1
|
Wang Z, Huang J, MinYang, Fu L, Liu S, Huang J, Han J, Zhao X. Identification of the ferroptosis-related prognostic gene signature in mesothelioma. Gene 2024; 919:148498. [PMID: 38670397 DOI: 10.1016/j.gene.2024.148498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 04/19/2024] [Accepted: 04/22/2024] [Indexed: 04/28/2024]
Abstract
Mesothelioma, an uncommon yet highly aggressive malignant neoplasm, presents challenges in the effectiveness of current therapeutic approaches. Ferroptosis, a non-apoptotic mechanism of cellular demise, exhibits a substantial association with the progression of diverse cancer forms. It is important to acknowledge that there exists a significant association between ferroptosis and the advancement of various forms of cancer. Nevertheless, the precise role of ferroptosis regulatory factors within the context of mesothelioma remains enigmatic. In our investigation, we initially scrutinized the prognostic significance of 24 ferroptosis regulatory factors in the realm of mesothelioma. Our observations unveiled that heightened expression levels of CARS1, CDKN1A, TFRC, FANCD2, FDFT1, HSPB1, SLC1A5, SLC7A11, coupled with reduced DPP4 expression, were indicative of an unfavorable prognosis. Built upon the nine previously discussed prognostic genes, the ferroptosis prognostic model offers a reliable means to forecast mesothelioma patients' survival with a substantial degree of precision. Furthermore, a notable correlation emerged between these prognostic ferroptosis regulators and parameters such as immune cell infiltration, tumor mutation burden, microsatellite instability, and PD-L1 expression in the context of mesothelioma. Within this cadre of nine ferroptosis regulatory factors with prognostic relevance, FANCD2 exhibited the most pronounced prognostic influence, as elucidated by our analyses. Subsequently, we executed a validation process employing clinical specimens sourced from our institution, thus confirming that heightened FANCD2 expression is a discernible harbinger of an adverse prognosis in the context of mesothelioma. In vitro experiments revealed that knocking down FANCD2 markedly suppressed the proliferation, migration, and ability of mesothelioma cells to attract immune cells. Furthermore, our findings also showed that reducing FANCD2 levels heightened the vulnerability of mesothelioma cells to inducers of ferroptosis. Furthermore, an extensive pan-cancer analysis uncovered a robust association between FANCD2 and the gene expression linked to immune checkpoints, thereby signifying an adverse prognosis across a broad spectrum of cancer types. Additional research is warranted to validate these findings.
Collapse
Affiliation(s)
- Zairui Wang
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Guangdong-Hong Kong Joint Laboratory for RNA Medicine, Medical Research Center, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, China; Department of Oncology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, China
| | - Jialin Huang
- Department of Neurology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, China
| | - MinYang
- Department of Pathology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, China
| | - Liren Fu
- Department of Oncology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, China
| | - Shijie Liu
- Department of Oncology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, China
| | - Jianghua Huang
- Department of Oncology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, China.
| | - Jingjing Han
- Department of Pathology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, China.
| | - Xiaohui Zhao
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Guangdong-Hong Kong Joint Laboratory for RNA Medicine, Medical Research Center, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, China; Department of Oncology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, China; Department of Oncology, Shenshan Medical Centre, Memorial Hospital of Sun Yat-Sen University, Shanwei, 516621.
| |
Collapse
|
2
|
Nofi CP, Roberts BK, Rich BS, Glick RD. Pediatric, Adolescent and Young Adult (AYA) Peritoneal and Pleural Mesothelioma: A National Cancer Database Review. J Pediatr Surg 2024; 59:1113-1120. [PMID: 38418273 DOI: 10.1016/j.jpedsurg.2024.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 01/11/2024] [Accepted: 02/02/2024] [Indexed: 03/01/2024]
Abstract
PURPOSE Malignant peritoneal and pleural mesothelioma are rare in young patients, with a paucity of data regarding clinical characteristics and outcomes. We aimed to describe the clinical characteristics, treatment strategies, and outcomes for pediatric and adolescent/young adult (AYA) patients. METHODS The National Cancer Database (NCDB) was queried for malignant peritoneal and pleural mesothelioma in pediatric and AYA patients (ages 0-39) from 2004 to 2019. Stratification was performed for pediatric (age 0-21) and young adult (age 22-39) patients. Chi-squared, multivariable cox regression, and Kaplan-Meier analyses were performed. RESULTS We identified 570 total patients, 46 pediatric and 524 young adult, with mesothelioma (363 peritoneal and 207 pleural). There were significant differences in sex distribution as patients with peritoneal mesothelioma were more frequently female (63.1%). Patients with peritoneal mesothelioma were more likely to have radical surgery compared to pleural mesothelioma (56.7% v. 24.6%, respectively). A majority of patients with peritoneal and pleural mesothelioma received chemotherapy (66.4% and 61.4%, respectively). For peritoneal mesothelioma, surgical resection was associated with improved overall survival, whereas male sex, neoadjuvant chemotherapy, and radiation were associated with worse overall survival. For pleural mesothelioma, intraoperative chemotherapy was associated with improved overall survival, whereas Black race was associated with worse overall survival. Mean overall survival was greater for patients with peritoneal mesothelioma (125 months) compared to those with pleural mesothelioma (69 months), which remained significant after stratification of pediatric and young adult patients. CONCLUSION By analyzing a large cohort of pediatric and AYA mesothelioma, this study highlights clinical, prognostic, and survival differences between peritoneal and pleural disease. LEVEL OF EVIDENCE Level III. TYPE OF STUDY Retrospective.
Collapse
Affiliation(s)
- Colleen P Nofi
- Cohen Children's Medical Center, Division of Pediatric General, Thoracic, and Endoscopic Surgery, 269-01 76th Avenue Queens New Hyde Park, NY 11040, USA.
| | - Bailey K Roberts
- Cohen Children's Medical Center, Division of Pediatric General, Thoracic, and Endoscopic Surgery, 269-01 76th Avenue Queens New Hyde Park, NY 11040, USA
| | - Barrie S Rich
- Cohen Children's Medical Center, Division of Pediatric General, Thoracic, and Endoscopic Surgery, 269-01 76th Avenue Queens New Hyde Park, NY 11040, USA; Zucker School of Medicine at Hofstra/Northwell 500 Hofstra Boulevard Hempstead, Hempstead, NY 11548, USA
| | - Richard D Glick
- Cohen Children's Medical Center, Division of Pediatric General, Thoracic, and Endoscopic Surgery, 269-01 76th Avenue Queens New Hyde Park, NY 11040, USA; Zucker School of Medicine at Hofstra/Northwell 500 Hofstra Boulevard Hempstead, Hempstead, NY 11548, USA
| |
Collapse
|
3
|
Bansal VV, Mitchell O, Drazer MW, Kindler HL, Turaga KK. ASO Author Reflections: Venous Thromboembolism in Peritoneal Mesothelioma. Ann Surg Oncol 2024; 31:3785-3786. [PMID: 38502295 DOI: 10.1245/s10434-024-15155-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Accepted: 02/20/2024] [Indexed: 03/21/2024]
Affiliation(s)
- Varun V Bansal
- Division of Surgical Oncology, Yale School of Medicine, New Haven, CT, USA
| | - Owen Mitchell
- Section of Hematology/Oncology, Department of Medicine, University of Chicago Medical Center, Chicago, IL, USA
| | - Michael W Drazer
- Section of Hematology/Oncology, Department of Medicine, University of Chicago Medical Center, Chicago, IL, USA
| | - Hedy L Kindler
- Section of Hematology/Oncology, Department of Medicine, University of Chicago Medical Center, Chicago, IL, USA
| | - Kiran K Turaga
- Division of Surgical Oncology, Yale School of Medicine, New Haven, CT, USA.
| |
Collapse
|
4
|
Zhang JW, Gong QX. [Advance in molecular genetics of mesothelioma]. Zhonghua Bing Li Xue Za Zhi 2024; 53:507-510. [PMID: 38678339 DOI: 10.3760/cma.j.cn112151-20231016-00267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/29/2024]
Affiliation(s)
- J W Zhang
- Department of Pathology, the First Affiliated Hospital of Nanjing Medical University(Jiangsu Province Hospital), Nanjing 210029, China
| | - Q X Gong
- Department of Pathology, the First Affiliated Hospital of Nanjing Medical University(Jiangsu Province Hospital), Nanjing 210029, China
| |
Collapse
|
5
|
Lombardo C, Maugeri G, D'Amico AG, Broggi G, Caltabiano R, Filetti V, Matera S, D'Agata V, Loreto C. Pleural mesothelioma from fluoro-edenite exposure: PACAP and PAC1 receptor. A preliminary report. Eur J Histochem 2024; 68. [PMID: 38699968 DOI: 10.4081/ejh.2024.3994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Accepted: 03/19/2024] [Indexed: 05/05/2024] Open
Abstract
Pleural mesothelioma is a devastating malignancy primarily associated with asbestos exposure. However, emerging evidence suggests that exposure to fluoro-edenite fibers, a naturally occurring mineral fiber, can also lead to the development of pleural mesothelioma. In this study, based on the hypothesis that pituitary adenylate cyclase-activating polypeptide (PACAP) and PACAP-preferring receptor (PAC1R) expressions could be dysregulated in pleural mesothelioma samples and that they could potentially act as diagnostic or prognostic biomarkers, we aimed to investigate the immunohistochemical expression of PACAP and PAC1R in pleural biopsies from patients with pleural mesothelioma exposed to fluoro-edenite fibers. A total of 12 patients were included in this study, and their biopsies were processed for immunohistochemical analysis to evaluate the expression of PACAP and its receptor. The study revealed a correlation between the overexpression of PACAP and PAC1R and shorter overall survival in patients with malignant mesothelioma. These findings suggest that PACAP and PAC1R expression levels could serve as potential prognostic biomarkers for malignant mesothelioma. Furthermore, the immunohistochemical analysis of PACAP and PAC1R may provide valuable information for clinicians to guide therapeutic decisions and identify patients with poorer prognosis.
Collapse
Affiliation(s)
- Claudia Lombardo
- Department of Biomedical and Biotechnology Sciences, Section of Human Anatomy, Histology and Sciences of Movement, University of Catania.
| | - Grazia Maugeri
- Department of Biomedical and Biotechnology Sciences, Section of Human Anatomy, Histology and Sciences of Movement, University of Catania.
| | - Agata Grazia D'Amico
- Department of Biomedical and Biotechnology Sciences, Section of Human Anatomy, Histology and Sciences of Movement, University of Catania.
| | - Giuseppe Broggi
- Department of Medical and Surgical Sciences and Advanced Technologies "G.F. Ingrassia", Section of Anatomic Pathology, University of Catania.
| | - Rosario Caltabiano
- Department of Medical and Surgical Sciences and Advanced Technologies "G.F. Ingrassia", Section of Anatomic Pathology, University of Catania.
| | - Veronica Filetti
- Department of Clinical and Experimental Medicine, Section of Occupational Medicine, University of Catania.
| | - Serena Matera
- Department of Clinical and Experimental Medicine, Section of Occupational Medicine, University of Catania.
| | - Velia D'Agata
- Department of Biomedical and Biotechnology Sciences, Section of Human Anatomy, Histology and Sciences of Movement, University of Catania.
| | - Carla Loreto
- Department of Biomedical and Biotechnology Sciences, Section of Human Anatomy, Histology and Sciences of Movement, University of Catania.
| |
Collapse
|
6
|
Hocking AJ, Mortimer LA, Farrall AL, Russell PA, Klebe S. Establishing mesothelioma patient-derived organoid models from malignant pleural effusions. Lung Cancer 2024; 191:107542. [PMID: 38555809 DOI: 10.1016/j.lungcan.2024.107542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 03/19/2024] [Accepted: 03/25/2024] [Indexed: 04/02/2024]
Abstract
OBJECTIVES Pleural mesothelioma is a cancer arising in the cells that line the lungs and chest wall with poor survival and poor response to first-line therapy. Organoid models of cancer can faithfully recapitulate the genetic and histopathological characteristics of individualized tumors and have potential to be used for precision medicine, however methods of establishing patient-derived mesothelioma organoids have not been well established in the published literature. MATERIALS AND METHODS Long-term mesothelioma patient-derived organoids were established from ten malignant pleural effusion fluids. Mesothelioma patient-derived organoids were compared to the corresponding biopsy tissue specimens using immunohistochemistry labelling for select diagnostic markers and the TruSight Oncology-500 sequencing assay. Cell viability in response to the chemotherapeutic drug cisplatin was assessed. RESULTS We established five mesothelioma patient-derived organoid cultures from ten malignant pleural effusion fluids collected from nine individuals with pleural mesothelioma. Mesothelioma patient-derived organoids typically reflected the histopathological and genomic features of patients' matched biopsy specimens and displayed cytotoxic sensitivity to cisplatin in vitro. CONCLUSION This is the first study of its kind to establish long-term mesothelioma organoid cultures from malignant pleural effusions and report on their utility to test individuals' chemotherapeutic sensitivities ex vivo.
