Mesothelioma

Cytogenetics and fluorescence in situ hybridization as adjuncts to cytology in the diagnosis of malignant mesothelioma

2009-10-02T07:31:00.000-07:00

Virtually all malignant mesotheliomas (MMs) exhibit clonal chromosomal aberrations. Although the chromosome regions affected by these aberration(s) may vary from 1 tumor to another, certain regions are commonly disrupted.

These aberrations are absent in benign mesothelial cells, and therefore their presence can be used to confirm a diagnosis of MM. In the current study, the authors investigated the value of karyotyping and fluorescence in situ hybridization (FISH) as adjuncts to conventional cytologic examination in patients with MM.

METHODS::
A retrospective analysis of 48 pleural or peritoneal fluids from patients with histologically confirmed MM was performed. Karyotypic analyses were attempted in all cases. In 27 cases, FISH for deletions of 9p21 (CDKN2A gene) and 22q was also performed because the karyotype was normal or unsuccessful.

RESULTS::
Karyotypes were obtained in 35 (73%) of the specimens. Of these, 15 (43%) were abnormal and 20 (57%) were normal. Thirteen additional abnormal results were detected by FISH in cases for which the karyotypes were normal or unsuccessful. A total of 24 cases (50%) had an associated cytologic interpretation. Karyotyping or FISH was abnormal in 8 cases that were interpreted cytologically as either negative or suspicious.

CONCLUSIONS::
The combination of FISH and karyotyping was found to improve on the diagnostic sensitivity of karyotyping alone in detecting MM in effusions. The authors concluded that karyotyping and FISH together were a more useful adjunct to cytology than FISH or karyotyping alone. Cancer (Cancer Cytopathol) 2009. (c) 2009 American Cancer Society.

"Cytogenetics and fluorescence in situ hybridization as adjuncts to cytology in the diagnosis of malignant mesothelioma"
Cancer Cytopathol. 2009 Jun 17; Factor RE, Dal Cin P, Fletcher JA, Cibas ES

Mesothelioma Cancer Victim

2009-10-01T15:24:00.000-07:00

Mesothelioma cancer is a rare form of cancer found in the lining of the lungs, stomach or heart. Mesothelioma victims typically do not know they have the illness until Deathly it too late to treat. This is because when the rare asbestos cancer attacks, it leaves a trail of symptoms that resemble those of common illnesses such as bronchitis or the stomach flu.

Mesothelioma & Asbestos Exposure Victims

Mesothelioma cancer is the only form of cancer that is directly related to the inhalation of asbestos fibers. Asbestos fibers, if separated, are extremely toxic. They are microscopic to the eye and can be easily inhaled. The tiny fibers can become embedded in the stomach, lungs or heart and overtime can accumulate and cause irritation.

After a length of time, the fibers can lead to the development of mesothelioma, sometimes taking up to 50 years to fully develop. Most mesothelioma cancer victims developed the cancer as a result of asbestos exposure in the workplace without knowing of the risk.

Asbestos was used in industrial, maritime, automotive and building products and around during WWII because of its durability and strength. Many retired industrial workers are just now developing the disease even though they may not have been exposed to asbestos in a long time.

Who is at risk of becoming a victim of mesothelioma cancer?
Although it has been proven that even the slightest amount of asbestos can be harmful, most cases of mesothelioma cancer have been seen in those who worked closely with cancer asbestos fibers on a daily basis.

Top states with the most cases of asbestos cancer are: California, Florida, Pennsylvania, New York, Texas.

Following is a list of at-risk occupations:
Pipe fitters
Shipyard workers
Steel mill workers
Railroad workers
Steamfitters
Electricians
Plumbers, maintenance workers
Drywallers, painters, plasterers
Firefighters
Demolition workers

Mesothelioma Cancer Victim?
The most important thing to do after being diagnosed is to ask your physician for a list of mesothelioma cancer specialists and treatment centers in your area. Mesothelioma treatment centers specialize in matching each individual victim with a specialist who can help design a treatment plan that suits their needs.

Highlight :
Mesothelioma Definition | Treatment of Mesothelioma Cancer | Cancer Mesothelioma Risk

Impact of malignant mesothelioma in Taiwan

2009-10-01T14:03:00.000-07:00

To describe the epidemiologic characteristics of malignant mesothelioma (MM) in Taiwan; to evaluate the impact of the condition.

METHODS:
The Taiwan Cancer Registry Database was used to retrieve the cases of MM registered from 1979 to 2005. Only cases of histopathologically verified MM were included. For evaluating the impact of MM, the cancer sites of the pleura and peritoneum (ICD-O codes 163 and 158, respectively) were used for statistical analysis and estimation of the expected years of life lost (EYLL).

Their survival was calculated by Kaplan-Meier analysis and extrapolated to obtain the EYLL using the Monte Carlo simulation by borrowing information from gender- and age-matched populations in Taiwan.

RESULTS:
A total of 423 cases of MM were included; MM of the pleura and peritoneum accounted for 91% of all cases (387/423). The median survival of pleural and peritoneal MM was 7.6 and 13.5 months for males and females, respectively. The incidence of MM increased during the observation period. A total of 232 males and 155 females diagnosed with MM were used for estimation of EYLL: 14.8 [95% Confidence Interval: 13.1-16.6] life years for males and 13.7 [11.2-16.2] life years for females.

CONCLUSION:
The increasing incidence and significant EYLL for MM were observed for both males and females during 1979-2005 in Taiwan, although under-diagnosis and under-estimation were likely.

"Impact of malignant mesothelioma in Taiwan: A 27-year review of population-based cancer registry data."
Lung Cancer. 2009 Jun 15; Lee LJ, Chang YY, Wang JD

Malignant pleural mesothelioma: ESMO clinical recommendations for diagnosis, treatment and follow-up.

2009-07-10T23:11:00.001-07:00

Ann Oncol. 2009 May; 20 Suppl 4: 73-5Stahel RA, Weder W, Felip E,

Microstructures and biological influence of environmental exposure of asbestos.

2009-07-10T20:32:00.001-07:00

Biomed Mater Eng. 2009; 19(2): 231-9Yada K, Kohyama NAsbestos minerals are thin fiber type of minerals and honorably said as "the minerals of the miracle" because of their valuable natures even in the strategic field. On the other hand, the relation between asbestos exposure and diseases such as lung cancer and malignant mesothelioma was proved around 1970 by epidemiology and an animal experiment in relation to their microstructures. Here, microstructures of chrysotile asbestos, a mainstream of asbestos substances, are shown. It is also shown that in what kinds of environment people are exposed to asbestos and what kinds of biological or epidemical things happen after asbestos exposure. Many kinds of fibrous materials as the substitutes of asbestos are described in relation to their carcinogenicity.

Interobserver variations in diagnosing asbestosis according to the ILO classification.

2009-07-10T18:03:00.001-07:00

Arh Hig Rada Toksikol. 2009 Jun; 60(2): 191-5PeriÄ I, Novak K, BarisiÄ I, Mise K, VuckoviÄ M, JankoviÄ S, Tocilj JInhalation of asbestos fibres leads to asbestosis of the pleura and the lung, with possible progression to lung cancer and malignant pleural or peritoneal mesothelioma. Asbestosis remains difficult to diagnose, especially in its early stages. The most important role in its diagnosis is that of chest radiographs. The aim of this cross-sectional study was to address interobserver variations in interpreting chest radiographs in asbestos workers, which remain to be an issue, despite improvements in the International Labour Office (ILO) classification system. In our ten-year study, we investigated 318 workers occupationally exposed to asbestos, and in 210 workers with diagnosed asbestos-related changes we compared interpretations of chest radiographs according to ILO by two independent radiologists. The apparent degree of interobserver variation in classifying lung fibrosis was 26.66% for the diameter of changes and 42.2% for the profusion of the changes. In cases with diffuse pleural thickening, the interobserver variation using ILO procedures was 34.93%. This investigation raises the issue of standardisation and objectivity of interpretation of asbestosis according to the ILO classification system. This study has revealed a significant disagreement in the estimated degree of pleural and parenchymal asbestos pulmonary disease. This is why we believe high-resolution computed tomography (HRCT) should also be used as a part of international classification.

[Statistical analysis of the incidence of some cancers in the province of Taranto 1999-2001]

2009-07-10T16:14:00.001-07:00

Epidemiol Prev. 2009 Jan-Apr; 33(1-2): 37-44Graziano G, Bilancia M, Bisceglia L, de Nichilo G, Pollice A, Assennato GOBJECTIVE: to estimate the spatial distribution of risk, in order to assess its correlation to environmental pollution exposure around the large production facilities located in the Taranto area, and to identify high risk areas not previously reported. SETTING: Italy, Taranto province (581,508 inhabitants). DESIGN: incidence data in 29 municipalities of the Taranto province were extracted from the Jonico Salentino Cancer Registry (RTJS) for the following cancer sites: lung (ICDX C33-C34); pleura, pleuric mesothelioma (ICDX C45.0); bladder, malignancies only (ICDX C67); brain (ICDX C70-72); non-Hodgkin lymphoma (ICDX C82-85, C96); leukaemia (ICDX C91-5). Age standardized incidence rates for the whole province were computed. High-level risk areas were classified using a Poisson model, computing area-specific p-values associated to the null hypothesis of no increased risk (i.e. relative risk equal to 1). A hierarchical spatial Bayesian model was estimated to strengthen results: specifically two additional variance components, accounting for relative risk spatial autocorrelation and excess heterogeneity respectively, were considered in the model specification. Bayesian mapping of disease incidence allows for the drawing of regularized (smoothed) maps. To adjust for the effect of socio-economic deprivation, a five-variable index was introduced into the model as an ecological covariate. RESULTS: an increased risk of lung, pleura and bladder cancer was observed among male residents in the city of Taranto (respectively: SIR 1.24, p-value < 0.01; SIR: 2.21, p-value < 0.01; SIR 1.28, p-value < 0.01). For non-Hodgkin lymphoma, a significant value was observed in the city of Taranto for males (SIR 1.46, p-value < 0.01), as well as in the neighbouring area of Pulsano for females (SIR 3.88, p-value < 0.01). An unexpected increased risk of brain cancer was found in both sexe risk (especially among males) of lung, pleura and bladder cancer is likely related to the chemical pollutants and asbestos, due to the presence of many industries and shipyards in the city of Taranto.

Asbestos, lung cancer and mesothelioma in the British Journal of Industrial Medicine.

2009-07-09T20:44:00.001-07:00

Occup Environ Med. 2009 Jul; 66(7): 426-7Newman Taylor A

Benign multicystic peritoneal mesothelioma.

