Mesothelioma diagnosis-still a challenge

Our plain-English summary of Mesothelioma diagnosis-still a challenge, by U.P. Santos (Jornal Brasileiro de Pneumologia, 2024).

The study

• Author: U.P. Santos
• Journal: Jornal Brasileiro de Pneumologia
• Published: 2024;50(2):e20240118
• Type of article: Editorial
• Read it: PubMed · Publisher · Free full text

In plain English

This article was a two-page editorial, not an original study. The author commented on a separate study by Bernardi and colleagues, published in the same journal issue. In that study, an expert pathology panel reviewed possible and hidden cases of malignant mesothelioma from the Hospital-Based Cancer Registry database in the State of São Paulo, Brazil. According to the editorial, that study found that 130 of 482 cases (27%) needed review. Biopsy specimens for 73 of them came from 11 of the 25 hospitals asked, and 14 hospitals did not cooperate. The panel confirmed mesothelioma in 9 of the 73 (12.3%). It excluded mesothelioma in 58 (79.5%), including 2 that had previously been diagnosed as mesothelioma, and found 6 (8.2%) inconclusive. The author noted that some hospitals lacked pathology expertise and stored biopsy material inadequately. Citing other sources, the author described Brazil's asbestos consumption as one of the highest worldwide and the number of diagnosed cases as low. The author called for regulations for hospitals, proper diagnostic criteria using immunohistochemistry markers, better biomarkers, and expert panels from several specialties for complex cases.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Editorial commenting on another study published in the same journal issue (Bernardi et al.); no original data
• Who was studied: None of its own. The editorial discusses a study of possible and occult mesothelioma cases retrieved from the Hospital-Based Cancer Registry database in the State of São Paulo, Brazil.
• Exposure: Not studied. As background, citing other sources, the author described Brazil's asbestos consumption as one of the highest worldwide. No fiber types are named.
• Main results:
  • As described by the editorial, the Bernardi study found that 27% of registry cases (130 of 482) needed review because pathological criteria for diagnosis were insufficient.
  • As described by the editorial, 73 biopsy specimens were made available for expert review, from 11 of the 25 hospitals asked.
  • As described by the editorial, 14 of the 25 hospitals selected did not cooperate or provide any materials.
  • As described by the editorial, of the 73 reviewed cases, mesothelioma was confirmed in 9 (12.3%). It was excluded in 58 (79.5%), 2 of which had previously been established as mesothelioma.
  • As described by the editorial, 6 of the 73 reviewed cases (8.2%) were inconclusive.
  • As described by the editorial, some hospitals lacked pathology services with expertise in mesothelioma, and there was evidence of inadequate storage of biopsy materials.
• The authors' conclusion: The author concluded that hospitals caring for patients with suspected mesothelioma need regulations and must use appropriate histopathological criteria, with adequate tissue sampling and a panel of immunohistochemistry markers. The author also called for further refinement of biomarkers and for multidisciplinary expert panels to confirm complex cases.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Mesothelioma.

Medical terms in this study, explained in our Lexicon: Mesothelioma.

Related studies

• Immunohistochemical analysis still has a limited role in the diagnosis of malignant mesothelioma. A study of thirteen antibodies — F. Roberts, C.M. Harper, et al. (2001)
• Challenges and controversies in the diagnosis of mesothelioma: Part 1. Cytology-only diagnosis, biopsies, immunohistochemistry, discrimination between mesothelioma and reactive mesothelial hyperplasia, and biomarkers — D.W. Henderson, G. Reid, et al. (2013)
• Challenges and controversies in the diagnosis of malignant mesothelioma: Part 2. Malignant mesothelioma subtypes, pleural synovial sarcoma, molecular and prognostic aspects of mesothelioma, BAP1, aquaporin-1 and microRNA — D.W. Henderson, G. Reid, et al. (2013)
• Young investigator challenge: MicroRNA-21/MicroRNA-126 profiling as a novel tool for the diagnosis of malignant mesothelioma in pleural effusion cytology — R. Cappellesso, L. Nicolè, et al. (2016)
• When the Diagnosis of Mesothelioma Challenges Textbooks and Guidelines — G. Rossi, F. Davoli, et al. (2021)
• Diffuse Pleural Mesothelioma: A Challenge in Early Diagnosis — A.A. Constantin, F.D. Mihaltan, et al. (2024)

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