Collapse
Affiliation(s)
- Ashleigh J Hocking
- College of Medicine and Public Health, Flinders University, Adelaide, Australia.
| | - Lauren A Mortimer
- College of Medicine and Public Health, Flinders University, Adelaide, Australia
| | - Alexandra L Farrall
- College of Medicine and Public Health, Flinders University, Adelaide, Australia
| | - Prudence A Russell
- LifeStrands Genomics and TissuPath Pathology, Mount Waverley, Victoria, Australia
| | - Sonja Klebe
- College of Medicine and Public Health, Flinders University, Adelaide, Australia; Anatomical Pathology, SA Pathology, Flinders Medical Centre, Bedford Park, Australia
| |
Collapse
|
7
|
Parra-Medina R, Castañeda-González JP, Chaves-Cabezas V, Alzate JP, Chaves JJ. Diagnostic performance of immunohistochemistry markers for malignant pleural mesothelioma diagnosis and subtypes. A systematic review and meta-analysis. Pathol Res Pract 2024; 257:155276. [PMID: 38603842 DOI: 10.1016/j.prp.2024.155276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 03/21/2024] [Accepted: 03/26/2024] [Indexed: 04/13/2024]
Abstract
BACKGROUND Malignant pleural mesothelioma (MPM) poses diagnostic challenges due to its resemblance to benign pleural pathologies and different histological subtypes. Several immunohistochemistry markers have been employed to aid in accurate diagnosis. METHODS The present systematic review and meta-analysis aimed to assess the diagnostic performance of various immunohistochemistry markers in malignant pleural mesothelioma diagnosis and its histological subtypes. Following the PRISMA guidelines, we systematically searched the literature for articles on using different immunohistochemical markers in MPM and its histological subtypes. EMBASE, LILACS, MEDLINE, and Virtual Health Library were searched for studies published up to August 2023. We used the QUADAS-2 (Quality Assessment of Diagnostic Accuracy Studies) criteria to assess the quality of the included articles. Meta-analyses were performed to determine prevalence using a random-effects model. RESULTS 103 studies met the inclusion criteria, comprising a diverse range of immunohistochemistry markers. EMA and desmin-loss exhibited high sensitivity (96% and 92%, respectively) in distinguishing malignant pleural mesothelioma from benign pleural pathologies. Specificity was notably high for both BAP1-loss and survivin expression at 100%. Subtype-specific analyses demonstrated that EMA and HEG1 were sensitive markers for epithelioid mesothelioma, while GLUT1 showed high sensitivity for sarcomatoid mesothelioma. In cases comparing epithelioid mesothelioma and lung adenocarcinoma, CAM5.2 and calretinin displayed high sensitivity, while WT1 and BAP1-loss demonstrated exceptional specificity for malignant epithelioid mesothelioma. In the case of sarcomatoid mesothelioma and sarcomatoid lung carcinoma, GATA3 exhibited the most heightened sensitivity, while GATA3 and D2-40 displayed the best specificity for sarcomatoid malignant mesothelioma diagnosis. CONCLUSION Immunohistochemistry markers are essential in accurately diagnosing malignant pleural mesothelioma and its histological subtypes. This systematic review and meta-analysis provide a comprehensive insight into the diagnostic performance of these markers, facilitating their potential clinical utility in the discrimination of malignant pleural mesothelioma from other pleural pathologies and the differentiation of malignant pleural mesothelioma subtypes.
Collapse
Affiliation(s)
- Rafael Parra-Medina
- Research Institute, Fundación Universitaria de Ciencias de la Salud (FUCS), Bogotá, Colombia; Department of Pathology, Fundación Universitaria de Ciencias de la Salud (FUCS), Bogotá, Colombia; Department of Pathology, Instituto Nacional de Cancerología, Bogotá.
| | - Juan Pablo Castañeda-González
- Research Institute, Fundación Universitaria de Ciencias de la Salud (FUCS), Bogotá, Colombia; Department of Pathology, Fundación Universitaria de Ciencias de la Salud (FUCS), Bogotá, Colombia.
| | - Viviana Chaves-Cabezas
- Department of Pathology, Fundación Universitaria de Ciencias de la Salud (FUCS), Bogotá, Colombia.
| | - Juan Pablo Alzate
- Research Institute, Fundación Universitaria de Ciencias de la Salud (FUCS), Bogotá, Colombia.
| | - Juan José Chaves
- Department of Medicine, Norwalk Hospital, Yale School of Medicine, Norwalk, CT, United States.
| |
Collapse
|
8
|
Jones TE, Geisler DL, Baskota SU, Ohori NP, Cuda J, Khader SN. Reliably making the primary diagnosis of mesothelioma utilizing serous fluid cytology specimens: an institutional experience. J Am Soc Cytopathol 2024; 13:174-182. [PMID: 38514361 DOI: 10.1016/j.jasc.2024.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 02/05/2024] [Accepted: 02/26/2024] [Indexed: 03/23/2024]
Abstract
INTRODUCTION The diagnosis of mesothelioma has historically been challenging, especially on serous fluid cytology (SFC). Distinguishing between reactive and neoplastic mesothelial cells can be difficult on cytomorphology alone. However, additional ancillary tests, such as BRCA1 associated protein-1 immunohistochemistry and fluorescence in situ hybridization for cyclin-dependent kinase inhibitor 2A deletion, can provide a sensitive and highly specific method of proving malignancy. MATERIALS AND METHODS SFC specimens diagnosed as mesothelioma, suspicious for mesothelioma (SM), and atypical mesothelial cells (AMCs) since 2012 were identified by querying the laboratory information system. Clinical data and pathologic parameters were gathered. RESULTS One hundred ten cases of mesothelioma, SM, and AMC were identified. Of these, 61 cases had a definitive diagnosis of mesothelioma on SFC. Average age at SFC diagnosis was 67 years (26-87 years), with most patients being male (67%). Out of the 61 cases, 11 cases (18%) had an initial diagnosis of mesothelioma made on SFC specimens, with 5 of these 11 cases being in patients that never received a histologic diagnosis of mesothelioma. Ancillary studies were utilized in all 11 cases. An initial diagnosis of metastatic mesothelioma was made on SFC in 9 cases (15%). For 6 of these 9 cases, the SFC diagnosis was the sole diagnosis of metastatic mesothelioma without a companion histologic diagnosis. In addition, 15 cases were diagnosed as SM, with 11 of these cases following a definitive mesothelioma diagnosis. Thirty-four cases were diagnosed as AMC, with 27 cases following a definitive mesothelioma diagnosis. CONCLUSIONS The diagnosis of mesothelioma can be reliably made on SFC with the appropriate cytomorphology criteria and/or confirmatory ancillary testing.
Collapse
Affiliation(s)
- Terri E Jones
- Department of Pathology, Magee-Womens Hospital, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
| | - Daniel L Geisler
- Department of Pathology, UPMC East, University of Pittsburgh Medical Center, Monroeville, Pennsylvania
| | - Swikrity Upadhyay Baskota
- Department of Pathology and Laboratory Medicine, University of California Davis Health System, Sacramento, California
| | - N Paul Ohori
- Department of Pathology, Presbyterian-Shadyside Hospitals, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Jacqueline Cuda
- Department of Pathology, Presbyterian-Shadyside Hospitals, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Samer N Khader
- Department of Pathology, Presbyterian-Shadyside Hospitals, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| |
Collapse
|
9
|
Tang F, Cui Y, Gao Y. Diagnosis and treatment of malignant retroperitoneal mesothelioma: A case report. Medicine (Baltimore) 2024; 103:e37985. [PMID: 38669368 PMCID: PMC11049770 DOI: 10.1097/md.0000000000037985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Accepted: 04/02/2024] [Indexed: 04/28/2024] Open
Abstract
RATIONALE Malignant peritoneal mesothelioma (MPM) is a rare clinical disease. Although there are several reports describing intraperitoneal mesothelioma of the lung, liver, and intestine, retroperitoneal mesothelioma is, to our knowledge, very rare and rarely reported. In recent years, our best clinical protocols for the treatment and diagnosis of retroperitoneal mesothelioma have not been proven and the diagnosis and treatment are challenging. PATIENT CONCERNS A 37-year-old Chinese woman complained of bilateral low back pain for a month, with obvious symptoms of low back pain on the left side. To treat low back pain, retroperitoneal masses were found during physical examination. The patient consulted a urological specialist for further treatment. DIAGNOSIS After the operation, pathological biopsy confirmed retroperitoneal epithelioid diffuse mesothelioma. INTERVENTIONS After exclusion of surgical contraindications, the patient underwent laparoscopic retroperitoneal lesion resection under tracheal intubation and general anesthesia, and the operation was successful. OUTCOMES On the tenth day after surgery, the patient vital signs were stable, and he was discharged. LESSONS Patients with malignant peritoneal mesothelioma may have no typical clinical symptoms, and the diagnosis is based on pathological and immunohistochemical examination. In selected patients, surgical cell reduction and intraoperative intraperitoneal heat chemotherapy have become the first choice of treatment, which can achieve ideal therapeutic effects and prolong survival.
Collapse
Affiliation(s)
- Feihu Tang
- Department of Clinical Medicine, Shandong Second Medical University, Weifang City, Shandong, China
| | - Yong Cui
- Department of Clinical Medicine, Shandong Second Medical University, Weifang City, Shandong, China
| | - Yuan Gao
- Department of Urinary Surgery, Weifang People’s Hospital, No.151 Guangwen Street, Weifang City, Shandong, China
| |
Collapse
|
10
|
Visonà SD, Bertoglio B, Capella S, Belluso E, Austoni B, Colosio C, Kurzhunbaeva Z, Ivic-Pavlicic T, Taioli E. Asbestos burden in lungs of mesothelioma patients with pleural plaques, lung fibrosis and/or ferruginous bodies at histology: a postmortem SEM-EDS study. Carcinogenesis 2024; 45:131-139. [PMID: 38069464 DOI: 10.1093/carcin/bgad090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 11/02/2023] [Accepted: 12/04/2023] [Indexed: 03/12/2024] Open
Abstract
The causal attribution of asbestos-related diseases to past asbestos exposures is of crucial importance in clinical and legal contexts. Often this evaluation is made based on the history of exposure, but this method presents important limitations. To assess past asbestos exposure, pleural plaques (PP), lung fibrosis and histological evidence of ferruginous bodies (FB) can be used in combination with anamnestic data. However, such markers have never been associated with a threshold value of inhaled asbestos. With this study we attempted to shed light on the dose-response relationship of PP, lung fibrosis and FBs, investigating if their prevalence in exposed individuals who died from malignant mesothelioma (MM) is related to the concentration of asbestos in lungs assessed using scanning electron microscopy equipped with energy dispersive spectroscopy. Moreover, we estimated the values of asbestos concentration in lungs associated with PP, lung fibrosis and FB. Lung fibrosis showed a significant positive relationship with asbestos lung content, whereas PP and FB did not. We identified, for the first time, critical lung concentrations of asbestos related to the presence of PP, lung fibrosis and FB at histology (respectively, 19 800, 26 400 and 27 400 fibers per gram of dry weight), that were all well-below the background levels of asbestos identified in our laboratory. Such data suggest that PP, lung fibrosis and FB at histology should be used with caution in the causal attribution of MM to past asbestos exposures, while evaluation of amphibole lung content using analytical electron microscopy should be preferred.
Collapse
Affiliation(s)
- S D Visonà
- Department of Public Health, Experimental and Forensic Medicine, Unit of Legal Medicine and Forensic Sciences, University of Pavia, Pavia, Italy
| | - B Bertoglio
- Department of Public Health, Experimental and Forensic Medicine, Unit of Legal Medicine and Forensic Sciences, University of Pavia, Pavia, Italy
| | - S Capella
- Department of Earth Sciences, University of Torino, Torino, Italy
- Interdepartmental Center for Studies on Asbestos and other Toxic Particulates 'G. Scansetti', University of Torino, Torino, Italy
| | - E Belluso
- Department of Earth Sciences, University of Torino, Torino, Italy
- Interdepartmental Center for Studies on Asbestos and other Toxic Particulates 'G. Scansetti', University of Torino, Torino, Italy
| | - B Austoni
- Department of Public Health, Experimental and Forensic Medicine, Unit of Legal Medicine and Forensic Sciences, University of Pavia, Pavia, Italy
| | - C Colosio
- Department of Health Sciences, University of Milan, Milan, Italy
- Occupational Health Unit, Santi Paolo e Carlo Hospital, Milan, Italy
| | - Z Kurzhunbaeva
- Department of Health Sciences; Course of Research Doctorate in Public Health Sciences, University of Milan, Milan, Italy
| | - T Ivic-Pavlicic
- Institute for Translational Epidemiology and Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - E Taioli
- Institute for Translational Epidemiology and Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| |
Collapse
|
11
|
Mutlu E, Inanc M. Prognostic significance of inflammation scores in malignant mesothelioma. Eur Rev Med Pharmacol Sci 2024; 28:2340-2350. [PMID: 38567597 DOI: 10.26355/eurrev_202403_35741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
OBJECTIVE The relationship between inflammatory markers and survival in many cancers has been investigated previously. Inflammatory markers may also offer the possibility of predicting surveillance in patients with malignant mesothelioma. Our study seeks to enhance comprehension of how variables such as the nutritional status and inflammation indices of malignant mesothelioma patients impact the disease's progression and prognosis. PATIENTS AND METHODS This study included patients who were treated at the Erciyes University Medical Oncology Clinic between 2010 and 2022 and diagnosed with malignant mesothelioma. This is a retrospective single-center cohort study. Receiver Operating Characteristic (ROC) analysis was applied to determine the inflammation markers' optimal cut-off values with high sensitivity and specificity. Patients were categorized based on these values. The differences in overall survival (OS) and progression-free survival (PFS) between categorized groups were assessed using Log-rank curves and Kaplan-Meier tests. Multivariate analysis was performed using Cox regression analysis on statistically significant data. The relationship between inflammation markers and malignant mesothelioma survival was evaluated. RESULTS There are 115 patients in this study. Pre-treatment high neutrophil to lymphocyte ratio (NLR) (HR: 1.34, 95% CI: 1.12-2.83, p=0.04), high pan-immune inflammation value (PIIV) (HR: 2.01, 95% CI: 1.32-4.79, p=0.03), and high systemic inflammation response index (SIRI) (HR: 1.34, 95% CI: 1.2-2.78, p=0.04) were associated with poor OS. Conversely, high advanced lung cancer inflammation index (ALI) (HR: 0.73, 95% CI: 0.53-0.84, p=0.03) and high hemoglobin-albumin-lymphocyte and platelet (HALP) (HR: 0.67, 95% CI: 0.23-0.78, p=0.02) were associated with favorable survival. CONCLUSIONS Our study investigated the prognostic value of various inflammation markers in malignant mesothelioma patients and suggests that composite formulas like NLR, PIIV, SIRI, ALI, and HALP that incorporate CBC cells and nutritional parameters like albumin, height, and weight could more consistently and accurately predict malignant mesothelioma prognosis.
Collapse
Affiliation(s)
- E Mutlu
- Medical Oncology Department, Erciyes University Medical School, Kayseri, Turkey.
| | | |
Collapse
|
12
|
Højsager KD, Kobberø H, Santoni-Rugiu E, Land LH, Sørensen JB. Mesothelioma of the tunica vaginalis testis. Ugeskr Laeger 2024; 186:V07230476. [PMID: 38305267 DOI: 10.61409/v07230476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2024]
Abstract
Mesothelioma of the tunica vaginalis testis (MTVT) is a rare tumour and a cause of hydrocele. This case report concerns a 26-year-old male with hydrocele treated with left hydrocelectomy. Histopathology revealed MTVT, and left radical orchiectomy was performed followed by chemotherapy. Fluorescence in situ hybridization, DNA and RNA next-generation sequencing showed no mesothelioma-associated tumour suppressor gene mutations, but deletion of CDKN2A and a rare TFG-ADGRG7 fusion both reported in pleural mesotheliomas, were detected. Clinicians should consider malignancy in case of discrepancy between symptoms and objective findings in scrotal conditions.