2009-07-08T08:21:00.001-07:00

Turk J Gastroenterol. 2009 Jun; 20(2): 138-41UzÃ¼m N, OzÃ§ay N, AtaoÄlu OBenign multicystic peritoneal mesothelioma is a rare tumor that occurs mainly in women in their reproductive age. It is characterized by the formation of multiple, thin-walled, multilocular cysts that frequently produce large, intra-abdominal masses. The short follow-ups and possible etiologies based on the published reports make it difficult to draw any firm conclusions.

An EMA negative, desmin positive malignant mesothelioma: limitations of immunohistochemistry?

2009-07-07T21:20:00.001-07:00

J Clin Pathol. 2009 Jul; 62(7): 651-2Salman WD, Eyden B, Shelton D, Howat A, Al-Dawoud A, Twaij ZHistopathologists in the current environment of medical negligence and litigation are more likely to use immunohistochemical investigations in their day-to-day practice to support their diagnosis and avoid future litigation. The caveat is that relying on immunohistochemistry is a double-edged sword and pathologists should be familiar with its limitations. We present a case of primary malignant peritoneal mesothelioma with an unusual immunohistochemical profile-desmin positive, EMA negative-and wish to highlight the importance of cautiously interpreting immunohistochemistry profiles when they do not fit the clinical history and histological appearance.

[Clinicopathological analysis and differential diagnosis of primary peritoneal adenocarcinoma]

2009-07-07T18:57:00.001-07:00

Zhonghua Yi Xue Za Zhi. 2009 Feb 24; 89(7): 463-5Gong HL, Wang CB, Zhang GJ, Li CF, Yang XY, Hou HL, Zhang XBOBJECTIVE: To investigate the clinicopathological characteristics and differential diagnosis of primary peritoneal adenocarcinoma. METHODS: The clinico-pathological data of 8 patients with primary peritoneal adenocarcinoma, all female, aged 55.7 (45 - 69), were analyzed retrospectively. Immunohistochemistry was used to detect the expression of pan-cytokine, cytokine (CK) 7, CK20, CA125, CEA, epithelial membrane antigen (EMA), vimentin, calretinin, and P63 in the specimens of tumor obtained during tumor reduction surgery. Microscopy was conducted for pathological examination. RESULTS: The common clinical symptoms of these 8 patients included abdominal distention and ascites. Pre-operationally, 6 cases were diagnosed as with ovarian cancer, I case as with malignant mesothelioma, and I as with peritoneal carcinoma. The misdiagnosis rate was 87.5%. Post-operational pathological examination showed 7 cases of serous papillary adenocarcinoma and one case of mucinous adenocarcinoma. Immunohistochemistry showed the positive rates of the different biological markers as follows: pan-CK (8/8), CK7 (8/8), CK20 (1/8), CA125 (7/8), CEA (7/8), EMA (8/8), vimentin (1/8), calretinin (1/8), and P53 (8/8). CONCLUSION: A rare malignant tumor arising from the secondary MÃ¼llerian system, primary peritoneal adenocarcinoma shares similar histopathological characters with ovary carcinoma, so is easy to be misdiagnosed. Immunohistochemical staining is helpful to the differential diagnosis.

Pemetrexed in the treatment of advanced non-squamous lung cancer.

2009-07-07T16:51:00.001-07:00

Lung Cancer. 2009 Jul 3; Rossi A, Ricciardi S, Maione P, de Marinis F, Gridelli CPemetrexed, a new cytotoxic agent, is a potent inhibitor of thymidylate synthase and other folate-dependent enzymes. Firstly, pemetrexed was approved in combination with cisplatin for the treatment of malignant pleural mesothelioma. Successively, it has been studied, as single-agent, in phase II and III trials for second-line therapy of non-small cell lung cancer (NSCLC). Based on these results, pemetrexed has been registered for the treatment of recurrent NSCLC. The next step was to test pemetrexed plus cisplatin versus gemcitabine plus cisplatin, as first-line therapy in advanced NSCLC patients, in a phase III, non-inferiority, randomized trial. This trial reported the pemetrexed plus cisplatin regimen to be not inferior, in terms of activity and efficacy, to the control arm but statistically better tolerated. The role of pemetrexed as maintenance therapy after first-line therapy for advanced NSCLC is currently being evaluated into a phase III trial. The consistency of the results of these recent studies has identified a predictive effect of NSCLC non-squamous histology for pemetrexed. To date, pemetrexed is registered, at the dose of 500mg/m(2) on day 1 of a 3-week schedule, in combination with cisplatin, for first-line therapy and, as single-agent, for second-line treatment of patients with non-squamous NSCLC.This review shows the latest and indicates the future developments of pemetrexed in the treatment of advanced NSCLC patients.

Pleural well-differentiated papillary mesothelioma: a case report.

2009-07-06T23:00:00.001-07:00

J Thorac Oncol. 2009 Jul; 4(7): 920-2Kao S, Mahon K, Lin B, Rutland J, Pawsey C, McCaughan B, Beale PWell-differentiated papillary mesothelioma is a pathologic entity distinct from malignant mesothelioma and has a different tumor biology highlighted by its relatively good prognosis. We report the case of a 27-year-old woman with pleural well-differentiated papillary mesothelioma, who was treated with bilateral pleurodesis and pericardial window to control the production of malignant fluid, without significant systemic anticancer treatment. She survived for 16 years, confirming its indolent nature. This case report also highlights the role of fluid cytology, immunohistochemistry, and electron microscopy in the diagnosis of well-differentiated papillary mesothelioma and the potential use of serum CA-125 as a marker of progression.

Cytokine alteration and speculated immunological pathophysiology in silicosis and asbestos-related diseases.

2009-07-06T01:41:00.001-07:00

Environ Health Prev Med. 2009 Mar 18; Murakami S, Nishimura Y, Maeda M, Kumagai N, Hayashi H, Chen Y, Kusaka M, Kishimoto T, Otsuki TThis review is partly composed of the presentation "Cytokine alteration and speculated immunological pathophysiology in silicosis and asbestos-related diseases" delivered during the symposium "Biological effects of fibrous and particulate substances and related areas" organized by the Study Group of Fibrous and Particulate Studies of the Japanese Society of Hygiene and held at the 78th Annual Meeting in Kumamoto, Japan. In this review, we briefly introduce the results of recent immunological analysis using the plasma of silica and asbestos-exposed patients diagnosed with silicosis, pleural plaque, or malignant mesothelioma. Thereafter, experimental background and speculation concerning the immunological pathophysiology of silica and asbestos-exposed patients are discussed.

Is D2-40 a useful marker for distinguishing malignant mesothelioma from pulmonary adenocarcinoma and benign mesothelial proliferations?

2009-07-05T22:31:00.001-07:00

Pathol Res Pract. 2009 Jun 30; Deniz H, Kibar Y, GÃ¼ldÃ¼r ME, BakÄ±r KSince pulmonary adenocarcinomas, malignant mesotheliomas (MM), and sometimes benign mesothelial proliferations show a great histomorphological resemblance to each other, an immunohistochemical panel is usually necessary for differential diagnosis. D2-40 is an available monoclonal antibody, which is already in use as a lymphatic endothelial marker. It has also been suggested to be useful in identifying the mesothelial differentiation. The aim of this study is to compare D2-40 immunostaining in MM, pulmonary adenocarcinoma, and benign mesothelial proliferations. In this retrospective study, D2-40 immunostaining was investigated in 37 cases of MM, 36 cases of pulmonary adenocarcinoma, and 31 cases of benign mesothelial proliferation. The diagnosis of MM had previously been confirmed by a panel including calretinin, CK5/6, and CEA. Predominantly membranous immunoreactivity was observed in 51% of MMs and in 55% of benign mesothelial proliferations. All the 36 pulmonary adenocarcinomas were negative. These results were statistically significant (p

Scoring system for differential diagnosis of malignant mesothelioma and reactive mesothelial cells on cytology specimens.

2009-07-05T19:01:00.001-07:00

Diagn Cytopathol. 2009 Jul 1; Kimura N, Dota K, Araya Y, Ishidate T, Ishizaka MCytology is the only useful tool in the detection of malignant mesothelioma (MM) at an early stage. No other methods, such as immunocytochemistry or electron microscopy, are available to distinguish MM from reactive mesothelial cells (RMC). Some objective analysis of cytology specimens is necessary. On the basis of our case review and cytological features described in previous articles, we developed a scoring system for malignant mesothelioma (SSMM) of effusion cytology to distinguish MM cells from RMC.Mesothelioma cells in effusions from 22 patients (20 pleural and 2 peritoneal mesotheliomas) were compared with RMC from 20 patients without obvious tumor cells and 50 effusions containing metastatic carcinoma cells. The SSMM is based on characteristic features of mesothelial and malignant cells. The total achievable score is 10 points: one point each is given for variety of cell size, cyanophilic cytoplasm with villosity/windows/bleb, sheet-like arrangement, mirror-ball-like cell clusters, nuclear atypia, and cannibalism, respectively. Further two points each are ascribed for acidophilic large nucleoli and multinucleated cells with more than eight nuclei. The total score for each of the 22 mesotheliomas was more than 5 points. On the other hand, all RMC and the 50 metastatic carcinoma cases scored less than 3 points, aside from two cases that were treated with OK432. No single characteristic feature was observed to be consistent within the 22 mesotheliomas analyzed. Ancillary use of immunocytochemistry, such as podoplanin (D2-40) and calretinin, supported the diagnostic accuracy of the SSMM. SSMM is useful for the differential diagnosis of MM. Diagn. Cytopathol. 2009. (c) 2009 Wiley-Liss, Inc.

Mesothelioma cells escape heat stress by upregulating Hsp40/Hsp70 expression via mitogen-activated protein kinases.

2009-07-05T17:58:00.001-07:00

J Biomed Biotechnol. 2009; 2009: 451084Roth M, Zhong J, Tamm M, Szilard JTherapy with hyperthermal chemotherapy in pleural diffuse malignant mesothelioma had limited benefits for patients. Here we investigated the effect of heat stress on heat shock proteins (HSP), which rescue tumour cells from apoptosis. In human mesothelioma and mesothelial cells heat stress (39-42 degrees C) induced the phosphorylation of two mitogen activated kinases (MAPK) Erk1/2 and p38, and increased Hsp40, and Hsp70 expression. Mesothelioma cells expressed more Hsp40 and were less sensitive to heat stress compared to mesothelial cells. Inhibition of Erk1/2 MAPK by PD98059 or by Erk1 siRNA down-regulated heat stress-induced Hsp40 and Hsp70 expression and reduced mesothelioma cell survival. Inhibition of p38MAPK by SB203580 or siRNA reduced Hsp40, but not Hsp70, expression and also increased mesothelioma cell death. Thus hyperthermia combined with suppression of p38 MAPK or Hsp40 may represent a novel approach to improve mesothelioma therapy.

