—epithelioid, sarcomatoid and biphasic. Major advances since the 2015 WHO classification include nuclear grading and the introduction of architectural patterns, cytological and [...] Read more.
The 2021 WHO Classification of Tumors of the Pleura has introduced significant changes in mesothelioma codification beyond the three current histological subtypes—epithelioid, sarcomatoid and biphasic. Major advances since the 2015 WHO classification include nuclear grading and the introduction of architectural patterns, cytological and stromal features for epithelioid diffuse mesothelioma. Mesothelioma in situ has been recognized as a diagnostic category. Demonstration of loss of BAP1 or MTAP by immunohistochemistry, or CDKN2A homozygous deletion by FISH, is valuable in establishing the diagnosis of epithelioid mesothelioma. Recent emerging data proved that grading and histological subtypes have prognostic implications and may be helpful to patient risk stratification and clinical management. Nevertheless, the latest mesothelioma classification increases the already non-negligible diagnostic pitfalls, especially concerning differential diagnosis of pre-invasive tumors. In this review, recent changes in histologic classification of mesothelioma and advances in molecular markers are presented and their relation to diagnostic challenges and prognostic implications is discussed. Full article
(This article belongs to the Special Issue Diagnostic Challenges of Malignant Pleural Mesothelioma)
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Other

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15 pages, 3497 KiB  
Systematic Review
Systematic Review, Meta-Analysis and Bioinformatic Analysis of Biomarkers for Prognosis of Malignant Pleural Mesothelioma
by Zhenhua Lu, Wenlong Zhang, Ke Huang, Mucheng Zhu, Xiaoting Gu, Defang Wei, Mingxuan Shi, Yaqiong Chen and Huihui Wang
Diagnostics 2022, 12(9), 2210; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics12092210 - 12 Sep 2022
Cited by 2 | Viewed by 1684
Abstract
In previous studies, non-invasive diagnostic biomarkers showed great benefit in the early-stage diagnosis of malignant pleural mesothelioma (MPM). However, the accuracy of different biomarkers was controversial. In this study, meta-analysis and bioinformatics analysis were conducted to compare the accuracy of the following three [...] Read more.
In previous studies, non-invasive diagnostic biomarkers showed great benefit in the early-stage diagnosis of malignant pleural mesothelioma (MPM). However, the accuracy of different biomarkers was controversial. In this study, meta-analysis and bioinformatics analysis were conducted to compare the accuracy of the following three biomarkers and explore the relationship between the gene expression levels and MPM. A systematic search of meta-analysis was conducted using PubMed, EMBASE and Cochrane Library to identify relevant studies from the inception to March 2021. QUADAS-2 for Quality Assessment of Diagnostic Accuracy Studies was used to evaluate the quality of eligible studies. The meta-analysis was performed utilizing Stata 15.0 and Review Manager 5.4 software. The meta-analysis results showed that 31 studies that involved 8750 participants were included. The pooled sensitivity and specificity (SPE) were 0.90 (95% CI: 0.74, 0.97) and 0.91 (95% CI: 0.84, 0.95) for Fibulin-3, 0.66 (95% CI, 0.51–0.78) and 0.91 (95% CI, 0.82–0.96) for mesothelin (MSLN), 0.68 (95% CI: 0.63,0.73) and 0.86 (95% CI: 0.82,0.90) for soluble mesothelin-related peptides (SMRP), and 0.74 (95% CI, 0.66-0.80) and 0.89 (95% CI, 0.85–0.91) for MSLN + SMRP + Fibulin-3. Compared with the other two biomarkers, Fibulin-3 may be more appropriate to be one of the indicators for combined diagnosis. Bioinformatics analysis showed that the low expression level of the MSLN gene was significantly related to longer survival time and better prognosis of MPM patients. However, considering the limitation in the quality and sample size of the included research, further studies are required. Full article
(This article belongs to the Special Issue Diagnostic Challenges of Malignant Pleural Mesothelioma)
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