Malignant pleural mesothelioma: biology and diagnosis
Wednesday, November 26th, 2008.
Revue des Maladies Respiratoires. 2008 Oct;25(8 Pt 2):3S183-90. [Link]
Scherpereel A, Grigoriu BD, Astoul P.
Service de Pneumologie et Oncologie Thoracique, Hôpital Calmette, CHRU de Lille, Lille, France. a-scherpereel@chru-lille.fr
Abstract
Malignant pleural mesothelioma (MPM) is a serious issue worldwide because of its increasing incidence and poor prognosis despite real recent improvements in the disease management. Most of the patients are diagnosed late in the course of the disease when radical treatment is no more an option. Therefore an earlier diagnosis of MPM is needed to significantly increase the survival of patients. Some soluble markers, including soluble mesothelin and osteopontin, have been previously proposed for MPM diagnosis but none has been validated yet. Soluble mesothelin, assessed in blood and in pleural effusion, seems to be the most promising candidate. However, even if it has a good diagnostic and prognostic value, it is quite specific for the epithelioid subtype, the most frequent one of mesothelioma, thus limiting its usefulness in practice. Despite sometimes a good sensitivity, other potential markers as osteopontin are of little interest for MPM diagnosis because of a low specificity. In conclusion, the present data do not justify the use of biology for MPM diagnosis in routine yet but rather suggest a need for a continuing evaluation of soluble mesothelin in clinical studies and the search for other potential tumor markers.
Keywords: Mesothelioma, Tumor marker, Biology, Thoracoscopy, Pleural cancer
Glossary
- prognosis
- (prog-no-sis) a prediction of the course of disease; the outlook for the cure of the patient. For example, women with breast cancer that was detected early and who received prompt treatment have a good prognosis.
- 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.
- DES
- abbreviation for diethylstilbestrola (die-eth-l-steh-BES-ter-ol), synthetic form of estrogen.
- cancer
- malignancy; a group of diseases typified by abnormal, generally out-of-control, cell growth.
- tumor
- an abnormal lump or mass of tissue. Tumors can be benign (not cancerous) or malignant (cancerous).
- tumor marker
- abnormal proteins on the surface of some cancerous cells that sometimes are used to monitor response to treatment or detect recurrence.
- mesothelioma
- a tumor derived from mesothelial tissue, such as the peritoneum (lining the abdomen) or pleura (lining the lungs). More on mesothelioma.
- pleural effusion
- an abnormal accumulation of fluid, usually caused by trauma or disease, in the pleural space.
