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Curated Journal Articles on Mesothelioma

Malignant Pleural Mesothelioma: Accuracy of CT Against Immunohistochemical Test Among Mexican Population

Archives of Medical Research 2015 February 20 [Epub ahead of print] [Link]

Gopar-Nieto R, Aguilar-Madrid G, Sotelo-Martínez L, Juárez-Pérez CA, Kelly-García J, Argote-Greene L, Ochoa-Vázquez MD, García-Bazán EM, Ramírez-Pérez J, Haro-García L, Jiménez-Ramírez C, Cabello-López A.

Abstract

Background and Aims

Malignant pleural mesothelioma (MPM) is associated with occupational and environmental exposure to asbestos. The incidence is expected to increase as the use of asbestos is not prohibited in many countries, such as in Mexico. We undertook this study to determine sensitivity, specificity, predictive values and likelihood ratios of computed tomography (CT) in a sample Mexican population with suspected MPM and other pleuropulmonary diseases.

Methods

CT films of 38 patients suspected of having MPM were analyzed. A single observer was blinded to MPM diagnoses. The frequencies of ten CT findings were identified. A cut-off point of ≥5 CT findings was established to determine high MPM probability. Sensitivity, specificity, predictive values and likelihood ratio of the CT against biopsy using immunohistochemical testing (IHC) for MPM were calculated.

Results

Of the 38 patients, 31 had MPM and seven had lung adenocarcinoma. The five key findings were mediastinal pleural thickening 96.7% (n = 30), nodular pleural thickening 93.3% (n = 29), pleural mass 83.9% (n = 26), diminished lung 70.9% (n = 22) and contracted hemithorax 70.9% (n = 22). Sensitivity 96.8% (83.2-99.4), specificity 85.7% (42.2-97.6), positive likelihood ratio 6.7 (1.1-41.6), and negative likelihood ratio of 0.04 (0.01-0.2) were reported.

Conclusions

Sensitivity and specificity in this study was greater than previously reported, 96.8% and 85.7 vs. 93.2 and 65.6% respectively. CT is an easily accessible and useful tool that should be incorporated into the medical education of general physicians to improve MPM diagnosis of suspected cases.

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