Calretinin: diagnostic utility in the female genital tract.

2009-07-03T21:27:00.001-07:00

Adv Anat Pathol. 2009 Mar; 16(2): 118-24Portugal R, Oliva EThe utility of calretinin was first described in the diagnosis of mesothelioma. In the female genital tract, calretinin was initially reported in Wolffian remnants and related lesions and later used in the diagnosis of sex cord stromal tumors of the ovary, endometrial stromal tumors with sex cord-like differentiation, and uterine tumors resembling sex cord tumors of the ovary. This review discusses calretinin expression in normal tissues of the female genital tract and highlights its potential utility in the diagnosis of these subsets of neoplasms with emphasis to tumors that may constitute a problem in their differential diagnosis. In particular, the limited utility of calretinin in the diagnosis of sex cord stromal tumors of the ovary, in the differential diagnosis between mesothelioma and serous tumors involving the ovary and/or peritoneum, and in the differential diagnosis between Wolffian lesions and endometrial carcinoma are addressed.

Therapeutics by Cytotoxic Metabolite Accumulation: Pemetrexed Causes ZMP Accumulation, AMPK Activation, and Mammalian Target of Rapamycin Inhibition.

2009-07-03T15:27:00.001-07:00

Cancer Res. 2009 Jun 23; Racanelli AC, Rothbart SB, Heyer CL, Moran RGPemetrexed represents the first antifolate cancer drug to be approved by the Food and Drug Administration in 20 years; it is currently in widespread use for first line therapy of mesothelioma and non-small cell lung cancer. Pemetrexed has more than one site of action; the primary site is thymidylate synthase. We now report that the secondary target is the downstream folate-dependent enzyme in de novo purine synthesis, aminoimidazolecarboxamide ribonucleotide formyltransferase (AICART). The substrate of the AICART reaction, ZMP, accumulated in intact pemetrexed-inhibited tumor cells, identifying AICART as the step in purine synthesis that becomes rate-limiting after drug treatment. The accumulating ZMP causes an activation of AMP-activated protein kinase with subsequent inhibition of the mammalian target of rapamycin (mTOR) and hypophosphorylation of the downstream targets of mTOR that control initiation of protein synthesis and cell growth. We suggest that the activity of pemetrexed against human cancers is a reflection of its direct inhibition of folate-dependent target proteins combined with prolonged inhibition of the mTOR pathway secondary to accumulation of ZMP. [Cancer Res 2009;69(13):5467-74].

[Clinicopathological analysis and differential diagnosis of primary peritoneal adenocarcinoma.]

2009-07-03T01:59:00.001-07:00

Evolution of pleural cancers and malignant pleural mesothelioma incidence in France between 1980 and 2005.

2009-07-02T23:08:00.001-07:00

Int J Cancer. 2009 Jun 30; Stang NL, Belot A, Soit Ilg AG, Rolland P, Astoul P, Bara S, Brochard P, Danzon A, Delafosse P, Grosclaude P, Guizard AV, Imbernon E, LapÃ´tre-Ledoux B, Ligier K, MoliniÃ© F, Pairon J, Sauleau E, TrÃ©tarre B, Velten M, Bossard N, Goldberg M, Launoy G, Galateau-SallÃ© FThe evolution of pleural cancers and malignant pleural mesothelioma incidence in France between 1980 and 2005 was analysed using data derived from the French network of cancer registries (FRANCIM) and the French National Mesothelioma Surveillance Program (PNSM). Mesothelioma proportions in pleural cancers were calculated by diagnosis year in the 1980-2000 period. Our results suggest that the incidences of pleural cancer and mesothelioma levelled off in French men since 2000 and continued to increase in French women. A decrease of the annual pleural cancer incidence average in men was noticed (-3.4% of annual rate of change) between 2000 and 2005. The proportion of pleural cancers that were mesothelioma was unchanged between 1980 and 2003 with an average of 86%. The age standardised incidence rate of pleural mesothelioma remained relatively stable between 1998 and 2005 with a slight falling trend. For women, the age standardised incidence rate of pleural cancers and mesothelioma increased during the period 1998-2005. Additionally the proportion of pleural cancers that were mesothelioma increased during the same period of time. Finally, the increased trend observed in the incidence of pleural mesothelioma and cancers in women is credibly due to their under diagnosis in the 1980-1997 period. The comparison between the French incidence and the American and British ones shows that the decreasing trend in incidence of mesothelioma and pleural cancers in French men since 2000 is potentially associated with a lower amphibole consumption and by the implementation of safety regulations at work from 1977. (c) 2009 UICC.

Malignant pleural mesothelioma: current treatments and emerging drugs.

2009-07-02T15:58:00.001-07:00

Expert Opin Emerg Drugs. 2009 Jun 24; Belli C, Fennell D, Giovannini M, Gaudino G, Mutti LBackground: Malignant pleural mesothelioma (MPM) is an uncommon disease whose incidence is increasing worldwide over the past 30 years. Surgical resection and radiotherapy represent the standard treatment in patient with resectable MPM. Chemotherapy is also necessary to reduce incidence of distant metastases, but the optimal setting of treatment (neoadjuvant, adjuvant and intrapleural) is not clarified. For the patients with unresectable MPM, the combination cisplatin and pemetrexed or ralitrexed is the standard treatment as supported by a Phase III study. Better understanding of molecular pathways involved in MPM has enabled inclusion of new drugs targeted against pathways responsible for proliferation, cell survival and angiogenesis. Objective: This review discusses the current treatment option, the specific signal pathways activated in MPM and the novel agents under evaluation in clinical trials. Methods: We use for this article abstracts, papers, oral presentations from ASCO and the website http://www.clinical-trials.gov. Results/ conclusion: This review summarizes the activity of chemotherapy and of new agents under evaluation in clinical trials. The better understanding of molecular pathways activated in MPM will hopefully provide new therapeutic options for these patients in the future.

Overview of asbestos issues in Korea.

2009-07-02T02:28:00.001-07:00

J Korean Med Sci. 2009 Jun; 24(3): 363-7Kim HRAsbestos is a carcinogen that causes diseases such as mesothelioma and lung cancer in humans. There was a sharp increase in the use of asbestos in Korea in the 1970s as Korea's economy developed rapidly, and asbestos was only recently banned from use. Despite the ban of its use, previously applied asbestos still causes many problems. A series of asbestos-related events that recently occurred in Korea have caused the general public to become concerned about asbestos. Therefore, it is necessary to take proper action to deal with asbestos-related events, such as mass outbreaks of mesothelioma among residents who lived near asbestos textile factories or asbestos mines. Although there have been no rapid increases in asbestos-related illnesses in Korea to date, such illnesses are expected to increase greatly due to the amount of asbestos used and long latency period. Decreasing the asbestos exposure level to levels as low as possible is the most important step in preventing asbestos-related illnesses in the next few decades. However, there is a lack of specialized facilities for the analysis of asbestos and experts to diagnose and treat asbestos-related illnesses in Korea; therefore, national-level concern and support are required.

Attenuated expression of SECIS binding protein 2 causes loss of telomeric reserve without affecting telomerase.

2009-07-01T17:54:00.001-07:00

Exp Gerontol. 2009 Jun 26; Squires JE, Davy P, Berry MJ, Allsopp RThe family of selenoproteins have a broad range of functions, including protection against oxidative damage. Previous studies have shown that elevated levels of oxidative damage can induce accelerated loss of telomeric DNA during proliferation of mammalian cells. The incorporation of selenocysteine (Sec) into proteins in mammalian cells requires the Sec insertion sequence (SECIS) binding protein 2 (SBP2). Thus in the present study we have assessed the effect of knocking down the expression of SBP2 on telomere length. Following knock-down of SBP2 expression in 2 different human cell lines, the MSTO mesothelioma cell line ( approximately 5 Kb average telomere length) and SY5Y neuroblastoma cell line ( approximately 4.2 Kb average telomere length), we observed a significant reduction (-0.6 to -1.1Kb; P0.01) in telomere length as compared to control cells. This reduction in telomere length was independent of affects on telomerase, since both telomerase activity levels and Tert mRNA expression levels were not altered by knock-down of SBP2 expression. Furthermore, telomeres were particularly sensitive to S1 nuclease digestion following SBP2 knock-down, indicating an increased frequency of oxidative damage induced lesions in the telomeric DNA in these cells.Together, these observations imply that selenoproteins may help protect telomeric reserve in mammalian cells.

Phenotype-dependent apoptosis signalling in mesothelioma cells after selenite exposure.

2009-07-01T15:11:00.001-07:00

J Exp Clin Cancer Res. 2009 Jun 29; 28(1): 92Nilsonne G, Olm E, Szulkin A, Mundt F, Stein A, Kocic B, Rundlof AK, Fernandes AP, Bjornstedt M, Dobra KABSTRACT: BACKGROUND: Selenite is a promising anticancer agent which has been shown to induce apoptosis in malignant mesothelioma cells in a phenotype-dependent manner, where cells of the chemoresistant sarcomatoid phenotype are more sensitive. METHODS: In this paper, we investigate the apoptosis signalling mechanisms in sarcomatoid and epithelioid mesothelioma cells after selenite treatment. Apoptosis was measured with the Annexin-PI assay. The mitochondrial membrane potential, the expression of Bax, Bcl-XL, and the activation of caspase-3 were assayed with flow cytometry and a cytokeratin 18 cleavage assay. Signalling through JNK, p38, p53, and cathepsins B, D, and E was investigated with chemical inhibitors. Furthermore, the expression, nuclear translocation and DNA-binding activity of p53 was investigated using ICC, EMSA and the monitoring of p21 expression as a downstream event. Levels of thioredoxin (Trx) were measured by ELISA. RESULTS: In both cell lines, 10 uM selenite caused apoptosis and a marked loss of mitochondrial membrane potential. Bax was up-regulated only in the sarcomatoid cell line, while the epithelioid cell line down-regulated Bcl-XL and showed greater caspase-3 activation. Nuclear translocation of p53 was seen in both cell lines, but very little p21 expression was induced. Chemical inhibition of p53 did not protect the cells from apoptosis. p53 lost its DNA binding ability after selenite treatment and was enriched in an inactive form. Levels of thioredoxin decreased after selenite treatment. Chemical inhibition of MAP kinases and cathepsins showed that p38 and cathepsin B had some mediatory effect while JNK had an anti-apoptotic role. CONCLUSIONS: We delineate pathways of apoptosis signalling in response to selenite, showing differences between epithelioid and sarcomatoid mesothelioma cells. These differences may partly explain why sarcomatoid cells are more sensitive to selenite.