Collapse
Affiliation(s)
| | | | | | | | - Jens Benn Sørensen
- Afdeling for Kræftbehandling, Københavns Universitetshospital - Rigshospitalet
| |
Collapse
|
13
|
Obacz J, Valer JA, Nibhani R, Adams TS, Schupp JC, Veale N, Lewis-Wade A, Flint J, Hogan J, Aresu G, Coonar AS, Peryt A, Biffi G, Kaminski N, Francies H, Rassl DM, Garnett MJ, Rintoul RC, Marciniak SJ. Single-cell transcriptomic analysis of human pleura reveals stromal heterogeneity and informs in vitro models of mesothelioma. Eur Respir J 2024; 63:2300143. [PMID: 38212075 PMCID: PMC10809128 DOI: 10.1183/13993003.00143-2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 10/30/2023] [Indexed: 01/13/2024]
Abstract
The pleural lining of the thorax regulates local immunity, inflammation and repair. A variety of conditions, both benign and malignant, including pleural mesothelioma, can affect this tissue. A lack of knowledge concerning the mesothelial and stromal cells comprising the pleura has hampered the development of targeted therapies. Here, we present the first comprehensive single-cell transcriptomic atlas of the human parietal pleura and demonstrate its utility in elucidating pleural biology. We confirm the presence of known universal fibroblasts and describe novel, potentially pleural-specific, fibroblast subtypes. We also present transcriptomic characterisation of multiple in vitro models of benign and malignant mesothelial cells, and characterise these through comparison with in vivo transcriptomic data. While bulk pleural transcriptomes have been reported previously, this is the first study to provide resolution at the single-cell level. We expect our pleural cell atlas will prove invaluable to those studying pleural biology and disease. It has already enabled us to shed light on the transdifferentiation of mesothelial cells, allowing us to develop a simple method for prolonging mesothelial cell differentiation in vitro.
Collapse
Affiliation(s)
- Joanna Obacz
- Cambridge Institute for Medical Research (CIMR), University of Cambridge, Cambridge, UK
- Division of Respiratory Medicine, Department of Medicine, University of Cambridge, Cambridge, UK
- Joint first authors
| | - Jose Antonio Valer
- Cambridge Institute for Medical Research (CIMR), University of Cambridge, Cambridge, UK
- Division of Respiratory Medicine, Department of Medicine, University of Cambridge, Cambridge, UK
- Joint first authors
| | - Reshma Nibhani
- Division of Respiratory Medicine, Department of Medicine, University of Cambridge, Cambridge, UK
| | - Taylor S Adams
- Section of Pulmonary, Critical Care, and Sleep Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Jonas C Schupp
- Department of Respiratory Medicine, Hannover Medical School, German Center for Lung Research (DZL), Hannover, Germany
| | - Niki Veale
- Cambridge Institute for Medical Research (CIMR), University of Cambridge, Cambridge, UK
- Division of Respiratory Medicine, Department of Medicine, University of Cambridge, Cambridge, UK
| | - Amanah Lewis-Wade
- Cambridge Institute for Medical Research (CIMR), University of Cambridge, Cambridge, UK
- Division of Respiratory Medicine, Department of Medicine, University of Cambridge, Cambridge, UK
| | - Jasper Flint
- Section of Pulmonary, Critical Care, and Sleep Medicine, Yale School of Medicine, New Haven, CT, USA
| | - John Hogan
- Royal Papworth Hospital NHS Foundation Trust, Cambridge, UK
| | - Giuseppe Aresu
- Royal Papworth Hospital NHS Foundation Trust, Cambridge, UK
| | - Aman S Coonar
- Royal Papworth Hospital NHS Foundation Trust, Cambridge, UK
| | - Adam Peryt
- Royal Papworth Hospital NHS Foundation Trust, Cambridge, UK
| | - Giulia Biffi
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, UK
| | - Naftali Kaminski
- Section of Pulmonary, Critical Care, and Sleep Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Hayley Francies
- Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, UK
| | - Doris M Rassl
- Royal Papworth Hospital NHS Foundation Trust, Cambridge, UK
| | - Mathew J Garnett
- Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, UK
- Joint senior authors
| | - Robert C Rintoul
- Royal Papworth Hospital NHS Foundation Trust, Cambridge, UK
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, UK
- Joint senior authors
| | - Stefan J Marciniak
- Cambridge Institute for Medical Research (CIMR), University of Cambridge, Cambridge, UK
- Division of Respiratory Medicine, Department of Medicine, University of Cambridge, Cambridge, UK
- Royal Papworth Hospital NHS Foundation Trust, Cambridge, UK
- Joint senior authors
| |
Collapse
|
14
|
Mikou P, Pergaris A, Engels M, Chandra A. Review of the impact of the International System for Serous Fluid Cytopathology. Cytopathology 2024; 35:16-22. [PMID: 37795809 DOI: 10.1111/cyt.13313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Revised: 09/08/2023] [Accepted: 09/15/2023] [Indexed: 10/06/2023]
Abstract
The International System for Reporting Serous Fluid Cytology (TIS) has been proposed by an expert working team composed of the International Academy of Cytology and the American Society of Cytopathology, following an international survey. Since its introduction, the TIS has gained worldwide acceptance, and this review aims to assess its global impact. A literature search revealed 25 studies which have presented data on the impact of the TIS. Most of them provide data, including risk of malignancy (ROM) for each diagnostic category, separately for pleural, peritoneal and pericardial effusions, while a few do not separate them. A few studies focus on specific diagnoses like mesothelioma on specific types of fluids or more specific issues like the optimal fluid volume for cytology or interobserver variability. A synopsis of the data from the literature search is presented in four tables. The ROM assessment is discussed, as well as interobserver variability and the use of ancillary diagnostic immunochemistry. In conclusion, our review of the published data suggests that the TIS is a valid classification scheme that has been widely accepted by pathologists globally, is highly reproducible and makes a valuable contribution to clinical therapeutic management.
Collapse
Affiliation(s)
| | - Alexandros Pergaris
- First Department of Pathology, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | | | | |
Collapse
|
15
|
Wolf AS, Rosenthal A, Giroux DJ, Nowak AK, Bille A, de Perrot M, Kindler HL, Rice D, Opitz I, Rusch VW, Pass HI. The International Association for the Study of Lung Cancer Pleural Mesothelioma Staging Project: Updated Modeling of Prognostic Factors in Pleural Mesothelioma. J Thorac Oncol 2023; 18:1689-1702. [PMID: 37567386 DOI: 10.1016/j.jtho.2023.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 08/02/2023] [Accepted: 08/04/2023] [Indexed: 08/13/2023]
Abstract
INTRODUCTION The International Association for the Study of Lung Cancer developed an international pleural mesothelioma database to improve staging. Data entered from 1995 to 2009 (training data set) were analyzed previously to evaluate supplemental prognostic factors. We evaluated these factors with new clinical data to determine whether the previous models could be improved. METHODS Patients entered into the database from 2009 to 2019 (validation cohort) were assessed for the association between previous prognosticators and overall survival using Cox proportional hazards regression with bidirectional stepwise selection. Additional variables were analyzed and models were compared using Harrell's C-index. RESULTS The training data set included 3101 patients and the validation cohort, 1733 patients. For the multivariable pathologic staging model applied to the training cohort, C-index was 0.68 (95% confidence interval [CI]: 0.656-0.705). For the validation data set (n = 497), C-index was 0.650 (95% CI: 0.614-0.685), and pathologic stage, histologic diagnosis, sex, adjuvant therapy, and platelet count were independently associated with survival. Adding anemia to the model increased the C-index to 0.652 (95% CI: 0.618-0.686). A basic presentation model including all parameters before staging yielded a C-index of 0.668 (95% CI: 0.641-0.695). In comparison, the European Organization for Research and Treatment of Cancer model yielded C-indices of 0.550 (95% CI: 0.511-0.589) and 0.577 (95% CI: 0.550-0.604) for pathologic staging and presentation models, respectively. CONCLUSIONS Although significant predictors differed slightly, the International Association for the Study of Lung Cancer training model performed well in the validation set and better than the model of the European Organization for Research and Treatment of Cancer. International collaboration is critical to improve outcomes in this rare disease.
Collapse
Affiliation(s)
- Andrea S Wolf
- Department of Thoracic Surgery, The Icahn School of Medicine at Mount Sinai, New York, New York.
| | | | | | - Anna K Nowak
- Medical School of the University of Western Australia, Crawley, Western Australia, Australia
| | - Andrea Bille
- Department of Thoracic Surgery, Guy's Hospital, London, United Kingdom
| | - Marc de Perrot
- Division of Thoracic Surgery, Toronto General Hospital, Ontario, Canada
| | - Hedy L Kindler
- Section of Hematology/Oncology, University of Chicago, Chicago, Illinois
| | - David Rice
- Department of Thoracic and Cardiovascular Surgery, MD Anderson Cancer Center, Houston, Texas
| | - Isabelle Opitz
- Department of Thoracic Surgery, University Hospital Zurich, Zurich, Switzerland
| | - Valerie W Rusch
- Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Harvey I Pass
- Department of Cardiothoracic Surgery, New York University (NYU) Langone Medical Center, New York, New York
| |
Collapse
|
16
|
Pu YQ, Zhang YP, Xiong W. [Research progress on immunohistochemical diagnostic markers for malignant pleural mesothelioma]. Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi 2023; 41:869-875. [PMID: 38073220 DOI: 10.3760/cma.j.cn121094-20221017-00497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
Malignant pleural mesothelioma (MPM) is a malignant tumor originating from the pleura, characterized by insidious onset, strong local invasiveness, short survival period, and poor prognosis. Clinical diagnosis is of paramount importance for the treatment and prognosis of MPM. Currently, the gold standard for diagnosing MPM is the results of histopathological examinations. Immunohistochemistry (IHC) is an effective auxiliary method in pathological diagnosis. Preliminary examinations can use two positive markers and two negative markers to distinguish pleural metastatic tumors, with additional antibodies selected based on differential diagnosis. The combined use of IHC markers plays a crucial role in the differential diagnosis between MPM and other tumors. This article primarily introduces commonly used IHC markers in MPM and the research progress of novel IHC markers in screening and differential diagnosis, aiming to provide reference for the clinical diagnosis and treatment of MPM.
Collapse
Affiliation(s)
- Y Q Pu
- Department of Biochemistry and Molecular Biology, School of Basic Medicine, Dali University, Dali 671000, China
| | - Y P Zhang
- Department of Pathology, the First People's Hospital of Chuxiong Yi Autonomous Prefecture, Chuxiong 651000, China
| | - W Xiong
- Department of Biochemistry and Molecular Biology, School of Basic Medicine, Dali University, Dali 671000, China
| |
Collapse
|
17
|
Qin C, Xia Q, Chen Z, Zhou Q, Zheng X. En bloc resection of the recurrent pleural mesothelioma and reconstruction of the chest wall after immunotherapy: A case report. Thorac Cancer 2023; 14:3063-3066. [PMID: 37658846 PMCID: PMC10599967 DOI: 10.1111/1759-7714.15095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 08/19/2023] [Accepted: 08/21/2023] [Indexed: 09/05/2023] Open
Abstract
Malignant pleural mesothelioma (MPM) is associated with previous asbestos exposure, while more clinical insights into this disease have come from other case studies. Maximal cytoreduction is critical in disease control and might help to improve the prognosis. Here, a 41-year-old female presented with a 6-month history of a mass detected in the chest wall following resection of a right pleural mesothelioma 2 years previously. A fluorodeoxyglucose positron emission tomography/computed tomography scan showed a right chest wall mass with a blurred boundary 8.9 cm × 3.7 cm in size. The patient had received one cycle of bevacizumab, carboplatin, and pemetrexed, and two cycles of nivolumab, ipilimumab, and gemcitabine 5 months before admission. We subsequently resected the tumor, the involved diaphragm, and the fifth and sixth ribs, and titanium mesh and continuous suture were used to close the thoracic cage. The fixed paraffin-embedded tissues showed epithelioid pleural mesothelioma. The patient received nivolumab and ipilimumab postoperatively, and no recurrence was detected 16 months after surgery. En bloc resection with reconstructive surgery effectively removed the locally advanced malignancy and restored the biological function of the thorax with a favorable prognosis. Neoadjuvant immunotherapy might therefore be conducive to radical resection and perioperative immunotherapy might improve the prognosis.
