Pleural mesothelioma: diagnostic problems and evaluation of prognostic factors
Thursday, February 28th, 2008.
Journal of the Egyptian National Cancer Institute. 2006 Dec;18(4):303-10. [Link] [Full Text PDF]
Ismail HM, Nouh MA, Abulkheir IL, Abd El-Rahman Ael-R, Tawfik HN.
The Department of Pathology, National Cancer Institute, Cairo University. hodanci@hotmail.com
Abstract
Background: Malignant pleural mesothelioma (MPM) in Egypt is mainly attributed to an environmental origin i.e exposure to asbestos, with a high incidence in women and young adults. Immunohistochemistry and ultrastructural features aid in the diagnosis. The p27Kip1 is a kinase inhibitor protein acting as a cell cycle regulator and a putative tumor suppressor gene playing a critical role in the pathogenesis of several human neoplasms. AIM: A clinicopathologic, immunohistochemical and ultrastructural study of mesothelioma in Egyptian patients, with identification of different prognostic factors.
Material and Methods: Sixty-one cases of MPM were collected from the department of pathology at the NCI, Cairo. Cases were stained by monoclonal antibodies against CK5/6, calretinin, vimentin, CD15, CEA and p27.
Results: More than half (57.4%) of the patients were residents in endemic areas; 50.8% were of epithelioid type. CK5/6 was positive in 45 (73.8%) cases, 39 (63.9%) cases were positive for vimentin, 49 (80.3%) cases were positive for calretinin. One case showed a focal weak positive reaction to CD15. None of the cases stained for CEA. There was a statistically significant relation between p27 expression and the histopathologic type (p=0.02) between overall survival and age (p=0.01), histopathologic type (p=0.02) and stage (p=0.006).
Conclusion: MPM is an increasing disaster in Egypt which is underestimated and neglected. A panel of immunohistochemical markers should be used for proper evaluation. p27 has proven to be a potential biologic prognostic marker for mesothelioma and more studies as regard its significance are recommended on a larger number.
Glossary
- monoclonal antibodies
- antibodies made in the laboratory and designed to target specific substances called antigens. Monoclonal antibodies which have been attached to chemotherapy drugs or radioactive substances are being studied to see if they can seek out antigens unique to cancer cells and deliver these treatments directly to the cancer, thus killing the cancer cells without harming healthy tissue. Monoclonal antibodies are also used in other ways, for example, to help find and classify cancer cells.
- gene
- a segment of DNA that contains information on hereditary characteristics such as hair color, eye color, and height, as well as susceptibility to certain diseases. Women who have BRCA1 or BRCA2 gene mutations (defects) have an inherited tendency to develop breast cancer.
- diagnosis
- identifying a disease by its signs or symptoms, and by using imaging procedures and laboratory findings. The earlier a diagnosis of cancer is made, the better the chance for long-term survival.
- cell
- the basic unit of which all living things are made. Cells replace themselves by splitting and forming new cells (mitosis). The processes that control the formation of new cells and the death of old cells are disrupted in cancer.
- cancer
- malignancy; a group of diseases typified by abnormal, generally out-of-control, cell growth.
- CEA
- carcinoembryonic antigen (car-sin-o-em-bre-ON-ic an-tuh-jin), antigens found in fetal tissue. If found in an adult, they may be specific to cancerous tumors. Tests for these antigens may help in diagnosing cancer and in finding out if the cancer has spread
- tumor
- an abnormal lump or mass of tissue. Tumors can be benign (not cancerous) or malignant (cancerous).
- mesothelioma
- a tumor derived from mesothelial tissue, such as the peritoneum (lining the abdomen) or pleura (lining the lungs). More on mesothelioma.