Laparoscopic intraperitoneal hyperthermic perfusion in palliaton of malignant ascites

2009-07-01T03:25:00.000-07:00

Malignant ascites is a pathological condition, due to several abdominal and extra-abdominal neoplasms, representing a difficult challenge in treatment.

Different medical and surgical options have been proposed, but none of them have shown efficacy, leading only to partial and temporary relief of symptoms. Laparoscopic intraperitoneal chemotherapy may be a valid therapeutic option in patients in whom medical therapies have failed and peritoneovenous shunting is contraindicated.

A 49-years old woman with malignant ascites, secondary to peritoneal localization of right pleural mesothelioma, underwent, after failure of medical therapy, laparoscopic intraperitoneal chemotherapy (with Cisplatin 25 mg/m2/L and Doxorubicin 7 mg/m2/L).

An important and lasting reduction of ascites and abdominal symptoms was documented till the exitus, due to pulmonary embolism after 11 months. Laparoscopic intraperitoneal chemotherapy may be a good therapeutic option to palliative malignant ascites in patient not eligible for a radical cytoreductive treatment, but further investigations are needed to standardized dosage and perfusion procedure.

"Laparoscopic intraperitoneal hyperthermic perfusion in palliaton of malignant ascites. Case report"
G Chir. 2009 May; 30(5): 237-9Graziosi L, Bugiantella W, Cavazzoni E, Donini A (Hubmed.org)

Highlight :
Mesothelioma Definition | Mesothelioma Cancer Treatment | The Risk of Mesothelioma | Benign Cystic Mesothelioma | Pericardial Mesothelioma Treatment

Transfer of occupational health problems from a developed to a developing country: Lessons from the Japan-South Korea experience.

2009-07-01T02:38:00.001-07:00

Am J Ind Med. 2009 Jun 26; Park J, Hisanaga N, Kim YMany corporations move their manufacturing facilities or technologies from developed to developing countries. Stringent regulations have made it costly for industries to operate in developed, industrialized countries. In addition, labor costs are high in these countries, and there is increasing awareness among the general public of the health risks associated with industry. The relocation of hazardous industries to developing countries is driven by economic considerations: high unemployment, a cheaper labor force, lack of regulation, and poor enforcement of any existing regulations make certain countries attractive to business. The transfer of certain industries from Japan to Korea has also brought both documented occupational diseases and a new occupational disease caused by chemicals without established toxicities. Typical examples of documented occupational diseases are carbon disulfide poisoning in the rayon manufacturing industry, bladder cancer in the benzidine industry, and mesothelioma in the asbestos industry. A new occupational disease due to a chemical without established toxicities is 2-bromopropane poisoning. These examples suggest that counter-measures are needed to prevent the transfer of occupational health problems from a developed to a developing country. Corporate social responsibility should be emphasized, close inter-governmental collaboration is necessary and cooperation among non-governmental organizations is helpful. Am. J. Ind. Med. 2009 (c) 2009 Wiley-Liss, Inc.

Mortality among sheet metal workers participating in a medical screening program.

2009-06-30T16:38:00.000-07:00

Am J Ind Med. 2009 Jun 26; Dement J, Welch L, Haile E, Myers DBACKGROUND: The Sheet Metal Occupational Health Institute Trust (SMOHIT) was formed in 1985 to examine the health hazards of the sheet metal industry in the U.S. and Canada through an asbestos disease screening program. A study of mortality patterns among screening program participants was undertaken. METHODS: A cohort of 17,345 individuals with 20 or more years in the trade and who participated in the asbestos disease screening program were followed for vital status and causes of death between 1986 and 2004. Data from the screening program included chest X-ray results by International Labour Office (ILO) criteria and smoking history. Standardized mortality ratios (SMRs) by cause were generated using U.S. death rates and Cox proportional hazards models were used to investigate lung cancer risk relative to chest X-ray changes while controlling for smoking. RESULTS: A significantly reduced SMR of 0.83 (95% CI = 0.80-0.85) was observed for all causes combined. Statistically significant excess mortality was observed for pleural cancers, mesothelioma, and asbestosis in the SMR analyses. Both lung cancer and COPD SMRs increased consistently and strongly with increasing ILO profusion score. In Cox models, which controlled for smoking, increased lung cancer risk was observed among workers with ILO scores of 0/1 (RR = 1.17, 95% CI = 0.89-1.54), with a strong trend for increasing lung cancer risk with increasing ILO profusion score >0/0. CONCLUSIONS: Sheet metal workers are at increased risk for asbestos-related diseases. This study contributes to the literature demonstrating asbestos-related diseases among workers with largely indirect exposures and supports an increased lung cancer risk among workers with low ILO profusion scores. Am. J. Ind. Med. 2009 (c) 2009 Wiley-Liss, Inc.

Localization of CD26/DPPIV in nucleus and its nuclear translocation enhanced by anti-CD26 monoclonal antibody with anti-tumor effect.

2009-06-30T15:15:00.001-07:00

Cancer Cell Int. 2009 Jun 26; 9(1): 17Yamada K, Hayashi M, Du W, Ohnuma K, Sakamoto M, Morimoto C, Yamada TABSTRACT: BACKGROUND: CD26 is a type II, cell surface glycoprotein known as dipeptidyl peptidase (DPP) IV. Previous studies have revealed CD26 expression in T cell leukemia/lymphoma and malignant mesothelioma, and an inhibitory effect of anti-CD26 monoclonal antibody (mAb) against the growth of CD26+ cancer cells in vitro and in vivo. The function of CD26 in tumor development is unknown and the machinery with which the CD26 mAb induces its anti-tumor effect remains uncharacterized. RESULTS: The localization of CD26 in the nucleus of T cell leukemia/lymphoma cells and mesothelioma cells was shown by biochemical and immuno-electron microscopic analysis. The DPPIV enzyme activity was revealed in the nuclear fraction of T cell leukemia/lymphoma cells. These expressions of intra-nuclear CD26 were augmented by treatment with the CD26 mAb, 1F7, with anti-tumor effect against the CD26+ T cell leukemia/lymphoma cells. In contrast, the CD26 mAb, 5F8, without anti-tumor effect, did not augment CD26 expressions in the nucleus. Biotin-labeled, cell surface CD26 translocated into the nucleus constantly, and this translocation was enhanced with 1F7 treatment but not with 5F8. CONCLUSIONS: These results indicate that the intra-nuclear CD26 which moves from plasma membrane may play certain roles in cell growth of human cancer cells.

[Update in respiratory disease and environmental exposure: an invisible relationship]

2009-06-30T06:39:00.001-07:00

Arch Bronconeumol. 2009; 45 Suppl 1: 21-4MartÃnez GonzÃ¡lez C, Cruz Carmona MJSignificant contributions have been made in the past year on different aspects of occupational/environmental respiratory disease. In the case of neoplastic diseases associated with asbestos inhalation, the areas of most interest have been in the search for tumour markers, the importance of the determination of asbestos fibre deposits in biological samples, and new therapeutic schemes in malignant pleural mesothelioma. A consensus article has been published on occupational asthma, in which some clinical evidenced-based recommendations are established, directed at the diagnosis and management of work-related asthma. As regards hypersensitivity-induced pneumonitis, the clinical and evolutionary aspects of this disease have been described in a large series of 86 patients with pigeon-fancier lung. There have also been interesting studies published this year that emphasise the need to take an occupational history in patients with respiratory symptoms in order to look for a causal or synergic relationship with smoking. Finally, the results of studies have been published which were directed at elucidating the role of urban contamination, mainly caused by road traffic, in the deterioration of lung function. A recent study showed that it would be possible to achieve a significant reduction in urban mortality attributed to urban contamination by reducing the levels of PM 2.5. They conclude that more restrictive standards need to be adopted in Europe to protect the health of the population, which coincides with the proposal by the World Health Organisation.

Survey and Biological Insights of Pemetrexed-Related Therapeutic Improvement in Mesothelioma: The Nancy Centre of Biological Resources' Mesothelioma Cohort.

2009-06-30T05:51:00.001-07:00

J Thorac Oncol. 2009 Jun 19; Vlastos F, Hillas G, Vidal P, Lacomme S, Galateau-SallÃ© F, Vollmer E, Guzman-Costabel J, Vignaud JM, Martinet NINTRODUCTION:: We report a survey of mesothelioma survival rates with insights into the survival benefit because of pemetrexed. We also studied a potential link between specific single nucleotide polymorphisms of transcobalamin II (TCII) gene and susceptibility to both asbestos and pemetrexed. METHODS:: Clinical and occupational data from 287 consecutive mesothelioma patients were collected from the north-east region of France (1989-2007). Blood or paired tumoral and normal samples were collected from the last 210 French patients to study the TCII single nucleotide polymorphisms at the codon 259 (quantitative polymerase chain reaction). Results were compared with those obtained from a group of 263 French control healthy subjects and to a group of 91 German mesothelioma patients. Patients' characteristics and genotypes results were statistically analyzed for significant correlations. RESULTS:: The mean overall patient's survival was 18.19 +/- 21.07 months. Pemetrexed increased the patients' survival by 50% (21.81 versus 16.99 months). The TCII allele Proline (Pro) was overrepresented into the mesothelioma cohort when compared with the controls (35 versus 19.77%). This also concerned German patients. The alleles Pro and Proline Arginine (ProArg) were more frequent among patients exposed to asbestos (p = 0.005, p < 0.001, respectively). The allele ProArg was associated with the longest survival while under pemetrexed (p = 0.007). No difference was found in the genotypes of patients untreated with pemetrexed. CONCLUSIONS:: Pemetrexed treatment is related to a survival increase in mesothelioma patients. The allele Pro seems overrepresented in mesothelioma patients. Those having the allele ProArg present a better outcome under pemetrexed.

Copy number variation has little impact on bead-array-based measures of DNA methylation.

2009-06-30T01:45:00.001-07:00

Bioinformatics. 2009 Jun 19; Houseman EA, Christensen BC, Karagas MR, Wrensch MR, Nelson HH, Wiemels JL, Zheng S, Wiencke JK, Kelsey KT, Marsit CJMOTIVATION: Integration of various genome-scale measures of molecular alterations is of great interest to researchers aiming to better define disease processes or identify novel targets with clinical utility. Particularly important in cancer are measures of gene copy number DNA methylation. However, copy number variation may bias the measurement of DNA methylation. To investigate possible bias, we analyzed integrated data obtained from 19 head and neck squamous cell carcinoma (HNSCC) tumors and 23 mesothelioma tumors. RESULTS: Statistical analysis of observational data produced results consistent with those anticipated from theoretical mathematical properties. Average beta value reported by Illumina GoldenGate (a bead-array platform) was significantly smaller than a similar measure constructed from the ratio of average dye intensities. Among CpGs that had only small variations in measured methylation across tumors (filtering out clearly biological methylation signatures), there were no systematic copy number effects on methylation for 3 and 4+ copies; however, 1 copy led to small systematic negative effects, and 0 copies led to substantial significant negative effects. Conclusions: Since mathematical considerations suggest little bias in methylation assayed using bead-arrays, the consistency of observational data with anticipated properties suggests little bias.However, further analysis of systematic copy number effects across CpGs suggest that though there may be little bias when there are copy number gains, small biases may result when 1 allele is lost, and substantial biases when both alleles are lost. These results suggest that further integration of these measures can be useful for characterizing the biological relationships between these somatic events.