Collapse
Affiliation(s)
- Changlong Qin
- Lung Cancer Center, West China HospitalSichuan UniversityChengduPeople's Republic of China
- Lung Cancer Institute, West China Hospital, Sichuan UniversityChengduPeople's Republic of China
| | - Qinghong Xia
- Operating Room of Anesthesia Surgery Center, West China HospitalSichuan UniversityChengduPeople's Republic of China
- West China School of NursingSichuan UniversityChengduPeople's Republic of China
| | - Zi‐Jia Chen
- Lung Cancer Center, West China HospitalSichuan UniversityChengduPeople's Republic of China
- Lung Cancer Institute, West China Hospital, Sichuan UniversityChengduPeople's Republic of China
| | - Qinghua Zhou
- Lung Cancer Center, West China HospitalSichuan UniversityChengduPeople's Republic of China
- Lung Cancer Institute, West China Hospital, Sichuan UniversityChengduPeople's Republic of China
| | - Xi Zheng
- Lung Cancer Center, West China HospitalSichuan UniversityChengduPeople's Republic of China
| |
Collapse
|
18
|
Bedirhan MA, Seyrek Y, Yaran V, Sezen CB, Cansever L, Metin M. Does mediastinal lymph node involvement influence the surgical outcome in malign pleural mesothelioma? Acta Chir Belg 2023; 123:517-524. [PMID: 35815370 DOI: 10.1080/00015458.2022.2099558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Accepted: 07/04/2022] [Indexed: 11/01/2022]
Abstract
BACKGROUND This study examined the effect of metastatic mediastinal lymph node involvement on the prognosis of patients with malignant pleural mesothelioma (MPM) who underwent extrapleural pneumonectomy (EPP) or extended pleurectomy (E/P) and also to assess the effect of metastatic mediastinal lymph node involvement on the prognosis of patients with MPM in these group of patients. METHODS This retrospective study included 84 patients with MPM (66 men [78.6%] and 18 women [21.4%]) who underwent EPP (n = 44) or E/P (n = 40) at our institution between January 2001 and July 2019. Survival analyses were performed according to histopathology, nodal status, and surgical approach. RESULTS In the EPP group, patients with T2-N2 status had a significantly better mean survival (17 ± 2.1 months) than patients with T3-N2 (7.3 ± 1.6 months) or T4-N2 (3.2 ± 1.1 months) status (p = .001). In the E/P group, patients with T2-N2 status had a mean survival of 18 ± 1.1 months, while patients with T3-N2 and T4-N2 status had mean survival durations of 6.6 ± 1.6 and 4.8 ± 1.2 months, respectively (p = .159). In both treatment groups, the survival rates of patients with epithelial tumors were better than those of patients with non-epithelial tumors, independent of N status. None of the patients with N2 disease survived until 5 years postoperatively. CONCLUSION In summary, our results suggested that mediastinal lymph node metastasis negatively influenced the prognosis of patients with T3 MPM, regardless of treatment by EPP or E/P. Under these circumstances, preoperative cervical mediastinoscopy or endobronchial ultrasound-guided transbronchial needle aspiration may be considered for patients with high-stage MPM who are scheduled for surgery with curative intent. In our study, N2 status was spotted as a significant factor affecting survival, nevertheless its significance in survival of pleural mesothelioma patients should be analyzed in multi-centered studies.
Collapse
Affiliation(s)
- Mehmet Ali Bedirhan
- Depatment of Thoracic Surgery, Yedikule Chest Disease and Thoracic Surgery Hospital, İstanbul, Turkey
| | - Yunus Seyrek
- Department of Thoracic Surgery, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Hospital, Istanbul, Turkey
| | - Volkan Yaran
- Depatment of Thoracic Surgery, Yedikule Chest Disease and Thoracic Surgery Hospital, İstanbul, Turkey
| | - Celal Buğra Sezen
- Depatment of Thoracic Surgery, Yedikule Chest Disease and Thoracic Surgery Hospital, İstanbul, Turkey
| | - Levent Cansever
- Depatment of Thoracic Surgery, Yedikule Chest Disease and Thoracic Surgery Hospital, İstanbul, Turkey
| | - Muzaffer Metin
- Depatment of Thoracic Surgery, Yedikule Chest Disease and Thoracic Surgery Hospital, İstanbul, Turkey
| |
Collapse
|
19
|
Sato K, Fukui H, Hagiwara Y, Ogawa R, Nishioka A, Numano T, Sugiyama T, Kawabe M, Mera Y, Yoneda T. Difference in carcinogenicities of two different vapor grown carbon fibers with different physicochemical characteristics induced by intratracheal instillation in rats. Part Fibre Toxicol 2023; 20:37. [PMID: 37770972 PMCID: PMC10537556 DOI: 10.1186/s12989-023-00547-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 08/29/2023] [Indexed: 09/30/2023] Open
Abstract
BACKGROUND Carbon fibers are high aspect ratio structures with diameters on the submicron scale. Vapor grown carbon fibers are contained within multi-walled carbon tubes, with VGCF™-H commonly applied as a conductive additive in lithium-ion batteries. However, several multi-walled carbon fibers, including MWNT-7, have been reported to induce lung carcinogenicity in rats. This study investigated the carcinogenic potential of VGCF™-H fibers in F344 rats of both sexes with the vapor grown carbon fibers VGCF™-H and MWNT-7 over 2 years. The carbon fibers were administered to rats by intratracheal instillation at doses of 0, 0.016, 0.08, and 0.4 mg/kg (total doses of 0, 0.128, 0.64, and 3.2 mg/kg) once per week for eight weeks and the rats were observed for up to 2 years after the first instillation. RESULTS Histopathological examination showed the induction of malignant mesothelioma on the pleural cavity with dose-dependent increases observed at 0, 0.128, 0.64, and 3.2 mg/kg in rats of both sexes that were exposed to MWNT-7. On the other hand, only two cases of pleural malignant mesothelioma were observed in the VGCF™-H groups; both rats that received 3.2 mg/kg in male. The animals in the MWNT-7 groups either died or became moribund earlier than those in the VGCF™-H groups, which is thought related to the development of malignant mesothelioma. The survival rates were higher in the VGCF™-H group, and more carbon fibers were observed in the pleural lavage fluid (PLF) of the MWNT-7 groups. These results suggest that malignant mesothelioma is related to the transfer of carbon fibers into the pleural cavity. CONCLUSIONS The intratracheal instillation of MWNT-7 clearly led to carcinogenicity in both male and female rats at all doses. The equivocal evidence for carcinogenic potential that was observed in male rats exposed to VGCF™-H was not seen in the females. The differences in the carcinogenicities of the two types of carbon fibers are thought due to differences in the number of carbon fibers reaching the pleural cavity. The results indicate that the carcinogenic activity of VGCF™-H is lower than that of MWNT-7.
Collapse
Affiliation(s)
- Kei Sato
- Chemical Management Department, Resonac Corporation, Tokyo Shiodome Bldg.,1-9-1, Higashi-Shimbashi, Minato-ku, Tokyo, 105-7325, Japan.
| | - Hiroko Fukui
- Chemical Management Department, Resonac Corporation, Tokyo Shiodome Bldg.,1-9-1, Higashi-Shimbashi, Minato-ku, Tokyo, 105-7325, Japan
| | - Yuji Hagiwara
- Chemical Management Department, Resonac Corporation, Tokyo Shiodome Bldg.,1-9-1, Higashi-Shimbashi, Minato-ku, Tokyo, 105-7325, Japan
| | - Ryoji Ogawa
- Chemical Management Department, Resonac Corporation, Tokyo Shiodome Bldg.,1-9-1, Higashi-Shimbashi, Minato-ku, Tokyo, 105-7325, Japan
| | - Ayako Nishioka
- Chemical Management Department, Resonac Corporation, Tokyo Shiodome Bldg.,1-9-1, Higashi-Shimbashi, Minato-ku, Tokyo, 105-7325, Japan
| | - Takamasa Numano
- DIMS Institute of Medical Science, Inc., 64 Goura, Nishiazai, Azai-cho, Ichinomiya-shi, Aichi, 491-0113, Japan
| | - Taiki Sugiyama
- DIMS Institute of Medical Science, Inc., 64 Goura, Nishiazai, Azai-cho, Ichinomiya-shi, Aichi, 491-0113, Japan
| | - Mayumi Kawabe
- DIMS Institute of Medical Science, Inc., 64 Goura, Nishiazai, Azai-cho, Ichinomiya-shi, Aichi, 491-0113, Japan
| | - Yukinori Mera
- DIMS Institute of Medical Science, Inc., 64 Goura, Nishiazai, Azai-cho, Ichinomiya-shi, Aichi, 491-0113, Japan
| | - Tadashi Yoneda
- Chemical Management Department, Resonac Corporation, Tokyo Shiodome Bldg.,1-9-1, Higashi-Shimbashi, Minato-ku, Tokyo, 105-7325, Japan
| |
Collapse
|
20
|
Kläger J, Oberndorfer F, Brunel C, Veser J, Compérat E. Well-differentiated Papillary Mesothelial Tumour of the Tunica Vaginalis Testis - A Rare Lesion, but one Pathologists Should Know About Two Patient Reports and a Review of the Literature. Int J Surg Pathol 2023; 31:1126-1131. [PMID: 36624609 DOI: 10.1177/10668969221129888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Besides malignant mesothelioma, benign mesothelial neoplasms do exist in the tunica vaginalis testis. However, histological criteria remain controversial, thus leading to diagnostic uncertainty and difficulty in their classification according to their biological behavior. In recent years, molecular markers have emerged that aid in the differentiation of benign and malignant mesothelial proliferations throughout the body. Here, we present two middle-aged men with well-differentiated papillary mesothelial tumors and a review of the literature. By now, more than a year after surgery, one patient showed no recurrence of disease after partial or complete orchiectomy without further treatment, for the second no information is available. In conclusion, well-differentiated papillary mesothelial tumors represent rare lesions in the tunica vaginalis testis, but one pathologists should know about to prevent unnecessary treatment and suffering of patients.
Collapse
Affiliation(s)
- Johannes Kläger
- Department of Pathology, Medical University Vienna, Vienna, Austria
| | | | - Cristophe Brunel
- Department of Histopathology, Central Institute, Sion, Switzerland
| | - Julian Veser
- Clinic for Urology, Medical University Vienna, Vienna, Austria
| | - Eva Compérat
- Department of Pathology, Medical University Vienna, Vienna, Austria
| |
Collapse
|
21
|
Huang KB, Cao Y, Yao K, Zhou FJ, Liu ZW, Li XD. [Diagnosis and treatment of malignant mesothelioma of the tunica vaginalis testis: a series of 7 cases]. Zhonghua Wai Ke Za Zhi 2023; 61:812-817. [PMID: 37491176 DOI: 10.3760/cma.j.cn112139-20221129-00504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 07/27/2023]
Abstract
Objective: To investigate the clinical features, diagnosis, prognosis of malignant mesothelioma of the tunica vaginalis testis (MMTVT). Methods: The clinicopathological data of 7 patients with MMTVT who treated at Sun Yat-sen University Cancer Center between January 2010 and October 2022 were retrospectively reviewed. Cases were first diagnosed at (M (IQR)) 49 (23) years old (range: 27 to 64 years old). The main clinical manifestations were scrotal enlargement (7 cases) and hydrocele (2 cases). Results: Three patients underwent radical orchiectomy as initial treatment, 2 cases underwent hydrocelectomy due to diagnosis of hydrocele, followed by radical orchiectomy at Sun Yat-sen University Cancer Center, and 2 cases underwent transscrotal orchiectomy. Common tumor markers of testicular cancer were not significantly elevated in MMTVT. The expression of tumor PD-L1 was positive in 2 out of the 3 cases. One patient received adjuvant chemotherapy and 2 patients received first-line chemotherapy after tumor recurrence. Chemotherapy regimens used include cisplatin+pemetrexed. Up to October 2022, 3 cases relapsed, of which 2 cases died. The median overall survival was 35 months (range: 4 to 87 months) and the median progression-free survival was 6 months (range: 2 to 87 months). Conclusions: MMTVT at early stage should be treated with early radical orchiectomy and followed up closely after surgery. The cisplatin+pemetrexed regimen is a common option for the treatment of metastatic MMTVT, while whether immune checkpoint inhibitors could serve as a second-line treatment option deserves further research.
Collapse
Affiliation(s)
- K B Huang
- Department of Urology, State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Guangzhou 510060, China
| | - Y Cao
- Department of Pathology, State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Guangzhou 510060, China
| | - K Yao
- Department of Urology, State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Guangzhou 510060, China
| | - F J Zhou
- Department of Urology, State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Guangzhou 510060, China
| | - Z W Liu
- Department of Urology, State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Guangzhou 510060, China
| | - X D Li
- Department of Urology, State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Guangzhou 510060, China
| |
Collapse
|
22
|
Roggl VL, Green CL, Liu B, Carney JM, Glass CH, Pavlisko EN. Chronological trends in the causation of malignant mesothelioma: Fiber burden analysis of 619 cases over four decades. Environ Res 2023; 230:114530. [PMID: 36965800 PMCID: PMC10542945 DOI: 10.1016/j.envres.2022.114530] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 10/05/2022] [Indexed: 05/30/2023]
Abstract
Malignant mesothelioma is a relatively rare malignancy with a strong association with prior asbestos exposure. A percentage of cases is not related to asbestos, and fiber analysis of lung tissue is a useful methodology for identifying idiopathic or spontaneous cases. We have performed fiber analyses in more than 600 cases of mesothelioma over the past four decades and were interested in looking for trends in terms of fiber types and concentrations as well as percentages of cases not related to asbestos. Demographic information was also considered including patient age, gender, and tumor location (pleural vs. peritoneal). The histologic pattern of the tumor and the presence or absence of pleural plaques or asbestosis were noted. Fiber analysis was performed in 619 cases, using the sodium hypochlorite technique for digestion of lung tissue samples. Asbestos bodies were counted by light microscopy (LM) and coated and uncoated fibers by scanning electron microscopy (EM). The results were stratified over four decades. Trends that were observed included increasing patient age, increasing percentage of women, increasing percentage of peritoneal cases, and increasing percentage of epithelial histological type. There was a decreasing trend in the percentage of patients with concomitant asbestosis (p < 0.001). The percentage of cases with an elevated lung asbestos content decreased from 90.5% in the 1980s to 54.1% in the 2010s (p < 0.001). This trend also held when the analysis was limited to 490 cases of pleural mesothelioma in men (91.8% in the 1980s vs. 65.1% in the 2010s). There was a decrease in the median asbestos body count by LM from 1390 asbestos bodies per gram of wet lung in the 1980s to 38 AB/gm in the 2010s. Similar trends were observed for each of the asbestos fiber types as detected by EM. We conclude that there has been a progressive decrease in lung fiber content of mesothelioma patients during the past four decades, with an increasing percentage of cases not related to asbestos and an increase in median patient age.
Collapse
Affiliation(s)
- Victor L Roggl
- Department of Pathology, Duke University Medical Center, Durham, NC, 27710, USA.
| | - Cynthia L Green
- Department of Biostatistics & Bioinformatics, Duke University Medical Center, Durham, NC, 27710, USA
| | - Beiyu Liu
- Department of Biostatistics & Bioinformatics, Duke University Medical Center, Durham, NC, 27710, USA
| | - John M Carney
- Department of Pathology, Duke University Medical Center, Durham, NC, 27710, USA
| | - Carolyn H Glass
- Department of Pathology, Duke University Medical Center, Durham, NC, 27710, USA
| | | |
Collapse
|
23
|
Strange CD, Marom EM, Ahuja J, Shroff GS, Gladish GW, Carter BW, Truong MT. Imaging of Malignant Pleural, Pericardial, and Peritoneal Mesothelioma. Adv Anat Pathol 2023; 30:280-291. [PMID: 36395181 DOI: 10.1097/pap.0000000000000386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Malignant mesothelioma is a rare tumor arising from the mesothelial cells that line the pleura, pericardium, peritoneum, and tunica vaginalis. Imaging plays a primary role in the diagnosis, staging, and management of malignant mesothelioma. Multimodality imaging, including radiography, computed tomography (CT), magnetic resonance imaging (MRI), and F-18 fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT), is used in a variety of scenarios, including diagnosis, guidance for tissue sampling, staging, and reassessment of disease after therapy. CT is the primary imaging modality used in staging. MRI has superior contrast resolution compared with CT and can add value in terms of determining surgical resectability in equivocal cases. MRI can further assess the degree of local invasion, particularly into the mediastinum, chest wall, and diaphragm, for malignant pleural and pericardial mesotheliomas. FDG PET/CT plays a role in the diagnosis and staging of malignant pleural mesothelioma (MPM) and has been shown to be more accurate than CT, MRI, and PET alone in the staging of malignant pleural mesothelioma. PET/CT can also be used to target lesions for biopsy and to assess prognosis, treatment response, and tumor recurrence.
