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Study Says New Flowchart Could Improve the Way Mesothelioma is Diagnosed

Mesothelioma is a rare cancer caused by exposure to asbestos. The disease can affect the lungs (malignant pleural mesothelioma or MPM), the abdomen (peritoneal mesothelioma), and in rare cases the heart (pericardial mesothelioma) or the testicles (testicular mesothelioma).

Decades ago, MPM was a disease that was rarely caught in its earliest and most treatable stages, making it a death sentence for hundreds of thousands of victims worldwide.

Today, extraordinary advances in medicine have made it possible to get in front of the disease by assessing a person’s risk factors and developing an effective monitoring plan long before symptoms begin.  This can lead to earlier detection and a much better chance at survival. Diagnostic tools that can help detect mesothelioma early include blood, fluid and tissue sample tests, chest x-rays, computed tomography (CT scan), positron emission tomography (PET), and magnetic resonance imaging (MRI).

Now, a team of researchers says it has discovered another detection tool (the Diagnostic Flowchart) that could help diagnose mesothelioma faster and more effectively.

In the retrospective study, “How to assess the best immunohistochemical panel in the diagnosis of malignant pleural mesothelioma in a pathology lab,” researchers analyzed around 30 MPM patients diagnosed over a 20-year-period. The sensitivity and specificity of eight different antibodies was assessed.

According to the team, “the microscopic exam concluded to an epithelioid mesothelioma (EM) in 17 cases, sarcomatoid mesothelioma (SM) in four cases and biphasic mesothelioma (BM) in nine cases. The immunohistochemical study was performed in all cases. A mean of eight antibodies was used in every case, average 4 to 20 antibodies. The immunohistochemical study was repeated from 2 to 5 times in 15 cases and concerned a mean of 3 antibodies per case.”

“In EM and BM, the antibodies with positive predictive value and highest sensitivity were calretinin, EMA, cytokeratin, and vimentin reaching respectively a sensitivity of 86.2%, 89.7%, 92.9% and 89.3%. The most valuable antibodies with negative predictive value were TTF1, CD15 and ACE that presented a specificity reaching respectively 100%. In sarcomatoid mesothelioma, the most sensitive antibody was the cytokeratin antibody.”

The team concluded that the results yielded to a Diagnostic Flowchart that can be used in routine practice “and that is in accordance with the literature findings.” The team added, “many diagnostic and technical pitfalls have to be known by pathologists when dealing with MPM.”

Although this is just one part of the puzzle, this new Diagnostic Flowchart has the potential to assist in diagnosing MPM faster and more effectively, which is promising news for anyone who is at risk of developing mesothelioma.

If you have been exposed to asbestos, see your doctor right away to get tested.



“Mesothelioma: Tests, Diagnosis, and Treatments.” WebMD. WebMD LLC, 2005-2018. Web. 02 July 2018.

Mlika, Mona, Oumeima Lamzibri and Saoussen Bacha. "How to assess the best immunohistochemical panel in the diagnosis of malignant pleural mesothelioma in a pathology lab." Taylor & Francis Group. Informa UK Limited, May 14 2018. Web. 02 July 2018.