Mesothelioma: Do asbestos and carbon nanotubes pose the same health risk?

2009-06-30T01:22:00.000-07:00

ABSTRACT: Carbon nanotubes (CNTs), the product of new technology, may be used in a wide range of applications. Because they present similarities to asbestos fibres in terms of their shape and size, it is legitimate to raise the question of their safety for human health. Recent animal and cellular studies suggest that CNTs elicit tissue and cell responses similar to those observed with asbestos fibres, which increases concern about the adverse biological effects of CNTs. While asbestos fibres' mechanisms of action are not fully understood, sufficient results are available to develop hypotheses about the significant factors underlying their damaging effects. This review will summarize the current state of knowledge about the biological effects of CNTs and will discuss to what extent they present similarities to those of asbestos fibres. Finally, the characteristics of asbestos known to be associated with toxicity will be analyzed to address the possible impact of CNTs.

"Mesothelioma: Do asbestos and carbon nanotubes pose the same health risk ?"
Part Fibre Toxicol. 2009 Jun 12; 6(1): 16Jaurand MC, Renier A, Daubriac J(Hubmed.org)

Highlight :
Mesothelioma Definition | Mesothelioma Treatment | Mesothelioma Risk Factors | Pericardial Mesothelioma Diagnosis

Regression of established AB1 murine mesothelioma induced by peritumoral injections of CpG oligodeoxynucleotide either alone or in combination with poly(I:C) and CD40 ligand plasmid DNA.

2009-06-29T23:01:00.001-07:00

J Thorac Oncol. 2009 Jul; 4(7): 802-8Stone GW, Barzee S, Snarsky V, Santucci C, Tran B, Kornbluth RSINTRODUCTION: Stimulation of the CD40 receptor using an agonistic anti-CD40 antibody can slow the growth of AB1 tumors. Stimulation of the GITR receptor may also have antitumor activity by countering the immunosuppressive effects of regulatory CD4 T cells. Similarly, agonists for Toll-Like Receptors (TLR) such as CpG oligodeoxynucleotides (TLR9 agonist) have activity against AB1 tumors. Combinations of CpG with CD40 ligand and polyinosinic-polycytidylic acid (poly(I:C), TLR3 agonist) may be even stronger than CpG alone. The synergistic effects of these combinations have been tested in other tumor types but not in mesothelioma. METHODS: Established AB1 mesothelioma tumors were injected with either plasmid DNA encoding a novel 4-trimer form of murine CD40 ligand (pSP-D-CD40L), GITR ligand (GITRL), or control plasmid DNA. In addition, CpG with or without poly(I:C) was also injected intratumorally. RESULTS: Plasmid injections of pSP-D-CD40L or pSP-D-GITRL, had no significant antitumor effect, possibly reflecting the difficulty of administering DNA injections into this very dense tissue. However, the injection of CpG with or without poly(I:C) strongly suppressed tumor growth and led to long-term tumor-free survival. The response to a triple combination of pSP-D-CD40L + CpG + poly(I:C) was demonstrated by an increase in intratumoral CD8 T cells and a dramatic increase in F4/80 macrophages. CONCLUSIONS: Intratumoral injections of plasmid DNAs encoding highly active forms of either CD40 ligand or GITR ligand had no significant antitumor effects in this model, although improved DNA delivery techniques could possibly improve this strategy. In contrast, intratumoral CpG injections had significant antitumor effects and there were indications that CpG plus poly(I:C) was even more effective. Taken together, these data confirm previous reports that immune stimulants, especially CpG TLR9 agonists, have potential as a treatment for mesothelioma.

Outcome for Patients with Malignant Pleural Mesothelioma Referred for Trimodality Therapy in Western Australia.

2009-06-29T18:11:00.001-07:00

J Thorac Oncol. 2009 Jun 19; Hasani A, Alvarez JM, Wyatt JM, Bydder S, Millward M, Byrne M, Musk AW, Nowak AKINTRODUCTION:: Trimodality therapy (TMT), consisting of extrapleural pneumonectomy (EPP), preoperative or postoperative combination chemotherapy, and high-dose hemithoracic radiotherapy, is the only therapy reported to achieve long-term survival in selected patients with malignant pleural mesothelioma (MPM). Thus, TMT was introduced as an option for such patients in Western Australia in 2004. However, TMT has never been compared with non-TMT therapy in the same patient population, thereby introducing a potential for selection bias. METHOD:: We performed a retrospective review of all patients referred for TMT consisting of EPP, adjuvant chemotherapy, and hemithoracic radiotherapy at a quaternary referral institution. Patient eligibility for referral for TMT was based on patients' tolerability for pneumonectomy, epithelioid subtype, and computed tomography and positron emission tomography scanning indicating operable disease, with the exclusion of extrapleural lymphadenopathy and metastatic disease (clinical stage T1-3N0-1M0). Eligible patients consenting to TMT also underwent a surgical staging procedure (bilateral thoracoscopy, mediastinoscopy, and laparoscopy) to confirm eligibility before EPP. RESULTS:: Thirty-six patients have been referred for TMT since 2004, and there has been a median of 27 months follow-up; of 31 patients having surgical staging, eight were ineligible for EPP and one declined EPP. Of the 22 planned for EPP, 18 underwent EPP and four had unresectable disease at surgery. There was one death in hospital six days post-EPP and another death postdischarge and 28 days post-EPP (30-day mortality 11%); 15 of 16 EPP survivors received adjuvant chemotherapy and 14 completed adjuvant radiotherapy. Pathologic analysis of the 18 resected EPP specimens revealed N2 disease in seven patients (39%) and nonepithelioid subtype in six patients (33%). Local recurrence did not occur among EPP survivors; however, 56% (9 of 16 patients) developed distant recurrence. Median and 1-year survival did not differ between the 18 EPP patients and 18 non-EPP patients (20.4 versus 20.7 months and 76 versus 78%, respectively; p = NS). DISCUSSION:: In this case series, we could not demonstrate a survival benefit for patients in the EPP group compared with that in the non-EPP group. After surgical staging, 26% of patients were ineligible for TMT. Thus, surgical staging is essential before proceeding with EPP. Despite aggressive imaging and surgical staging, 39% of patients will have N2 disease and 18% will have unresectable disease at operation. Although complete locoregional control was achieved with TMT, distant recurrence affected most EPP survivors despite careful patient selection and a high rate of completion of adjuvant therapy. We conclude that TMT for operable epithelioid MPM requires further assessment in randomized controlled trials.

From RECIST to PERCIST: Evolving Considerations for PET response criteria in solid tumors.

2009-06-29T16:18:00.001-07:00

J Nucl Med. 2009 May; 50 Suppl 1: 122S-50SWahl RL, Jacene H, Kasamon Y, Lodge MAThe purpose of this article is to review the status and limitations of anatomic tumor response metrics including the World Health Organization (WHO) criteria, the Response Evaluation Criteria in Solid Tumors (RECIST), and RECIST 1.1. This article also reviews qualitative and quantitative approaches to metabolic tumor response assessment with (18)F-FDG PET and proposes a draft framework for PET Response Criteria in Solid Tumors (PERCIST), version 1.0. METHODS: PubMed searches, including searches for the terms RECIST, positron, WHO, FDG, cancer (including specific types), treatment response, region of interest, and derivative references, were performed. Abstracts and articles judged most relevant to the goals of this report were reviewed with emphasis on limitations and strengths of the anatomic and PET approaches to treatment response assessment. On the basis of these data and the authors' experience, draft criteria were formulated for PET tumor response to treatment. RESULTS: Approximately 3,000 potentially relevant references were screened. Anatomic imaging alone using standard WHO, RECIST, and RECIST 1.1 criteria is widely applied but still has limitations in response assessments. For example, despite effective treatment, changes in tumor size can be minimal in tumors such as lymphomas, sarcoma, hepatomas, mesothelioma, and gastrointestinal stromal tumor. CT tumor density, contrast enhancement, or MRI characteristics appear more informative than size but are not yet routinely applied. RECIST criteria may show progression of tumor more slowly than WHO criteria. RECIST 1.1 criteria (assessing a maximum of 5 tumor foci, vs. 10 in RECIST) result in a higher complete response rate than the original RECIST criteria, at least in lymph nodes. Variability appears greater in assessing progression than in assessing response. Qualitative and quantitative approaches to (18)F-FDG PET response assessment have been applied and require a consistent PET methodology to allow quantitative assessments. Statistically significant changes in tumor standardized uptake value (SUV) occur in careful test-retest studies of high-SUV tumors, with a change of 20% in SUV of a region 1 cm or larger in diameter; however, medically relevant beneficial changes are often associated with a 30% or greater decline. The more extensive the therapy, the greater the decline in SUV with most effective treatments. Important components of the proposed PERCIST criteria include assessing normal reference tissue values in a 3-cm-diameter region of interest in the liver, using a consistent PET protocol, using a fixed small region of interest about 1 cm(3) in volume (1.2-cm diameter) in the most active region of metabolically active tumors to minimize statistical variability, assessing tumor size, treating SUV lean measurements in the 1 (up to 5 optional) most metabolically active tumor focus as a continuous variable, requiring a 30% decline in SUV for "response," and deferring to RECIST 1.1 in cases that do not have (18)F-FDG avidity or are technically unsuitable. Criteria to define progression of tumor-absent new lesions are uncertain but are proposed. CONCLUSION: Anatomic imaging alone using standard WHO, RECIST, and RECIST 1.1 criteria have limitations, particularly in assessing the activity of newer cancer therapies that stabilize disease, whereas (18)F-FDG PET appears particularly valuable in such cases. The proposed PERCIST 1.0 criteria should serve as a starting point for use in clinical trials and in structured quantitative clinical reporting. Undoubtedly, subsequent revisions and enhancements will be required as validation studies are undertaken in varying diseases and treatments.

Gefitinib in patients with malignant mesothelioma

2009-06-29T02:44:00.000-07:00

The Cancer and Leukemia Group B conducted a phase II study of gefitinib, an inhibitor of the epidermal growth factor receptor (EGFR) tyrosine kinase, in patients with previously untreated malignant mesothelioma.