Collapse
Affiliation(s)
- Chad D Strange
- Department of Thoracic Imaging, University of Texas MD Anderson Cancer Center, Houston, TX
| | - Edith M Marom
- Department of Diagnostic Radiology, Chaim Sheba Medical Center, Tel Aviv University, Ramat Gan, Israel
| | - Jitesh Ahuja
- Department of Thoracic Imaging, University of Texas MD Anderson Cancer Center, Houston, TX
| | - Girish S Shroff
- Department of Thoracic Imaging, University of Texas MD Anderson Cancer Center, Houston, TX
| | - Gregory W Gladish
- Department of Thoracic Imaging, University of Texas MD Anderson Cancer Center, Houston, TX
| | - Brett W Carter
- Department of Thoracic Imaging, University of Texas MD Anderson Cancer Center, Houston, TX
| | - Mylene T Truong
- Department of Thoracic Imaging, University of Texas MD Anderson Cancer Center, Houston, TX
| |
Collapse
|
24
|
Sato Y, Elbadawy M, Suzuki K, Tsunedomi R, Nagano H, Ishihara Y, Yamamoto H, Azakami D, Uchide T, Nabeta R, Fukushima R, Abugomaa A, Kaneda M, Yamawaki H, Shinohara Y, Usui T, Sasaki K. Establishment of an experimental model of canine malignant mesothelioma organoid culture using a three-dimensional culture method. Biomed Pharmacother 2023; 162:114651. [PMID: 37030135 DOI: 10.1016/j.biopha.2023.114651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 03/21/2023] [Accepted: 03/31/2023] [Indexed: 04/09/2023] Open
Abstract
Canine malignant mesothelioma (cMM) is a rare and drug-resistant malignant tumor. Due to few patients and experimental models, there have not been enough studies to demonstrate the pathogenesis of the disease and novel effective treatment for cMM. Since cMM resembles human MM (hMM) in histopathological characteristics, it is also considered a promising research model of hMM. Compared with conventional 2-dimensional (2D) culture methods, 3-dimensional (3D) organoid culture can recapitulate the properties of original tumor tissues. However, cMM organoids have never been developed. In the present study, we for the first time generated cMM organoids using the pleural effusion samples. Organoids from individual MM dogs were successfully generated. They exhibited the characteristics of MM and expressed mesothelial cell markers, such as WT-1 and mesothelin. The sensitivity to anti-cancer drugs was different in each strain of cMM organoids. RNA sequencing analysis showed cell adhesion molecule pathways were specifically upregulated in cMM organoids compared with their corresponding 2D cultured cells. Among these genes, the expression level of E-cadherin was drastically higher in the organoids than that in the 2D cells. In conclusion, our established cMM organoids might become a new experimental tool to provide new insights into canine and human MM therapy.
Collapse
Affiliation(s)
- Yomogi Sato
- Laboratory of Veterinary Pharmacology, Department of Veterinary Medicine, Faculty of Agriculture, Tokyo University of Agriculture and Technology, 3-5-8 Saiwai-cho, Fuchu, Tokyo 183-8509, Japan
| | - Mohamed Elbadawy
- Laboratory of Veterinary Pharmacology, Department of Veterinary Medicine, Faculty of Agriculture, Tokyo University of Agriculture and Technology, 3-5-8 Saiwai-cho, Fuchu, Tokyo 183-8509, Japan; Department of Pharmacology, Faculty of Veterinary Medicine, Benha University, 13736, Moshtohor, Toukh, Elqaliobiya, Egypt.
| | - Kazuhiko Suzuki
- Laboratory of Veterinary Toxicology, Department of Veterinary Medicine, Faculty of Agriculture, Tokyo University of Agriculture and Technology, 3-5-8 Saiwai-cho, Fuchu, Tokyo 183-8509, Japan
| | - Ryouichi Tsunedomi
- Department of Gastroenterological, Breast and Endocrine Surgery, Yamaguchi University Graduate School of Medicine, 1-1-1 Minami-Kogushi, Ube, Yamaguchi 755-8505, Japan
| | - Hiroaki Nagano
- Department of Gastroenterological, Breast and Endocrine Surgery, Yamaguchi University Graduate School of Medicine, 1-1-1 Minami-Kogushi, Ube, Yamaguchi 755-8505, Japan
| | - Yusuke Ishihara
- Laboratory of Veterinary Pharmacology, Department of Veterinary Medicine, Faculty of Agriculture, Tokyo University of Agriculture and Technology, 3-5-8 Saiwai-cho, Fuchu, Tokyo 183-8509, Japan
| | - Haru Yamamoto
- Laboratory of Veterinary Pharmacology, Department of Veterinary Medicine, Faculty of Agriculture, Tokyo University of Agriculture and Technology, 3-5-8 Saiwai-cho, Fuchu, Tokyo 183-8509, Japan
| | - Daigo Azakami
- Laboratory of Veterinary Clinical Oncology, Faculty of Agriculture, Tokyo University of Agriculture and Technology, 3-5-8 Saiwai-cho, Fuchu, Tokyo 183-8509, Japan
| | - Tsuyoshi Uchide
- Laboratory of Veterinary Molecular Pathology and Therapeutics, Faculty of Agriculture, Tokyo University of Agriculture and Technology, 3-5-8 Saiwai-cho, Fuchu, Tokyo 183-8509, Japan
| | - Rina Nabeta
- Laboratory of Veterinary Molecular Pathology and Therapeutics, Faculty of Agriculture, Tokyo University of Agriculture and Technology, 3-5-8 Saiwai-cho, Fuchu, Tokyo 183-8509, Japan
| | - Ryuji Fukushima
- Animal Medical Emergency Center, Faculty of Agriculture, Tokyo University of Agriculture and Technology, 2-24-16 Nakamachi, Koganei, Tokyo 184-8588, Japan
| | - Amira Abugomaa
- Laboratory of Veterinary Pharmacology, Department of Veterinary Medicine, Faculty of Agriculture, Tokyo University of Agriculture and Technology, 3-5-8 Saiwai-cho, Fuchu, Tokyo 183-8509, Japan; Faculty of Veterinary Medicine, Mansoura University, 35516 Mansoura, Egypt
| | - Masahiro Kaneda
- Laboratory of Veterinary Anatomy, Department of Veterinary Medicine, Faculty of Agriculture, Tokyo University of Agriculture and Technology, 3-5-8 Saiwai-cho, Fuchu, Tokyo 183-8509, Japan
| | - Hideyuki Yamawaki
- Laboratory of Veterinary Pharmacology, School of Veterinary Medicine, Kitasato University, 35-1, Higashi 23 ban-cho, Towada, Aomori 034-8628, Japan
| | - Yuta Shinohara
- Pet Health & Food Division, Iskara Industry CO., LTD, 1-14-2, Nihonbashi, Chuo-ku, Tokyo, 103-0027, Japan
| | - Tatsuya Usui
- Laboratory of Veterinary Pharmacology, Department of Veterinary Medicine, Faculty of Agriculture, Tokyo University of Agriculture and Technology, 3-5-8 Saiwai-cho, Fuchu, Tokyo 183-8509, Japan.
| | - Kazuaki Sasaki
- Laboratory of Veterinary Pharmacology, Department of Veterinary Medicine, Faculty of Agriculture, Tokyo University of Agriculture and Technology, 3-5-8 Saiwai-cho, Fuchu, Tokyo 183-8509, Japan
| |
Collapse
|
25
|
Galateau-Salle F, Hamilton T, MacNeill A, Hofman V, Sequeiros R, Sagan C, Le Stang N, Churg A. Mesothelioma In Situ Mimicking Well-differentiated Papillary Mesothelial Tumor. Am J Surg Pathol 2023; 47:611-617. [PMID: 36876759 DOI: 10.1097/pas.0000000000002033] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/07/2023]
Abstract
We have previously hypothesized that well-differentiated papillary mesothelial tumor (WDPMT) consists of 2 morphologically identical lesions, one of which is true WDPMT, while the other is a form of mesothelioma in situ. Here, we report 8 examples of the latter phenomenon, 3 with pleural disease (2 men/1 woman, ages 66 to 78 y); and 5 with peritoneal disease (all women, ages 31 to 81 y). At presentation the pleural cases all had effusions but no evidence of pleural tumor on imaging. Four of the 5 peritoneal cases had ascites as the initial finding and all 4 had nodular lesions that by imaging and/or direct inspection were thought to represent a diffuse peritoneal malignancy. The fifth peritoneal case presented with an umbilical mass. Microscopically, the pleural and peritoneal lesions looked like diffuse WDPMT, but all had lost BAP1. Occasional microscopic foci of superficial invasion were present in 3/3 pleural cases, while single nodules of invasive mesothelioma and/or occasional foci of superficial microscopic invasion were found in all of the peritoneal cases. The pleural tumor patients developed what clinically appeared to be invasive mesothelioma at 45, 69, and 94 months. Four/five peritoneal tumor patients underwent cytoreductive surgery and heated intraperitoneal chemotherapy. Three with follow-up data are alive without recurrence at 6, 24, and 36 months; 1 patient refused treatment but is alive at 24 months. We conclude that mesothelioma in situ morphologically mimicking WDPMT is strongly associated with the synchronous or metachronous development of invasive mesothelioma, but that these lesions appear to progress very slowly.
Collapse
Affiliation(s)
| | | | | | - Véronique Hofman
- Laboratory of Clinical and Experimental Pathology, Biobank BB-0033-0025, CHU Nice, FHU OncoAge, Nice Pasteur Hospital, Côte d'Azur University, Nice
| | - Ruth Sequeiros
- MESOPATH, MESOBANK, Department of BioPathology, Léon Bérard Center, Lyon
| | | | - Nolwenn Le Stang
- Cancer Registry, CHU Poitiers, University of Medicine-Pharmacy, Poitiers, France
| | - Andrew Churg
- Department of Pathology, Vancouver General Hospital, Vancouver, BC, Canada
| |
Collapse
|
26
|
Okita R, Mimura-Kimura Y, Kawamoto N, Yamamoto N, Umeda M, Okada M, Inokawa H, Mimura Y, Murakami T, Nakata M, Okabe K. Effects of tumor-infiltrating CD8+ T cells, PD1/PD-L1 axis, and expression patterns of HLA class I on the prognosis of patients with malignant pleural mesothelioma who underwent extra-pleural pneumonectomy. Cancer Immunol Immunother 2023; 72:865-879. [PMID: 36115921 DOI: 10.1007/s00262-022-03292-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 09/05/2022] [Indexed: 01/21/2023]
Abstract
Programmed cell death protein-1 (PD1), PD1 ligand 1 (PD-L1), and human leukocyte antigen (HLA) class I molecule play pivotal roles in T cell-induced anti-tumor immunity; however, the clinical impact of these parameters in resected malignant pleural mesothelioma (MPM) cases is unknown. We immunohistochemically evaluated the tumor infiltrated lymphocytes (TILs), PD1/PD-L1 axis, and expression of HLA class I in resected specimens from 58 patients with MPM who underwent extra-pleural pneumonectomy (EPP). Higher infiltration of CD3-TIL, CD8-TIL, and PD1-TIL, loss of HLA class I, and overexpression of PD-L1 by tumor cells (PD-L1 TC) or immune cells (PD-L1 IC) were observed in 34 (58.6%), 27 (46.6%), 41 (70.7%), 45 (77.6%), 29 (50.0%), and 33 (56.4%) of 58 cases, respectively. Interestingly, the CD3-TIL score positively correlated with PD-L1 TC and PD1-TIL scores. HLA class I expression level was inversely correlated with the expression levels of PD-L1 TC and PD-L1 IC. Multivariate analysis showed that age, histology, and node metastasis were independent prognostic factors for 5-year overall survival (OS) and loss of HLA class I coincided with a positive prognosis (p = 0.011). The concomitant lack of infiltrating CD8+ T cells with no loss of HLA class I predicted worse 5-year OS (p = 0.007). Moreover, cluster classifications among multiple immunoparameters showed that categories among CD3/PD-L1 TC/HLA class I (p = 0.043), CD8/PD1/HLA class I (p = 0.032), CD8/PD-L1 TC/HLA class I (p = 0.011), and PD1/PD-L1 TC/HLA class I (p = 0.032) predicted 5-year OS in EPP cases for MPM. These immunoparameters could guide surgical indications for patients with MPM.
