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Integrative approach to cytologic and molecular diagnosis of malignant pleural mesothelioma

The global incidence of malignant mesothelioma (MM) causes considerable disease burden, suffering and health care costs. Beside preventive measures and ban the use of asbestos, early diagnosis would largely improve the chance of curative treatment. Current histologic criteria, however, requiring pre...

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Autores principales: Hjerpe, Anders, Abd Own, Sulaf, Dobra, Katalin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: AME Publishing Company 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7354145/
https://www.ncbi.nlm.nih.gov/pubmed/32676359
http://dx.doi.org/10.21037/tlcr-2019-pps-10
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author Hjerpe, Anders
Abd Own, Sulaf
Dobra, Katalin
author_facet Hjerpe, Anders
Abd Own, Sulaf
Dobra, Katalin
author_sort Hjerpe, Anders
collection PubMed
description The global incidence of malignant mesothelioma (MM) causes considerable disease burden, suffering and health care costs. Beside preventive measures and ban the use of asbestos, early diagnosis would largely improve the chance of curative treatment. Current histologic criteria, however, requiring presence of invasion in the surrounding fatty tissue fail to identify MM in sufficiently early stage. Unilateral accumulation of pleural effusion is one of the earliest clinical manifestations of MM that occurs in approximately 90% of the patients. Therapeutic thoracocenthesis is necessary to remove the fluid and to relieve patients’ symptoms. This effusion is easily accessible and offers early and minimally invasive diagnosis by combining cytology with immunologic, molecular- and biomarker analyses. Typically, the fluid is rich in malignant cells and cell groups, but incipient stages of the disease may be difficult to recognize as the malignant cells can be masked by presence of inflammatory or reactive mesothelial cells. Recurrent, hemorrhagic and cell rich effusion should always be suspicious for MM and adequately prepared and analyzed to provide necessary information for subsequent therapy. Importantly, early detection of MM by integrating cytology and molecular approaches has high sensitivity and positive predictive value and has a major impact on patient survival. Thus, a conclusive positive MM cytology should lead to treatment without delay. This review summarizes molecular and diagnostic criteria of MM diagnosis.
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spelling pubmed-73541452020-07-15 Integrative approach to cytologic and molecular diagnosis of malignant pleural mesothelioma Hjerpe, Anders Abd Own, Sulaf Dobra, Katalin Transl Lung Cancer Res Review Article on Selected Highlights of the 2019 Pulmonary Pathology Society Biennial Meeting The global incidence of malignant mesothelioma (MM) causes considerable disease burden, suffering and health care costs. Beside preventive measures and ban the use of asbestos, early diagnosis would largely improve the chance of curative treatment. Current histologic criteria, however, requiring presence of invasion in the surrounding fatty tissue fail to identify MM in sufficiently early stage. Unilateral accumulation of pleural effusion is one of the earliest clinical manifestations of MM that occurs in approximately 90% of the patients. Therapeutic thoracocenthesis is necessary to remove the fluid and to relieve patients’ symptoms. This effusion is easily accessible and offers early and minimally invasive diagnosis by combining cytology with immunologic, molecular- and biomarker analyses. Typically, the fluid is rich in malignant cells and cell groups, but incipient stages of the disease may be difficult to recognize as the malignant cells can be masked by presence of inflammatory or reactive mesothelial cells. Recurrent, hemorrhagic and cell rich effusion should always be suspicious for MM and adequately prepared and analyzed to provide necessary information for subsequent therapy. Importantly, early detection of MM by integrating cytology and molecular approaches has high sensitivity and positive predictive value and has a major impact on patient survival. Thus, a conclusive positive MM cytology should lead to treatment without delay. This review summarizes molecular and diagnostic criteria of MM diagnosis. AME Publishing Company 2020-06 /pmc/articles/PMC7354145/ /pubmed/32676359 http://dx.doi.org/10.21037/tlcr-2019-pps-10 Text en 2020 Translational Lung Cancer Research. All rights reserved. https://creativecommons.org/licenses/by-nc-nd/4.0/Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) .
spellingShingle Review Article on Selected Highlights of the 2019 Pulmonary Pathology Society Biennial Meeting
Hjerpe, Anders
Abd Own, Sulaf
Dobra, Katalin
Integrative approach to cytologic and molecular diagnosis of malignant pleural mesothelioma
title Integrative approach to cytologic and molecular diagnosis of malignant pleural mesothelioma
title_full Integrative approach to cytologic and molecular diagnosis of malignant pleural mesothelioma
title_fullStr Integrative approach to cytologic and molecular diagnosis of malignant pleural mesothelioma
title_full_unstemmed Integrative approach to cytologic and molecular diagnosis of malignant pleural mesothelioma
title_short Integrative approach to cytologic and molecular diagnosis of malignant pleural mesothelioma
title_sort integrative approach to cytologic and molecular diagnosis of malignant pleural mesothelioma
topic Review Article on Selected Highlights of the 2019 Pulmonary Pathology Society Biennial Meeting
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7354145/
https://www.ncbi.nlm.nih.gov/pubmed/32676359
http://dx.doi.org/10.21037/tlcr-2019-pps-10
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