EXPERIMENTAL DESIGN:
Eligible patients had unresectable pleural or peritoneal mesothelioma, measurable disease, no prior therapy, and performance status 0-1 by Cancer and Leukemia Group B criteria. Gefitinib (500 mg p.o.) was administered once a day for 21 days. Patients underwent restaging after every two cycles.

Therapy was continued until disease progression or unacceptable toxicity.

RESULTS:
The most common grade 3 toxicities were diarrhea (16%) and nausea (12%). Of 43 patients enrolled, 1 patient (2%) had a complete response, 1 patient (2%) had a partial response, 21 (49%) had stable disease lasting two to eight cycles, 15 (35%) had progressive disease, and 5 (12%) had early deaths.

One-year survival was 32% [95% confidence interval (CI), 21-50%]. Median survival and failure-free survival were 6.8% (95% CI, 3.5-10.3) and 2.6 months (95% CI, 1.5-4.0), respectively. The 3-month failure-free survival was 40% (95% CI, 25-56%).

EGFR expression score by immunohistochemistry done in 28 patients was categorized as low (EGFR 1+ or 2+) or high (EGFR 3+) expression: 97% had EGFR overexpression (2+ or 3+). The median and 3-month failure-free survival were 3.6 months and 40% for those patients with low EGFR expression compared with 8.1 and 40% for those with high EGFR expression.

CONCLUSIONS:
Although 97% of patients with mesothelioma had EGFR overexpression, gefitinib was not active in malignant mesothelioma. EGFR expression does not correlate with failure-free survival.

"Gefitinib in patients with malignant mesothelioma: a phase II study by the Cancer and Leukemia Group B.
Govindan R, Kratzke RA, Herndon JE, Niehans GA, Vollmer R, Watson D, Green MR, Kindler HL, Cancer and Leukemia Group B (CALGB 30101)
Clin Cancer Res. 2005 Mar 15; 11(6): 2300-4 (Hubmed.org)

Highlight :
Mesothelioma Definition | New Mesothelioma Treatment | Mesothelioma Risk Factors | Benign Multicystic Mesothelioma | Pericardial Mesothelioma Treatment

A prognostic index for progression-free survival in malignant mesothelioma with application to the design of phase II trials

2009-06-28T01:08:00.000-07:00

For cytostatic agents or when the response assessment is difficult, adaptations to phase II designs may allow a better assessment of therapeutic activity: first by using the progression-free survival rate (PFSR) as primary end-point instead of the response rate, and second by considering progression-free survival (PFS) risk groups based on a prognostic index (PI). In mesothelioma, current treatments yield disappointingly poor results and there is a need to investigate new regimens. The purpose of this report is to provide a PI for PFS in mesothelioma and reference values for the PFSR.

MATERIALS AND METHODS:
Data on 523 patients included in 10 European Organisation for Research and Treatment of Cancer (EORTC) mesothelioma studies were analysed to identify prognostic factors using a multivariate Cox regression model. Subsequently, a PI and a nomogram for PFS were developed. The PFSRs at 3, 4, 5 and 6 months were estimated.

RESULTS:
A performance status>0, stage IV disease and mixed or sarcomatous histological type were indicators of a poor prognosis for PFS. From the PI, based on these three variables, four risk groups were defined. The median progression-free survival ranged from 5.3 to 2.1 months in these risk categories. The PFSRs at 3 months were 70.6%, 62.4%, 54.2% and 42.1% in the four categories, respectively.

CONCLUSION:
The PI allows dividing patients into homogeneous risk categories in which PFSRs can be calculated and used to design future phase II mesothelioma trials. Defining homogeneous categories of patients avoids dilution of results between groups and improves the assessment of therapeutic activity.

"A prognostic index for progression-free survival in malignant mesothelioma with application to the design of phase II trials: A combined analysis of 10 EORTC trials.
Eur J Cancer. 2009 Jun 5; Francart J, Vaes E, Henrard S, Legrand C, Baas P, Gaafar R, van Meerbeeck JP, Sylvester R, Robert A (Hubmed.org)

Highlight :
Mesothelioma Definition | New Mesothelioma Treatment | Cancer Mesothelioma Risk | Benign Peritoneal Mesothelioma | Pericardial Effusion,

Comparison of different clones (WT49 versus 6F-H2) of WT-1 antibodies for immunohistochemical diagnosis of malignant pleural mesothelioma.

2009-06-27T02:34:00.000-07:00

Malignant pleural mesothelioma (MPM) is known to mimic the morphology of a number of diverse neoplastic conditions. WT-1 protein is conventionally used as a positive mesothelioma marker.

Recently, a new monoclonal antibody clone WT49 has recently become commercially available. To compare specificity and sensitivity of the conventionally used clone 6F-H2 for the diagnosis of MPM to those of the new clone WT49.

Forty cases of MPM, and 55 cases of lung carcinoma, 10 cases of synovial sarcoma of the intrathoracic region were analyzed. Of the 40 cases of MPM tested, clone WT49 and 6F-H2 stained 30 (75.0%) and 26 (65.0%) cases, respectively.

Nuclear staining of clone WT49 was observed in 4 (7.2%) cases of lung carcinomas and in 1 (10.0%) case of synovial sarcoma. However, there was no nuclear staining of clone 6F-H2 in lesions other than MPM.

There was no cytoplasmic staining of clone WT49 in any tumor. However, cytoplasmic staining of clone 6F-H2 was observed in 7 (17.5%) cases of MPM, 17 (30.1%) cases of lung carcinomas, and 5 (50.0%) cases of synovial sarcoma.

The main advantage of WT49 is its higher reactivity with the sarcomatoid area of biphasic mesothelioma, but the results also indicate 1 drawback, that this clone was seen to react with a small percentage of lung carcinomas when it is used to distinguish epithelioid mesotheliomas from lung carcinomas. Furthermore, the positive reaction of clone WT49 was restricted to nucleus without cytoplasmic staining, which is seen in conventionally used WT-1 antibodies.

"Comparison of different clones (WT49 versus 6F-H2) of WT-1 antibodies for immunohistochemical diagnosis of malignant pleural mesothelioma"
Appl Immunohistochem Mol Morphol. 2009 Mar; 17(2): 126-30Tsuta K, Kato Y, Tochigi N, Hoshino T, Takeda Y, Hosako M, Maeshima AM, Asamura H, Kondo T, Matsuno Y (Hubmed.org)

Highlight :
Mesothelioma Definition | Peritoneal Mesothelioma Treatment | The Risk of Mesothelioma | Benign Peritoneal Mesothelioma | Pericardial Mesothelioma Treatment

Pleurodesis in follow-up and treatment of malignant pleural mesothelioma patients.

2009-06-26T01:13:00.000-07:00

We analyzed the necessity of pleurodesis in the follow-up of the patients with malignant pleural mesothelioma (MPM), and how much it contributes to the survival period by determining the indications, efficiency, and reliability of the pleurodesis application. 191 patients were assessed retrospectively and 69 (36%) of them were established with a pleurodesis indication.

In 42 patients accepting pleurodesis, the pleurodesis success was evaluated. Factors affecting the success of pleurodesis and the effect of pleurodesis on survival were assessed. Pleurodesis was a success in 26 (62%) of the 42 patients.

In the group in which the pleurodesis process was a success, it was observed that KPS and pleural fluid pH were higher (p= 0.030, p= 0.032, respectively). In case of KPS >/= 80, the sensitivity was: 76.9%, specificity: 50.0%, PPV: 71.4%, and NPV was established as 57.1%. In case of pleural fluid pH > 7.27, the sensitivity was: 92.9%, specificity: 50.0%, PPV: 76.5%, and NPV was observed as 80.0%.

In the group in which pleurodesis was a success, the median survival was longer (Log-rank: 11.2; p= 0.0008). Independently from chemotherapy, the chance of living longer for patients whose pleurodesis was a success was 2.6 times higher.

A severe complication concerning the process was not observed. Pleurodesis is performed less frequently than it is assumed on patients with MPM. In patients with KPS >/= 80, pleural fluid pH > 7.27, and with indication, pleurodesis must be administered. In feasible patients, a successful pleurodesis with talc increases the survival of patients with MPM, and it can be safely administered.

"Pleurodesis in follow-up and treatment of malignant pleural mesothelioma patients"
Tuberk Toraks. 2009 Jan; 57(1): 22-31Ak G, MetintaÅŸ M, YÄ±ldÄ±rÄ±m H, MetintaÅŸ S, DÃ¼ndar E, Erginel S, AlataÅŸ F (Hubmed.org)

Highlight :
Mesothelioma Definition | Mesothelioma Treatment | Mesothelioma Risk Factors | Pericardial Mesothelioma Diagnosis

Adaptation of a commercial fluorescent in situ hybridization test to the diagnosis of malignant cells in effusions.

2009-06-25T02:25:00.000-07:00

In effusion cytology, adjuvant techniques are often needed for the differentiation of reactive proliferating mesothelial cells and malignant cells. In the case of malignancy the further challenge is to distinguish metastatic tumors from the primary malignant mesothelioma. Fluorescence in situ hybridization (FISH) of cells in interphase is an accurate method to monitor the genetic status of cells, detecting aneuploid signals and gene deletions.

Moreover, it has been proposed that a homozygous deletion of the p16(INK4A) gene could more specifically identify malignant mesothelial cells among the exfoliated cells. The first objective of this study was to adapt the commercial FISH-test, UroVysion originally designed for the cytological diagnosis of bladder cancer, to the analysis of cells in effusions.

The second objective was to test the clinical utility of the test. Sixty-eight pleural effusions were evaluated. The cytological diagnosis was malignant in 29 cases, inconclusive in 24 cases and benign in 15 cases.

The independently verified final diagnoses were mesothelioma in 21 cases, metastatic cancer in 29 and benign in 18 cases. The algorithm for aneuploidy distinguished almost all tested malignant conditions from benign ones, also those with inconclusive cytology. The 9p21 locus, carrying the p16(INK4A) gene, was homozygously deleted in two of the metastatic cancers, while this was seen in 12 of the 21 malignant mesotheliomas. Thus the commercial UroVysion-test can be used to accurately distinguish malignant and reactive cells in effusions, particularly when cytology is inconclusive. The test may also indicate presence of MM.

"Adaptation of a commercial fluorescent in situ hybridization test to the diagnosis of malignant cells in effusions"
Lung Cancer. 2009 Jun 10; Flores-Staino C, Darai-Ramqvist E, Dobra K, Hjerpe A (Hubmed.org)

Highlight :
Mesothelioma Definition | New Mesothelioma Treatment | The Risk of Mesothelioma, Asbestos Risk | Benign Mesothelioma | Pericardial Mesothelioma

Onconase cytotoxicity relies on the distribution of its positive charge.