Collapse
Affiliation(s)
- Riki Okita
- Department of Thoracic Surgery, National Hospital Organization Yamaguchi Ube Medical Center, Higashikiwa 685, Ube, Yamaguchi, 755-0241, Japan.
| | - Yuka Mimura-Kimura
- Clinical Research, National Hospital Organization Yamaguchi Ube Medical Center, Higashikiwa 685, Ube, Yamaguchi, 755-0241, Japan
| | - Nobutaka Kawamoto
- Department of Thoracic Surgery, National Hospital Organization Yamaguchi Ube Medical Center, Higashikiwa 685, Ube, Yamaguchi, 755-0241, Japan
| | - Naoki Yamamoto
- Gastroenterology and Hepatology, National Hospital Organization Yamaguchi Ube Medical Center, Higashikiwa 685, Ube, Yamaguchi, 755-0241, Japan
- Department of Gastroenterology and Hepatology, Yamaguchi Health Administration Center, Yamaguchi University Graduate School of Medicine, Minami Kogushi 1-1-1, Ube, Yamaguchi, 755-8505, Japan
| | - Masashi Umeda
- Department of Thoracic Surgery, National Hospital Organization Yamaguchi Ube Medical Center, Higashikiwa 685, Ube, Yamaguchi, 755-0241, Japan
| | - Masanori Okada
- Department of Thoracic Surgery, National Hospital Organization Yamaguchi Ube Medical Center, Higashikiwa 685, Ube, Yamaguchi, 755-0241, Japan
| | - Hidetoshi Inokawa
- Department of Thoracic Surgery, National Hospital Organization Yamaguchi Ube Medical Center, Higashikiwa 685, Ube, Yamaguchi, 755-0241, Japan
| | - Yusuke Mimura
- Clinical Research, National Hospital Organization Yamaguchi Ube Medical Center, Higashikiwa 685, Ube, Yamaguchi, 755-0241, Japan
| | - Tomoyuki Murakami
- Clinical Research, National Hospital Organization Yamaguchi Ube Medical Center, Higashikiwa 685, Ube, Yamaguchi, 755-0241, Japan
- Department of Pathology, National Hospital Organization Kanmon Medical Center, Chofusotoura-cho 1-1, Shimonoseki, Yamaguchi, 752-8510, Japan
| | - Masao Nakata
- Department of General Thoracic Surgery, Kawasaki Medical School, Matsushima 577, Kurashiki, 7010192, Japan
| | - Kazunori Okabe
- Department of Thoracic Surgery, National Hospital Organization Yamaguchi Ube Medical Center, Higashikiwa 685, Ube, Yamaguchi, 755-0241, Japan
- Department of Thoracic Surgery, Bell Land General Hospital, Higashiyama 500-3, Nakaku, Sakai, Osaka, 599-8247, Japan
| |
Collapse
|
27
|
Offin M, Yang SR, Egger J, Jayakumaran G, Spencer RS, Lopardo J, Nash GM, Cercek A, Travis WD, Kris MG, Ladanyi M, Sauter JL, Zauderer MG. Molecular Characterization of Peritoneal Mesotheliomas. J Thorac Oncol 2022; 17:455-460. [PMID: 34648949 PMCID: PMC8882128 DOI: 10.1016/j.jtho.2021.09.012] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 09/09/2021] [Accepted: 09/11/2021] [Indexed: 12/19/2022]
Abstract
INTRODUCTION Malignant peritoneal mesothelioma (MPeM) is clinically distinct and less studied than malignant pleural mesothelioma. We report the genomic and immunophenotypic features of a prospectively collected MPeM cohort. METHODS Next-generation sequencing (NGS) was performed on MPeM tumors. Genomic near-haploidization (GNH) was assessed. WT1, BAP1, mesothelin, VISTA, and programmed death-ligand 1 were evaluated by immunohistochemistry (IHC) when tissue was available. Overall survival was stratified by selected genomic and IHC features. RESULTS A total of 50 consented patients with MPeM (45 epithelioid, 5 nonepithelioid) were studied exhibiting common alterations in BAP1 (60%; 30 of 50), NF2 (24%; 12 of 50) SETD2 (22%; 11 of 50), and TP53 (16%; 8 of 50). A total of 76% (38 of 50) of specimens were assessable for allele-specific copy number analysis; 8% (3 of 38) had GNH. IHC positivity rates were 93% (37 of 40) for mesothelin, 96% (46 of 48) for WT1, 50% (19 of 38) for programmed death-ligand 1, and 89% (34 of 38) for VISTA. BAP1 loss by IHC was observed in 76% (29 of 38), including five wild-type on NGS. Combining NGS and IHC for BAP1, overall survival was worse with alteration or loss compared with wild-type or retained in all patients (n = 37 versus 13, 43.8 versus 117.3 mo, p = 0.04) Three of 30 patients had a pathogenic germline variant: POT1 I78T, MUTYH R109Y, and BAP1 E402∗. CONCLUSIONS MPeM has distinct biology and genomic composition. CDKN2A/B alterations were rare in MPeM, whereas BAP1, NF2, TP53, SETD2, and LATS2 were common. BAP1 alteration/loss was associated with shorter survival when all patients were included. A notable minority of specimens had GNH associated with NF2, TP53, and SETDB1 mutations. Pathogenic germline mutations were found in 3 of 30 patients.
Collapse
Affiliation(s)
- Michael Offin
- Thoracic Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York; Department of Medicine, Weill Cornell Medical College, New York, New York.
| | - Soo-Ryum Yang
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Jacklynn Egger
- Thoracic Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York; Department of Medicine, Weill Cornell Medical College, New York, New York
| | - Gowtham Jayakumaran
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Rowanne S Spencer
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Jessica Lopardo
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Garrett M Nash
- Department of Colorectal Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Andrea Cercek
- Department of Medicine, Weill Cornell Medical College, New York, New York; Gastrointestinal Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - William D Travis
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Mark G Kris
- Thoracic Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York; Department of Medicine, Weill Cornell Medical College, New York, New York
| | - Marc Ladanyi
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Jennifer L Sauter
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Marjorie G Zauderer
- Thoracic Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York; Department of Medicine, Weill Cornell Medical College, New York, New York
| |
Collapse
|
28
|
Chapel DB, Hirsch MS. SOX6 Expression Is Sensitive for Peritoneal Epithelioid Malignant Mesothelioma, But Not Specific in the Differential Diagnosis With Tubo-ovarian Serous Neoplasia. Am J Surg Pathol 2022; 46:213-219. [PMID: 34411029 DOI: 10.1097/pas.0000000000001792] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Primary peritoneal malignant mesothelioma (MM) can demonstrate morphologic overlap with low-grade and high-grade tubo-ovarian serous neoplasms; it is also biologically and prognostically distinct from benign mesothelial proliferations. Currently, there is no single biomarker that can definitively distinguish these neoplasms. Sex-determining region Y box 6 (SOX6) immunohistochemistry has been recently described to differentiate pleural epithelioid MM from lung adenocarcinoma, but it has not been evaluated in the peritoneum. SOX6 immunohistochemistry was performed on 43 peritoneal epithelioid MM, 7 peritoneal biphasic MM, 5 well-differentiated papillary mesotheliomas, 5 serous borderline tumors, 29 low-grade serous carcinomas (LGSCs), 20 high-grade serous carcinomas (HGSCs), and 25 cases of peritoneal reactive mesothelial hyperplasia. Quantitative SOX6 expression in epithelioid MM (median, 100% of tumor cells) was significantly greater than in LGSC/serous borderline tumor (median, 90%; P=0.004) and HGSC (median, 45%; P=0.0001). However, when SOX6 is expression is defined as ≥10% of tumor cells, there was no significant difference in the rate of SOX6 positivity between epithelioid MM (41/43, 95%), LGSC (28/29, 97%; P=1.0), and HGSC (17/20, 85%; P=0.16). Quantitative extent of SOX6 expression in epithelioid MM was significantly greater than in biphasic MM (median, 0%; P=0.0001), well-differentiated papillary mesothelioma (median, 20%; P=0.001), and reactive mesothelial hyperplasia (median, 20%; P=0.0001), but not significantly different from flat quiescent mesothelium (median, 90%; P=0.82). SOX6 immunohistochemistry is 95% sensitive for peritoneal epithelioid MM, but is also consistently expressed in LGSC and HGSC, negating its usefulness in this common differential diagnosis. SOX6 also shows variable expression across the spectrum of reactive, benign neoplastic, and malignant mesothelial lesions of the peritoneum, and does not appear to be diagnostically useful in distinguishing benign from malignant mesothelial proliferations.
Collapse
MESH Headings
- Adult
- Aged
- Aged, 80 and over
- Biomarkers, Tumor/analysis
- Cell Proliferation
- Databases, Factual
- Diagnosis, Differential
- Epithelioid Cells/chemistry
- Epithelioid Cells/pathology
- Fallopian Tube Neoplasms/chemistry
- Fallopian Tube Neoplasms/pathology
- Female
- Humans
- Immunohistochemistry
- Male
- Mesothelioma, Malignant/chemistry
- Mesothelioma, Malignant/pathology
- Middle Aged
- Neoplasms, Cystic, Mucinous, and Serous/classification
- Neoplasms, Cystic, Mucinous, and Serous/pathology
- Ovarian Neoplasms/chemistry
- Ovarian Neoplasms/pathology
- Peritoneal Neoplasms/chemistry
- Peritoneal Neoplasms/pathology
- Predictive Value of Tests
- SOXD Transcription Factors/analysis
- Young Adult
Collapse
Affiliation(s)
- David B Chapel
- Department of Pathology and Clinical Laboratories, University of Michigan - Michigan Medicine, Ann Arbor, MI
| | - Michelle S Hirsch
- Women's and Perinatal Division, Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| |
Collapse
|
29
|
Aldrian D, Neu N, Oberhuber G, Kropshofer G, Müller T, Vogel GF. Pediatric Malignant Peritoneal Mesothelioma With Meningeal Metastasis. J Pediatr Hematol Oncol 2022; 44:e272-e274. [PMID: 33633025 DOI: 10.1097/mph.0000000000002118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Accepted: 01/20/2021] [Indexed: 11/25/2022]
Abstract
Malignant peritoneal mesothelioma (MPM) is an extremely rare entity with a poor prognosis. We report on a 16-year-old boy with ascites and abdominal distension. A computed tomography scan showed peritoneal thickening and a mass adjacent to the transverse colon. Neither repeated cytologic testing of ascitic fluid, nor peritoneal tissue biopsy detected malignant cells. After the patient became progressively comatose, a magnetic resonance imaging scan of the brain showed leptomeningeal enhancement. An autopsy showed MPM infiltrating the pleura and the meninges. This is the first report on meningeal metastasis of MPM in a pediatric patient illustrating the enigmatic behavior of the tumor and highlighting the diagnostic pitfalls.
Collapse
Affiliation(s)
| | | | - Georg Oberhuber
- INNPATH, Tirol-Kliniken University Hospital Innsbruck, Innsbruck, Austria
| | | | | | - Georg-Friedrich Vogel
- Department of Paediatrics I
- Institute of Cell Biology, Medical University of Innsbruck
| |
Collapse
|
30
|
Malpica A, Euscher ED, Marques-Piubelli ML, Miranda RN, Fournier KF, Raghav KP, Ramalingam P. Malignant Peritoneal Mesothelioma Associated With Endometriosis: A Clinicopathologic Study of 15 Cases. Int J Gynecol Pathol 2022; 41:59-67. [PMID: 33577225 DOI: 10.1097/pgp.0000000000000762] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Only a few cases of malignant peritoneal mesothelioma (MPeM) associated with endometriosis have been published; with chronic inflammation of the peritoneum associated with the latter being postulated as an inducing factor in the pathogenesis of this tumor. We assessed the clinicopathologic characteristics of MPeM associated with endometriosis to determine if there were other factors besides inflammation that may contribute to the pathogenesis in this patient population. Fifteen MPeM associated with endometriosis were retrieved from our files. Most presented with abdominal/pelvic pain, mass or distention; median age was 45 yr. Only 16% of patients had a history of asbestos exposure. In contrast, a third of the patients had a personal history of other neoplasms, and >80% had a family history of malignancies. Although most tumors had gross and microscopic features typical of MPeM, some had confounding features including "adhesion-like" appearance or gelatinous cysts/nodules, and signet ring cells. Tumors were epithelioid (9) and biphasic (6). MPeM was misdiagnosed as Müllerian carcinoma in 40% of cases. All patients (n=15) had cytoreductive surgery in addition to other therapies. Only 2/12 patients died of disease (17%). The 3- and 5-yr overall survival was 90%. MPeM associated with endometriosis tends to occur in patients with personal/familial history of malignancies, which may be a predisposing factor. In light of this finding, the role of endometriosis in the pathogenesis of MPeM is likely less relevant. The favorable outcome seen in these patients may be related to germline mutations or the hormonal milieu and needs further investigation.
Collapse
|
31
|
Otsubo K, Sakai H, Kimura H, Miyazawa T, Marushima H, Kojima K, Furuya N, Mineshita M, Chosokabe M, Koike J, Saji H. Thoracic mesenchymal malignant tumors and programed cell death ligand-1 status: Clinicopathologic and prognostic analysis of eight pulmonary sarcomatoid carcinomas and eight malignant mesotheliomas. Thorac Cancer 2021; 12:3169-3176. [PMID: 34655161 PMCID: PMC8636199 DOI: 10.1111/1759-7714.14177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 09/14/2021] [Accepted: 09/16/2021] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND The current study aimed to evaluate the significance of clinicopathological factors, particularly the immunohistochemistry of programed cell death ligand-1 (PD-L1), in eight cases each of pulmonary sarcomatoid carcinoma (PSC) and malignant pleural mesothelioma (MPM) at our hospital. METHODS From January 2004 to December 2020, a total of 16 consecutive patients (eight with PSC and eight with MPM diagnosed via surgical resection or biopsy) were included in this study. After retrospectively reviewing the patient characteristics, the associations between PD-L1 status and age, sex, stage, histological type, and prognosis were investigated. RESULTS PD-L1-positive staining was observed in four (50%) PSC cases and one (12.5%) MPM case. Among the four PD-L1-positive PSC cases, two showed high PD-L1 expression in the vimentin-positive sarcomatoid compartment. Moreover, among those with PSC, two survived for about 10 years, whereas the others died within 5 years. No clear correlation was found between PD-L1 expression and prognosis. Among the patients with MPM, four survived for more than 2 years, with the longest being 9 years. Among MPM cases who received nivolumab, one patient with positive PD-L1 staining in the sarcomatoid survived, whereas the other with negative PD-L1 staining did not. CONCLUSION The present study showed that sarcomatoid carcinoma had a higher PD-L1 expression compared to non-small-cell lung cancer and that both PSC and MPM tended to exhibit PD-L1 positivity in the sarcomatoid compartment. Moreover, while immune checkpoint inhibitors may somewhat prolong the prognosis of both tumors, further studies with a larger cohort are necessary to confirm our results.