2009-06-24T03:46:00.000-07:00

Onconase((R)) (ONC) is a member of the ribonuclease A superfamily that is toxic to cancer cells in vitro and in vivo. ONC is now in Phase IIIb clinical trials for the treatment of malignant mesothelioma.

Internalization of ONC to the cytosol of cancer cells is essential for its cytotoxic activity, despite the apparent absence of a cell-surface receptor protein. Endocytosis and cytotoxicity do, however, appear to correlate with the net positive charge of ribonucleases.

To dissect the contribution made by the endogenous arginine and lysine residues of ONC to its cytotoxicity, 22 variants were created in which cationic residues were replaced with alanine. Variants with the same net charge (+2 to +5) as well as equivalent catalytic activity and conformational stability were found to exhibit large (> 10-fold) differences in toxicity for the cells of a human leukemia line.

In addition, a more cationic ONC variant could be either much more or much less cytotoxic than a less cationic variant, again depending on the distribution of its cationic residues. The endocytosis of variants with widely divergent cytotoxic activity was quantified by flow cytometry using a small-molecule fluorogenic label, and was found to vary by twofold or less.

This small difference in endocytosis did not account for the large difference in cytotoxicity, implicating the distribution of cationic residues as being critical for lipid-bilayer translocation subsequent to endocytosis.

This finding has fundamental implications for understanding the interaction of ribonucleases and other proteins with mammalian cells.

"Onconase cytotoxicity relies on the distribution of its positive charge"
FEBS J. 2009 Jun 10; Turcotte RF, Lavis LD, Raines RT (Hubmed.org)

Highlight :
Mesothelioma Definition | Mesothelioma Treatment Options | Mesothelioma Risk Factors | Benign Peritoneal Mesothelioma | Pericardial Effusion,

Clinical utility of diagnostic markers for malignant pleural mesothelioma.

2009-06-23T01:08:00.000-07:00

Malignant mesothelioma has a very dismal prognosis with very few patients surviving one year after diagnosis. Early multimodal treatment, however, is expected to improve the outcome. Today, there is a strong need to have disease markers which could be used for screening, diagnosing, and/or monitoring tumour response to treatment. Old markers such as hyaluronic acid, various cytokeratin fragments (CYFRA 21.1, TPA) and other cancer antigens (CA 15.3, CA 125 or CA 19.9 or CEA) are not sensitive or specific enough and cannot be used in practice. More recently new molecules, such as soluble mesothelin and osteopontin, have been proposed for diagnostic purposes. Soluble mesothelin has a good specificity but has a sub-optimal sensitivity being negative in all sarcomatoid and in up to one half of epithelioid mesothelioma. On the contrary osteopontin has an inadequate specificity. Combining different markers together does not lead to an improvement in diagnostic accuracy. Neither marker can be used for screening purposes, the main limitation being the very low incidence of the disease in the at-risk, asbestos exposed population. Mesothelin is also a promising marker for monitoring response to treatment but published data is still insufficient to make recommendations. There is still a strong need for research is this area both in order to discover new markers as well as to correct the positioning of each existing molecule (alone or in combination) is the evaluation of the patients with a mesothelioma.

"Clinical utility of diagnostic markers for malignant pleural mesothelioma.
Monaldi Arch Chest Dis. 2009 Mar; 71(1): 31-8Grigoriu BD, Grigoriu C, Chahine B, Gey T, Scherpereel A (Hubmed.org)

Highlight :
Mesothelioma Definition | Mesothelioma Cancer Treatment | The Risk of Mesothelioma | Benign Mesothelioma Symptoms | Pericardial Mesothelioma Diagnosis

Causes of Mesothelioma Cancer

2009-06-22T14:28:00.000-07:00

The causes of mesothelioma have been under study for several decades. It is estimated that nine out of ten cases of mesothelioma are caused by exposure to asbestos, the mineral which was eleven widely used in construction materials, brake pad linings, and hundreds of other products found in everyday life.

Other possible but as yet unproven causes of mesothelioma cancer are discussed below.
Genetic Mutation of Cells
According to the Mayo Clinic, the causes of mesothelioma can be traced to the genetic mutation that turns healthy cells into cancer cells. These abnormal cells multiply randomly and do not die as normal cells do. The accumulation of cancer cells forms a tumor, which can invade other body tissues and spread further through the body.

It's not yet known what causes the genetic mutation that leads to the cancer mesothelioma, and the interaction of several factors appears to affect its impact:

Inherited conditions
A given individual's environment
Overall health
Lifestyle choices such as smoking

Asbestos Exposure Initiated Mutation
This genetic mutation can apparently be initiated when asbestos fibers lodge in the lungs or other internal organs. 2.000 to 3.000 Some people are diagnosed with mesothelioma cancer each year in the United States alone. Nearly all of these unfortunate individuals have asbestos exposure in their history. However, a complete determination of the exact causes of mesothelioma is desirable and would be very helpful in the fight to find a cure for this devastating disease.

A Nationwide Study of the Causes of Mesothelioma
A large-scale research and clinical study with the purpose of finding out more about the causes of mesothelioma is being conducted in the United Kingdom. This "National Study of Occupation and Lung Diseases" is designed to more closely identify causes of mesothelioma among the thousands of victims in the UK, and the results will shed light on causes of mesothelioma in individuals all over the world.

Other Causes of Mesothelioma Cancer
In studies using animals, the Simian virus (SV40) was found to cause mesothelioma. Some polio vaccines given during the mid-1950s to the early 1960s were found to be contaminated with SV40, but no definitive link between SV40 and mesothelioma has been established.

In contrast, there are a Handful of documented cases of mesothelioma in patients who underwent x-ray imaging that used Thorium dioxide. These x-rays have not been in use for many years because of the link between cancer and Thorium dioxide.

Highlight :
Mesothelioma Definition | Treatment of Mesothelioma Cancer | Cancer Mesothelioma Risk

Osteopontin modulates malignant pleural mesothelioma cell functions in vitro.

2009-06-21T03:21:00.000-07:00

Although serum osteopontin (OPN) concentration is elevated in patients with malignant pleural mesothelioma (MPM), the role of OPN in the pathogenesis and development of MPM remains unknown.

MATERIALS AND METHODS:
To determine the roles of OPN in MPM, immunohistochemical staining was performed to investigate the concentration of OPN in the pleural tumor of patients with mesothelioma; cell adhesion, proliferation and migration assays of H28 cells, an MPM cell line, were also carried out in vitro.

RESULTS:
H28 cells cultured on OPN-coated plates revealed enhanced adhesion, proliferation, migration, cell survival and phosphorylated focal adhesion kinase activities. As expected, these enhancements were markedly suppressed with the addition of anti-alphavbeta3 antibody or arginine-glycine-aspartic acid serine (RGDS) peptide to the medium.

CONCLUSION:
OPN is speculated to play an important role in the enhancement of adhesion, proliferation and migration activities of H28 cells, presumably by interacting with the alphavbeta3 integrin.

"Osteopontin modulates malignant pleural mesothelioma cell functions in vitro."
Anticancer Res. 2009 Jun; 29(6): 2205-14Ohashi R, Tajima K, Takahashi F, Cui R, Gu T, Shimizu K, Nishio K, Fukuoka K, Nakano T, Takahashi K (Hubmed.org)

Highlight :
Mesothelioma Definition | New Mesothelioma Treatment | Risk of Mesothelioma | Benign Peritoneal Mesothelioma | Pericardial Mesothelioma Treatment

MicroRNA Signature of Malignant Mesothelioma with Potential Diagnostic and Prognostic Implications.

2009-06-20T01:44:00.000-07:00

MicroRNAs (miRNAs) post-transcriptionally regulate the expression of target genes and may behave as oncogenes or tumor suppressors. Human malignant mesothelioma is an asbestos-related cancer, with poor prognosis and low median survival.

Here we report for the first time a cross-evaluation of miRNA expression in mesothelioma (MPP-89, REN) and mesothelial cells (HMC-TERT). Microarray profiling, confirmed by Real Time quantitative RT-PCR (qRT-PCR), revealed a differential expression of miRNAs between mesothelioma and mesothelial cells.

In addition, a computational analysis combining miRNA and gene expression profiles allowed the accurate prediction of genes potentially targeted by dysregulated miRNAs. Several predicted genes belong to Gene Ontology (GO) terms associated to the development and progression of mesothelioma, suggesting that miRNAs may be key players in mesothelioma oncogenesis.

We further investigated miRNA expression on a panel of 24 mesothelioma specimens, representative of the three histotypes (epithelioid, biphasic and sarcomatoid), by qRT-PCR. The expression of miR-17-5p, miR-21, miR-29a, miR-30c, miR-30e-5p, miR-106a and miR-143 was significantly associated with the histopathological subtypes.

Noteworthy, the reduced expression of two miRNAs (miR-17-5p and miR-30c) correlated with better survival of patients with sarcomatoid subtype. Our preliminary analysis suggests miRNAs as potential diagnostic and prognostic markers of mesothelioma and suggests novel tools for the therapy of this malignancy.

"MicroRNA Signature of Malignant Mesothelioma with Potential Diagnostic and Prognostic Implications"
Am J Respir Cell Mol Biol. 2009 Jun 5; Busacca S, Germano S, De Cecco L, Rinaldi M, Comoglio F, Favero F, Murer B, Mutti L, Pierotti M, Gaudino G (Hubmed.org)

Highlight :
Mesothelioma Definition | Treatment of Mesothelioma Cancer | Cancer Mesothelioma Risk

A case of malignant pleural mesothelioma with long-term disease control after 4 different lines of systemic chemotherapy and pleurodesis

2009-06-19T01:25:00.000-07:00

We report the case of a 68-year-old man with malignant pleural mesothelioma who was successfully treated with 4 lines of systemic chemotherapy and pleurodesis. The diagnosis was made by cytological examination of pleural effusion, using the cell block method for immunochemical staining.

The patient received first-line chemotherapy with carboplatin plus gemcitabine, and underwent pleurodesis with carboplatin. This first-line chemotherapy was repeated for 20 cycles, leading to maintained partial regression of the tumor and pleural effusion.

After 16 months, recurrence of the tumor with pleural effusion was observed, and single agent vinorelbine as second-line treatment (6 cycles) and single agent gemcitabine as third-line treatment (6 cycles) were administered sequentially.

During these periods, diagnostic imaging indicated stable disease or progressive disease, respectively. Fourth-line chemotherapy with cisplatin plus pemetrexed, which was approved in Japan in January 2008, was administered.

Pleurodesis with cisplatin was performed at the same time. Partial remission was achieved, but this treatment was stopped after 6 cycles because of renal toxicity limiting further cisplatinum chemotherapy.

The overall tumor-control time is more than four years. The patient benefited from outpatient chemotherapy with less severe toxic effects and is alive with a good performance status. It is suggested that combination of several systemic chemotherapy lines and regional disease control such as pleurodesis may be effective for disease control in patients with advanced malignant pleural mesothelioma.

"A case of malignant pleural mesothelioma with long-term disease control after 4 different lines of systemic chemotherapy and pleurodesis"
Nihon Kokyuki Gakkai Zasshi. 2009 May; 47(5): 383-7Tanaka A, Takahashi T (Hubmed.org)

Highlight :
Mesothelioma Definition | Treatment of Mesothelioma Cancer | Cancer Mesothelioma Risk

Pericardial Mesothelioma

2009-06-18T20:32:00.000-07:00

The least common type of mesothelioma cancer is pericardial mesothelioma. There are many fewer cases of pericardial mesothelioma recorded, compared with other forms of mesothelioma. The symptoms of pericardial mesothelioma can be generalized weakness, chest pain, shortness of breath, persistent coughing, palpitations and other heart-related signs. The diagnosis and treatment of pericardial mesothelioma is similar to the diagnosis and treatment of the other two types.

The types of mesothelioma cancer can be classified according to the position of the tumor. When the tumor can be detected in the pleural, "Most of the outer membrane of the lungs, which is called pleural mesothelioma. When the tumor can be detected in the peritoneum, the tissue lining of the abdominal organs, which is called peritoneal mesothelioma. The last type of malignant mesothelioma is cancer when the tumor can be revealed in the pericardium, the tissue lining heart, called pericardial mesothelioma

Pericardial mesothelioma affects the pericardium, the thin tissue that covers the heart. Pericardial mesothelioma is the most unusual type of mesothelioma, diagnosed in less than 1% of cases. Symptoms include chest pain,

Pericardial mesothelioma is an extremely rare form of asbestos mesothelioma. Many of the pericardial mesothelioma symptoms are similar to those of pleural mesothelioma: a constant cough, shortness of breath, or chest pain. Palpitations are another symptom. As with the other forms of mesothelioma, these symptoms are similar to those of other diseases, so tell your doctor if you've been exposed to asbestos.

Tags:
malignant pericardial mesothelioma, pericardial mesothelioma attacks, primary pericardial mesothelioma

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Mesothelioma Definition | Treatment of Mesothelioma Cancer | Cancer Mesothelioma Risk

Benign Mesothelioma

2009-06-18T20:26:00.000-07:00

This benign epithelial neoplasm, sometimes called benign mesothelioma, is a local tumor growth usually joined by a pedicle to the pleural surface.

It may be a small tumor (1 to 2cm) or may be significantly larger, but still remains confined to the surface of the lung. These tumors usually produce no curiously pleural effusion.

Benign mesothelioma may be a small tumor (1 to 2cm) or may be significantly larger, but still remains confined to the surface of the lung. These tumors usually produce no curiously pleural effusion.

Macroscopically are trained by dense fibrous tissue with a viscous fluid-filled cyst. The tumor cells show immunohistochemical positivity for lymphocytes negative for keratin and CD34, and these characteristics may be useful for differentiating these lesions from malignant mesothelioma. Benign fibrous tumor is not related to exposure to asbestos and malignant tumors.

Benign mesothelioma is a benign tumor can be very variable in size. It is located in the lining of the pleura or thoracic cavity. It is more common in men than in women. The benign mesothelioma symptoms include : cough, chest pain, fever .

This form tumor masses of variable size, especially in the visceral pleura. Usually asymptomatic and 50% of patients listed as radiological findings. The benign mesothelioma symptoms described cough, dull chest pain, fever and hypertrophic osteoarthropathy, which refers to the removal of the tumor. Only 10% had a stroke, which has no prognostic implication. The benign mesothelioma surgical treatment is curative, although 10% of patients had local recurrence.

Benign mesothelioma is the non-malignant mesothelioma tumors pose the threat of becoming malignant after some time, so it is best to have removed the benign tumors.

Tags:
etiology of benign mesothelioma, benign mesothelioma of peritoneum, multicystic benign mesothelioma

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Mesothelioma Definition | Treatment of Mesothelioma Cancer | Cancer Mesothelioma Risk

Estimation and inference for case-control studies with multiple non-gold standard exposure assessments: with an occupational health application.

2009-06-18T16:57:00.000-07:00

In occupational case-control studies, work-related exposure assessments are often fallible measures of the true underlying exposure.

In lieu of a gold standard, often more than 2 imperfect measurements (e.g. triads) are used to assess exposure. While methods exist to assess the diagnostic accuracy in the absence of a gold standard, these methods are infrequently used to correct for measurement error in exposure-disease associations in occupational case-control studies.

Here, we present a likelihood-based approach that (a) provides evidence regarding whether the misclassification of tests is differential or nondifferential; (b) provides evidence whether the misclassification of tests is independent or dependent conditional on latent exposure status, and (c) estimates the measurement error-corrected exposure-disease association.

These approaches use information from all imperfect assessments simultaneously in a unified manner, which in turn can provide a more accurate estimate of exposure-disease association than that based on individual assessments.

The performance of this method is investigated through simulation studies and applied to the National Occupational Hazard Survey, a case-control study assessing the association between asbestos exposure and mesothelioma.

"Estimation and inference for case-control studies with multiple non-gold standard exposure assessments: with an occupational health application"
Biostatistics. 2009 Jun 9; Chu H, Cole SR, Wei Y, Ibrahim JG (Hubmed.org)

Highlight :
Mesothelioma Definition | Treatment of Mesothelioma Cancer | Cancer Mesothelioma Risk

Who Is At Risk Mesothelioma Cancer ?

2009-06-17T14:22:00.000-07:00

The mesothelioma risk development is increased in people who are exposed to high levels of asbestos over long periods of time. Because asbestos fibers are strong and resistant to heat, they are used in a wide variety of applications and people may suffer exposure without even knowing it.

Following are some of the occupations of individuals who are exposed to high levels of asbestos on a daily basis and may be at cancer mesothelioma risk development:

Pipe fitters
Steamfitters
Shipyard workers
Electricians
Power plant workers
Demolition workers
Railroad workers
Steel mills workers
Plumbers, maintenance workers
Drywallers, plasterers, painters
School teachers

Others who may be at cancer mesothelioma risk :
Family members:
People living with those exposed to high levels of asbestos fibers are at cancer mesothelioma risk development. The dust containing asbestos fibers can get trapped in the workers' clothing and brought home.

Neighborhoods near manufacturing plants:
People living near plants manufacturing asbestos-containing products are also at cancer mesothelioma risk development as the fibers can be leaked into the environment.

Smokers developing risk of mesothelioma cancer:
While smoking is not directly related to mesothelioma, studies show smoking may trigger the disease in people who have been exposed to asbestos.

Tags:
mesothelioma risk factors, presents mesothelioma risk, mesothelioma risk model, possible mesothelioma risk, variation of mesothelioma risk

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Mesothelioma Definition | Treatment of Mesothelioma Cancer

Treatment Of Mesothelioma Cancer

2009-06-17T14:17:00.000-07:00

Five of the most important method for treatment of mesothelioma are surgery, radiotherapy, chemotherapy, palliative therapy and biological therapy. The intensity of any treatment of mesothelioma always depends on the physical health of a patient, age, location and stage (severity) of the disease and the degree of exposure to asbestos.

Surgery as treatment of mesothelioma
Patients who have been diagnosed with pleural mesothelioma can be considered as potential candidates for a surgical procedure called pneumonectomy. This is the surgical removal of lung damage and, if necessary, anywhere around the diaphragm that has been affected.

Radiotherapy as treatment of mesothelioma
The radiotherapy is the treatment of disease using an external source of high-energy rays (x-rays or gamma rays) or internally implanted radioactive substances. In contrast to chemotherapy, radiation is focused on a specific area and can treat the affected area without exposing the healthy tissue that is around.

The radiation can be used as a treatment in combination with surgery, or can be used independently to fight mesothelioma. As with most treatments, a high dose of radiation can cause health complications.

Chemotherapy as treatment of mesothelioma
The chemotherapy is the use of drugs for the treatment of cancer. The standard chemotherapy treatments are administered as pills or injected medication, and can be used independently or in conjunction with surgery and irradiation.

In chemotherapy, drugs are given according to a written protocol, or a plan, detailing exactly how it is that drugs will be administered.

Palliative Care as treatment of mesothelioma
Palliative therapy is not a cure, but relief, which seeks to treat and control the symptoms of mesothelioma. During this therapy, a needle is used to remove the suction through the excess liquid from the affected tissue. Generally, post-remedial drugs are administered to patients to prevent further accumulation of fluid.

Biological as treatment of mesothelioma
A more recent method for cancer treatment, including treatment of mesothelioma is the use of self defense mechanisms of the body to fight the tumor cells. Medical specialists are exploring how the immune system can restore, enhance, replicate,
manipulate and destroy cancer cells.

Tags:
overview of treatment of mesothelioma, multimodal treatment of mesothelioma, general information treatment of mesothelioma, program for treatment of mesothelioma, conventional treatment of mesothelioma

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Mesothelioma Definition

Mesothelioma: The Basics

2009-06-16T21:36:00.000-07:00

What is mesothelioma?

Mesothelioma occurs when the mesothelial cells grow without control. These cells also lose the ability to stop the production of lubricating fluid when there is enough. This is where the bodies are encased in an undesirably thick rind of tumor tissue and excessive accumulation of fluid, ultimately causing symptoms.

These cells can grow and invade other organs, or spread to other areas of the body. When the cells invade other areas of the body, this is called metastasis.

Mesothelioma is a cancer whose incidence is increasing in recent years and in which survival is low: in the best cases not exceeding 14 months. Combination treatment for mesothelioma helps the results.

Most of the mesotheliomas are in the coating of the lung (65 to 70%). Around 20 to 30% of cases are found in the coating of the abdominal cavity, and even more rarely, mesothelioma is found in the coating of the heart (1 to 2%) and testes.

Mesothelioma is a tumor that affects the serous (pleura and peritoneum) and its origin is almost always associated with exposure to asbestos (asbestos) used in the building industry as insulating material, while exposure to the causative agent may have taken place between 20 and 50 years before the onset of mesothelioma (mesothelioma). Therefore carries important legal consequences in some patients throughout the world.

The average age of diagnosis is 60 years and found more frequently in males.
The classic symptoms of mesothelioma are: dyspnea (breathing difficulty), chest pain, cough and weight loss.

The diagnosis of mesothelioma is based initially on imaging tests (chest x-ray, CT, ...), followed by pathological diagnosis (pleural fluid cytology and lung biopsy).