Collapse
Affiliation(s)
- Kanji Otsubo
- Departments of Chest SurgerySt. Marianna University School of MedicineKawasakiJapan
| | - Hiroki Sakai
- Departments of Chest SurgerySt. Marianna University School of MedicineKawasakiJapan
| | - Hiroyuki Kimura
- Departments of Chest SurgerySt. Marianna University School of MedicineKawasakiJapan
| | - Tomoyuki Miyazawa
- Departments of Chest SurgerySt. Marianna University School of MedicineKawasakiJapan
| | - Hideki Marushima
- Departments of Chest SurgerySt. Marianna University School of MedicineKawasakiJapan
| | - Koji Kojima
- Departments of Chest SurgerySt. Marianna University School of MedicineKawasakiJapan
| | - Naoki Furuya
- Division of Respiratory Medicine, Department of Internal MedicineSt. Marianna University School of MedicineKawasakiJapan
| | - Masamichi Mineshita
- Division of Respiratory Medicine, Department of Internal MedicineSt. Marianna University School of MedicineKawasakiJapan
| | - Motohiro Chosokabe
- Department of PathologySt. Marianna University School of MedicineKawasakiJapan
| | - Junki Koike
- Department of PathologySt. Marianna University School of MedicineKawasakiJapan
| | - Hisashi Saji
- Departments of Chest SurgerySt. Marianna University School of MedicineKawasakiJapan
| |
Collapse
|
32
|
Chen Z, Yang C, Guo Z, Song S, Gao Y, Wang D, Mao W, Liu J. A novel PDX modeling strategy and its application in metabolomics study for malignant pleural mesothelioma. BMC Cancer 2021; 21:1235. [PMID: 34789172 PMCID: PMC8600931 DOI: 10.1186/s12885-021-08980-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 11/08/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Malignant pleural mesothelioma (MPM) is a rare and aggressive carcinoma located in pleural cavity. Due to lack of effective diagnostic biomarkers and therapeutic targets in MPM, the prognosis is extremely poor. Because of difficulties in sample extraction, and the high rate of misdiagnosis, MPM is rarely studied. Therefore, novel modeling methodology is crucially needed to facilitate MPM research. METHODS A novel patient-derived xenograft (PDX) modeling strategy was designed, which included preliminary screening of patients with pleural thickening using computerized tomography (CT) scan, further reviewing history of disease and imaging by a senior sonographer as well as histopathological analysis by a senior pathologist, and PDX model construction using ultrasound-guided pleural biopsy from MPM patients. Gas chromatography-mass spectrometry-based metabolomics was further utilized for investigating circulating metabolic features of the PDX models. Univariate and multivariate analysis, and pathway analysis were performed to explore the differential metabolites, enriched metabolism pathways and potential metabolic targets. RESULTS After screening using our strategy, 5 out of 116 patients were confirmed to be MPM, and their specimens were used for modeling. Two PDX models were established successfully. Metabolomics analysis revealed significant metabolic shifts in PDX models, such as dysregulations in amino acid metabolism, TCA cycle and glycolysis, and nucleotide metabolism. CONCLUSIONS To sum up, we suggested a novel modeling strategy that may facilitate specimen availability for MM research, and by applying metabolomics in this model, several metabolic features were identified, whereas future studies with large sample size are needed.
Collapse
Affiliation(s)
- Zhongjian Chen
- The Cancer Research Institute, The Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Institute of Cancer and Basic Medicine (ICBM), Chinese Academy of Sciences, Zhejiang, 310022, Hangzhou, China
- Key Laboratory Diagnosis and Treatment Technology on Thoracic Oncology, Zhejiang, 310022, Hangzhou, China
| | - Chenxi Yang
- The Cancer Research Institute, The Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Institute of Cancer and Basic Medicine (ICBM), Chinese Academy of Sciences, Zhejiang, 310022, Hangzhou, China
- Key Laboratory Diagnosis and Treatment Technology on Thoracic Oncology, Zhejiang, 310022, Hangzhou, China
| | - Zhenying Guo
- The Cancer Research Institute, The Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Institute of Cancer and Basic Medicine (ICBM), Chinese Academy of Sciences, Zhejiang, 310022, Hangzhou, China
- Key Laboratory Diagnosis and Treatment Technology on Thoracic Oncology, Zhejiang, 310022, Hangzhou, China
| | - Siyu Song
- The Cancer Research Institute, The Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Institute of Cancer and Basic Medicine (ICBM), Chinese Academy of Sciences, Zhejiang, 310022, Hangzhou, China
- Key Laboratory Diagnosis and Treatment Technology on Thoracic Oncology, Zhejiang, 310022, Hangzhou, China
| | - Yun Gao
- The Cancer Research Institute, The Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Institute of Cancer and Basic Medicine (ICBM), Chinese Academy of Sciences, Zhejiang, 310022, Hangzhou, China
- Key Laboratory Diagnosis and Treatment Technology on Thoracic Oncology, Zhejiang, 310022, Hangzhou, China
| | - Ding Wang
- The Cancer Research Institute, The Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Institute of Cancer and Basic Medicine (ICBM), Chinese Academy of Sciences, Zhejiang, 310022, Hangzhou, China
- Key Laboratory Diagnosis and Treatment Technology on Thoracic Oncology, Zhejiang, 310022, Hangzhou, China
| | - Weimin Mao
- The Cancer Research Institute, The Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Institute of Cancer and Basic Medicine (ICBM), Chinese Academy of Sciences, Zhejiang, 310022, Hangzhou, China.
- Key Laboratory Diagnosis and Treatment Technology on Thoracic Oncology, Zhejiang, 310022, Hangzhou, China.
| | - Junping Liu
- The Cancer Research Institute, The Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Institute of Cancer and Basic Medicine (ICBM), Chinese Academy of Sciences, Zhejiang, 310022, Hangzhou, China.
- Key Laboratory Diagnosis and Treatment Technology on Thoracic Oncology, Zhejiang, 310022, Hangzhou, China.
| |
Collapse
|
33
|
Ramundo V, Zanirato G, Aldieri E. The Epithelial-to-Mesenchymal Transition (EMT) in the Development and Metastasis of Malignant Pleural Mesothelioma. Int J Mol Sci 2021; 22:ijms222212216. [PMID: 34830097 PMCID: PMC8621591 DOI: 10.3390/ijms222212216] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 10/27/2021] [Accepted: 11/03/2021] [Indexed: 12/19/2022] Open
Abstract
Malignant pleural mesothelioma (MPM) is an aggressive tumor mainly associated with asbestos exposure and is characterized by a very difficult pharmacological approach. One of the molecular mechanisms associated with cancer onset and invasiveness is the epithelial-to-mesenchymal transition (EMT), an event induced by different types of inducers, such as transforming growth factor β (TGFβ), the main inducer of EMT, and oxidative stress. MPM development and metastasis have been correlated to EMT; On one hand, EMT mediates the effects exerted by asbestos fibers in the mesothelium, particularly via increased oxidative stress and TGFβ levels evoked by asbestos exposure, thus promoting a malignant phenotype, and on the other hand, MPM acquires invasiveness via the EMT event, as shown by an upregulation of mesenchymal markers or, although indirectly, some miRNAs or non-coding RNAs, all demonstrated to be involved in cancer onset and metastasis. This review aims to better describe how EMT is involved in driving the development and invasiveness of MPM, in an attempt to open new scenarios that are useful in the identification of predictive markers and to improve the pharmacological approach against this aggressive cancer.
Collapse
Affiliation(s)
- Valeria Ramundo
- Department of Oncology, University of Torino, 10126 Torino, Italy; (V.R.); (G.Z.)
| | - Giada Zanirato
- Department of Oncology, University of Torino, 10126 Torino, Italy; (V.R.); (G.Z.)
| | - Elisabetta Aldieri
- Department of Oncology, University of Torino, 10126 Torino, Italy; (V.R.); (G.Z.)
- Interdepartmental Center for Studies on Asbestos and Other Toxic Particulates “G. Scansetti”, University of Torino, 10126 Torino, Italy
- Correspondence:
| |
Collapse
|
34
|
Fennell DA, Ewings S, Ottensmeier C, Califano R, Hanna GG, Hill K, Danson S, Steele N, Nye M, Johnson L, Lord J, Middleton C, Szlosarek P, Chan S, Gaba A, Darlison L, Wells-Jordan P, Richards C, Poile C, Lester JF, Griffiths G. Nivolumab versus placebo in patients with relapsed malignant mesothelioma (CONFIRM): a multicentre, double-blind, randomised, phase 3 trial. Lancet Oncol 2021; 22:1530-1540. [PMID: 34656227 PMCID: PMC8560642 DOI: 10.1016/s1470-2045(21)00471-x] [Citation(s) in RCA: 115] [Impact Index Per Article: 38.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2021] [Revised: 08/02/2021] [Accepted: 08/04/2021] [Indexed: 12/20/2022]
Abstract
BACKGROUND No phase 3 trial has yet shown improved survival for patients with pleural or peritoneal malignant mesothelioma who have progressed following platinum-based chemotherapy. The aim of this study was to assess the efficacy and safety of nivolumab, an anti-PD-1 antibody, in these patients. METHODS This was a multicentre, placebo-controlled, double-blind, parallel group, randomised, phase 3 trial done in 24 hospitals in the UK. Adult patients (aged ≥18 years) with an Eastern Cooperative Oncology Group performance status of 0 or 1, with histologically confirmed pleural or peritoneal mesothelioma, who had received previous first-line platinum-based chemotherapy and had radiological evidence of disease progression, were randomly assigned (2:1) to receive nivolumab at a flat dose of 240 mg every 2 weeks over 30 min intravenously or placebo until disease progression or a maximum of 12 months. The randomisation sequence was generated within an interactive web response system (Alea); patients were stratified according to epithelioid versus non-epithelioid histology and were assigned in random block sizes of 3 and 6. Participants and treating clinicians were masked to group allocation. The co-primary endpoints were investigator-assessed progression-free survival and overall survival, analysed according to the treatment policy estimand (an equivalent of the intention-to-treat principle). All patients who were randomly assigned were included in the safety population, reported according to group allocation. This trial is registered with Clinicaltrials.gov, NCT03063450. FINDINGS Between May 10, 2017, and March 30, 2020, 332 patients were recruited, of whom 221 (67%) were randomly assigned to the nivolumab group and 111 (33%) were assigned to the placebo group). Median follow-up was 11·6 months (IQR 7·2-16·8). Median progression-free survival was 3·0 months (95% CI 2·8-4·1) in the nivolumab group versus 1·8 months (1·4-2·6) in the placebo group (adjusted hazard ratio [HR] 0·67 [95% CI 0·53-0·85; p=0·0012). Median overall survival was 10·2 months (95% CI 8·5-12·1) in the nivolumab group versus 6·9 months (5·0-8·0) in the placebo group (adjusted HR 0·69 [95% CI 0·52-0·91]; p=0·0090). The most frequently reported grade 3 or worse treatment-related adverse events were diarrhoea (six [3%] of 221 in the nivolumab group vs two [2%] of 111 in the placebo group) and infusion-related reaction (six [3%] vs none). Serious adverse events occurred in 90 (41%) patients in the nivolumab group and 49 (44%) patients in the placebo group. There were no treatment-related deaths in either group. INTERPRETATION Nivolumab represents a treatment that might be beneficial to patients with malignant mesothelioma who have progressed on first-line therapy. FUNDING Stand up to Cancer-Cancer Research UK and Bristol Myers Squibb.
Collapse
Affiliation(s)
- Dean A Fennell
- Mesothelioma Research Programme, Leicester Cancer Research Centre, University of Leicester, Leicester, UK; University Hospitals of Leicester NHS Trust, Leicester, UK.
| | - Sean Ewings
- Cancer Research UK, Southampton Clinical Trials Unit, University of Southampton, Southampton, UK
| | - Christian Ottensmeier
- Department of Molecular & Clinical Cancer Medicine, University of Liverpool, Liverpool, UK
| | | | - Gerard G Hanna
- Peter MacCullum Cancer Centre, University of Melbourne, Melbourne, VIC, Australia
| | - Kayleigh Hill
- Cancer Research UK, Southampton Clinical Trials Unit, University of Southampton, Southampton, UK
| | - Sarah Danson
- Department of Radiation Oncology, University of Sheffield, Sheffield, UK
| | - Nicola Steele
- Department of Oncology and Metabolism University of Glasgow, Glasgow, UK
| | - Mavis Nye
- Mavis Nye Foundation, University of Southampton, Southampton, UK
| | - Lucy Johnson
- Cancer Research UK, Southampton Clinical Trials Unit, University of Southampton, Southampton, UK
| | - Joanne Lord
- Southampton Health Technology Assessments Centre, University of Southampton, Southampton, UK
| | - Calley Middleton
- Cancer Research UK, Southampton Clinical Trials Unit, University of Southampton, Southampton, UK
| | - Peter Szlosarek
- Cancer Research UK Barts Cancer Institute, Queen Mary University of London, London, UK
| | - Sam Chan
- York Teaching Hospital NHS Foundation Trust, York, UK
| | - Aarti Gaba
- Mesothelioma Research Programme, Leicester Cancer Research Centre, University of Leicester, Leicester, UK
| | - Liz Darlison
- University Hospitals of Leicester NHS Trust, Leicester, UK; Department of Oncology, Mesothelioma UK, Leicester, UK
| | | | - Cathy Richards
- University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Charlotte Poile
- Mesothelioma Research Programme, Leicester Cancer Research Centre, University of Leicester, Leicester, UK
| | | | - Gareth Griffiths
- Cancer Research UK, Southampton Clinical Trials Unit, University of Southampton, Southampton, UK
| |
Collapse
|
35
|
Nastase A, Mandal A, Lu SK, Anbunathan H, Morris-Rosendahl D, Zhang YZ, Sun XM, Gennatas S, Rintoul RC, Edwards M, Bowman A, Chernova T, Benepal T, Lim E, Taylor AN, Nicholson AG, Popat S, Willis AE, MacFarlane M, Lathrop M, Bowcock AM, Moffatt MF, Cookson WOCM. Integrated genomics point to immune vulnerabilities in pleural mesothelioma. Sci Rep 2021; 11:19138. [PMID: 34580349 PMCID: PMC8476593 DOI: 10.1038/s41598-021-98414-w] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 09/02/2021] [Indexed: 12/21/2022] Open
Abstract
Pleural mesothelioma is an aggressive malignancy with limited effective therapies. In order to identify therapeutic targets, we integrated SNP genotyping, sequencing and transcriptomics from tumours and low-passage patient-derived cells. Previously unrecognised deletions of SUFU locus (10q24.32), observed in 21% of 118 tumours, resulted in disordered expression of transcripts from Hedgehog pathways and the T-cell synapse including VISTA. Co-deletion of Interferon Type I genes and CDKN2A was present in half of tumours and was a predictor of poor survival. We also found previously unrecognised deletions in RB1 in 26% of cases and show sub-micromolar responses to downstream PLK1, CHEK1 and Aurora Kinase inhibitors in primary mesothelioma cells. Defects in Hippo pathways that included RASSF7 amplification and NF2 or LATS1/2 mutations were present in 50% of tumours and were accompanied by micromolar responses to the YAP1 inhibitor Verteporfin. Our results suggest new therapeutic avenues in mesothelioma and indicate targets and biomarkers for immunotherapy.
Collapse
Affiliation(s)
- Anca Nastase
- National Heart and Lung Institute, Imperial College London, Dovehouse Street, London, SW36LY, UK
| | - Amit Mandal
- National Heart and Lung Institute, Imperial College London, Dovehouse Street, London, SW36LY, UK
| | - Shir Kiong Lu
- National Heart and Lung Institute, Imperial College London, Dovehouse Street, London, SW36LY, UK
| | - Hima Anbunathan
- National Heart and Lung Institute, Imperial College London, Dovehouse Street, London, SW36LY, UK
| | - Deborah Morris-Rosendahl
- National Heart and Lung Institute, Imperial College London, Dovehouse Street, London, SW36LY, UK
- Clinical Genetics and Genomics, Royal Brompton and Harefield NHS Foundation Trust, London, UK
| | - Yu Zhi Zhang
- National Heart and Lung Institute, Imperial College London, Dovehouse Street, London, SW36LY, UK
- Department of Histopathology, Royal Brompton and Harefield NHS Foundation Trust, London, UK
| | - Xiao-Ming Sun
- Medical Research Council Toxicology Unit, University of Cambridge, Cambridge, UK
| | - Spyridon Gennatas
- National Heart and Lung Institute, Imperial College London, Dovehouse Street, London, SW36LY, UK
| | - Robert C Rintoul
- Department of Thoracic Oncology, Papworth Hospital, Cambridge, UK
- Department of Oncology, University of Cambridge, Cambridge, UK
| | - Matthew Edwards
- Clinical Genetics and Genomics, Royal Brompton and Harefield NHS Foundation Trust, London, UK
| | - Alex Bowman
- Department of Histopathology, Royal Brompton and Harefield NHS Foundation Trust, London, UK
| | - Tatyana Chernova
- Medical Research Council Toxicology Unit, University of Cambridge, Cambridge, UK
| | - Tim Benepal
- Department of Oncology, St George's Healthcare NHS Foundation Trust, London, UK
| | - Eric Lim
- Department of Thoracic Surgery, Royal Brompton and Harefield NHS Foundation Trust, London, UK
| | - Anthony Newman Taylor
- National Heart and Lung Institute, Imperial College London, Dovehouse Street, London, SW36LY, UK
| | - Andrew G Nicholson
- National Heart and Lung Institute, Imperial College London, Dovehouse Street, London, SW36LY, UK
- Department of Histopathology, Royal Brompton and Harefield NHS Foundation Trust, London, UK
| | - Sanjay Popat
- Department of Medicine, Royal Marsden Hospital, London, UK
- The Institute of Cancer Research, London, UK
| | - Anne E Willis
- Medical Research Council Toxicology Unit, University of Cambridge, Cambridge, UK
| | - Marion MacFarlane
- Medical Research Council Toxicology Unit, University of Cambridge, Cambridge, UK
| | - Mark Lathrop
- Department of Human Genetics, McGill Genome Centre, Montreal, QC, Canada
| | - Anne M Bowcock
- National Heart and Lung Institute, Imperial College London, Dovehouse Street, London, SW36LY, UK
| | - Miriam F Moffatt
- National Heart and Lung Institute, Imperial College London, Dovehouse Street, London, SW36LY, UK.
| | - William O C M Cookson
- National Heart and Lung Institute, Imperial College London, Dovehouse Street, London, SW36LY, UK.
| |
Collapse
|
36
|
Affiliation(s)
- Sam M Janes
- From the Lungs for Living Research Centre, UCL Respiratory, University College London (S.M.J., D.A.), the Department of Thoracic Medicine, University College London Hospital (S.M.J.), London, and the University of Leicester, Leicester (D.A.F.) - all in the United Kingdom
| | - Doraid Alrifai
- From the Lungs for Living Research Centre, UCL Respiratory, University College London (S.M.J., D.A.), the Department of Thoracic Medicine, University College London Hospital (S.M.J.), London, and the University of Leicester, Leicester (D.A.F.) - all in the United Kingdom
| | - Dean A Fennell
- From the Lungs for Living Research Centre, UCL Respiratory, University College London (S.M.J., D.A.), the Department of Thoracic Medicine, University College London Hospital (S.M.J.), London, and the University of Leicester, Leicester (D.A.F.) - all in the United Kingdom
| |
Collapse
|
37
|
Sudo H, Tsuji AB, Sugyo A, Kaneko MK, Kato Y, Nagatsu K, Suzuki H, Higashi T. Preclinical Evaluation of Podoplanin-Targeted Alpha-Radioimmunotherapy with the Novel Antibody NZ-16 for Malignant Mesothelioma. Cells 2021; 10:cells10102503. [PMID: 34685483 PMCID: PMC8533940 DOI: 10.3390/cells10102503] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 09/06/2021] [Accepted: 09/10/2021] [Indexed: 01/11/2023] Open
Abstract
The prognosis of advanced mesothelioma is poor. Podoplanin (PDPN) is highly expressed in most malignant mesothelioma. This study aimed to evaluate the potential alpha-radioimmunotherapy (RIT) with a newly developed anti-PDPN antibody, NZ-16, compared with a previous antibody, NZ-12. METHODS The in vitro properties of radiolabeled antibodies were evaluated by cell binding and competitive inhibition assays using PDPN-expressing H226 mesothelioma cells. The biodistribution of 111In-labeled antibodies was studied in tumor-bearing mice. The absorbed doses were estimated based on biodistribution data. Tumor volumes and body weights of mice treated with 90Y- and 225Ac-labeled NZ-16 were measured for 56 days. Histologic analysis was conducted. RESULTS The radiolabeled NZ-16 specifically bound to H226 cells with higher affinity than NZ-12. The biodistribution studies showed higher tumor uptake of radiolabeled NZ-16 compared with NZ-12, providing higher absorbed doses to tumors. RIT with 225Ac- and 90Y-labeled NZ-16 had a significantly higher antitumor effect than RIT with 90Y-labeled NZ-12. 225Ac-labeled NZ-16 induced a larger amount of necrotic change and showed a tendency to suppress tumor volumes and prolonged survival than 90Y-labeled NZ-16. There is no obvious adverse effect. CONCLUSIONS Alpha-RIT with the newly developed NZ-16 is a promising therapeutic option for malignant mesothelioma.
Collapse
Affiliation(s)
- Hitomi Sudo
- Department of Molecular Imaging and Theranostics, Institute for Quantum Medical Science (iQMS), National Institutes for Quantum and Radiological Science and Technology (QST), 4-9-1 Anagawa, Inage, Chiba 263-8555, Japan; (H.S.); (A.S.); (T.H.)
| | - Atsushi B. Tsuji
- Department of Molecular Imaging and Theranostics, Institute for Quantum Medical Science (iQMS), National Institutes for Quantum and Radiological Science and Technology (QST), 4-9-1 Anagawa, Inage, Chiba 263-8555, Japan; (H.S.); (A.S.); (T.H.)
- Correspondence: ; Tel.: +81-43-382-3704
| | - Aya Sugyo
- Department of Molecular Imaging and Theranostics, Institute for Quantum Medical Science (iQMS), National Institutes for Quantum and Radiological Science and Technology (QST), 4-9-1 Anagawa, Inage, Chiba 263-8555, Japan; (H.S.); (A.S.); (T.H.)
| | - Mika K. Kaneko
- Department of Antibody Drug Development, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575, Japan; (M.K.K.); (Y.K.)
| | - Yukinari Kato
- Department of Antibody Drug Development, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575, Japan; (M.K.K.); (Y.K.)
- Department of Molecular Pharmacology, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575, Japan
| | - Kotaro Nagatsu
- Department of Advanced Nuclear Medicine Science, Institute for Quantum Medical Science (iQMS), National Institutes for Quantum and Radiological Science and Technology (QST), 4-9-1 Anagawa, Inage, Chiba 263-8555, Japan; (K.N.); (H.S.)
| | - Hisashi Suzuki
- Department of Advanced Nuclear Medicine Science, Institute for Quantum Medical Science (iQMS), National Institutes for Quantum and Radiological Science and Technology (QST), 4-9-1 Anagawa, Inage, Chiba 263-8555, Japan; (K.N.); (H.S.)
| | - Tatsuya Higashi
- Department of Molecular Imaging and Theranostics, Institute for Quantum Medical Science (iQMS), National Institutes for Quantum and Radiological Science and Technology (QST), 4-9-1 Anagawa, Inage, Chiba 263-8555, Japan; (H.S.); (A.S.); (T.H.)
| |
Collapse
|
38
|
Ollila H, Paajanen J, Wolff H, Ilonen I, Sutinen E, Välimäki K, Östman A, Anttila S, Kettunen E, Räsänen J, Kallioniemi O, Myllärniemi M, Mäyränpää MI, Pellinen T. High tumor cell platelet-derived growth factor receptor beta expression is associated with shorter survival in malignant pleural epithelioid mesothelioma. J Pathol Clin Res 2021; 7:482-494. [PMID: 33955203 PMCID: PMC8363931 DOI: 10.1002/cjp2.218] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Revised: 03/10/2021] [Accepted: 04/01/2021] [Indexed: 11/11/2022]
Abstract
Malignant pleural mesothelioma (MPM) has a rich stromal component containing mesenchymal fibroblasts. However, the properties and interplay of MPM tumor cells and their surrounding stromal fibroblasts are poorly characterized. Our objective was to spatially profile known mesenchymal markers in both tumor cells and associated fibroblasts and correlate their expression with patient survival. The primary study cohort consisted of 74 MPM patients, including 16 patients who survived at least 60 months. We analyzed location-specific tissue expression of seven fibroblast markers in clinical samples using multiplexed fluorescence immunohistochemistry (mfIHC) and digital image analysis. Effect on survival was assessed using Cox regression analyses. The outcome measurement was all-cause mortality. Univariate analysis revealed that high expression of secreted protein acidic and cysteine rich (SPARC) and fibroblast activation protein in stromal cells was associated with shorter survival. Importantly, high expression of platelet-derived growth factor receptor beta (PDGFRB) in tumor cells, but not in stromal cells, was associated with shorter survival (hazard ratio [HR] = 1.02, p < 0.001). A multivariable survival analysis adjusted for clinical parameters and stromal mfIHC markers revealed that tumor cell PDGFRB and stromal SPARC remained independently associated with survival (HR = 1.01, 95% confidence interval [CI] = 1.00-1.03 and HR = 1.05, 95% CI = 1.00-1.11, respectively). The prognostic effect of PDGFRB was validated with an artificial intelligence-based analysis method and further externally validated in another cohort of 117 MPM patients. In external validation, high tumor cell PDGFRB expression associated with shorter survival, especially in the epithelioid subtype. Our findings suggest PDGFRB and SPARC as potential markers for risk stratification and as targets for therapy.
Collapse
Affiliation(s)
- Hely Ollila
- Institute for Molecular Medicine Finland (FIMM), Helsinki Institute of Life Science (HiLIFE)University of HelsinkiHelsinkiFinland
- Individualized Drug Therapy Research Program, Faculty of MedicineUniversity of HelsinkiHelsinkiFinland
- Department of Pulmonary MedicineHeart and Lung Center, University of Helsinki and Helsinki University HospitalHelsinkiFinland
| | - Juuso Paajanen
- Individualized Drug Therapy Research Program, Faculty of MedicineUniversity of HelsinkiHelsinkiFinland
- Department of Pulmonary MedicineHeart and Lung Center, University of Helsinki and Helsinki University HospitalHelsinkiFinland
| | - Henrik Wolff
- Laboratory of PathologyFinnish Institute of Occupational HealthHelsinkiFinland
- Department of PathologyUniversity of Helsinki and Helsinki University HospitalHelsinkiFinland
| | - Ilkka Ilonen
- Individualized Drug Therapy Research Program, Faculty of MedicineUniversity of HelsinkiHelsinkiFinland
- Department of General Thoracic and Esophageal SurgeryHeart and Lung Center, University of Helsinki and Helsinki University HospitalHelsinkiFinland
| | - Eva Sutinen
- Individualized Drug Therapy Research Program, Faculty of MedicineUniversity of HelsinkiHelsinkiFinland
- Department of Pulmonary MedicineHeart and Lung Center, University of Helsinki and Helsinki University HospitalHelsinkiFinland
| | - Katja Välimäki
- Institute for Molecular Medicine Finland (FIMM), Helsinki Institute of Life Science (HiLIFE)University of HelsinkiHelsinkiFinland
| | - Arne Östman
- Department of Oncology‐PathologyKarolinska InstitutetSolnaSweden
| | - Sisko Anttila
- Department of PathologyUniversity of Helsinki and Helsinki University HospitalHelsinkiFinland
| | - Eeva Kettunen
- Laboratory of PathologyFinnish Institute of Occupational HealthHelsinkiFinland
| | - Jari Räsänen
- Department of General Thoracic and Esophageal SurgeryHeart and Lung Center, University of Helsinki and Helsinki University HospitalHelsinkiFinland
| | - Olli Kallioniemi
- Institute for Molecular Medicine Finland (FIMM), Helsinki Institute of Life Science (HiLIFE)University of HelsinkiHelsinkiFinland
| | - Marjukka Myllärniemi
- Individualized Drug Therapy Research Program, Faculty of MedicineUniversity of HelsinkiHelsinkiFinland
- Department of Pulmonary MedicineHeart and Lung Center, University of Helsinki and Helsinki University HospitalHelsinkiFinland
| | - Mikko I Mäyränpää
- Department of PathologyUniversity of Helsinki and Helsinki University HospitalHelsinkiFinland
| | - Teijo Pellinen
- Institute for Molecular Medicine Finland (FIMM), Helsinki Institute of Life Science (HiLIFE)University of HelsinkiHelsinkiFinland
| |
Collapse
|
39
|
Lisini D, Lettieri S, Nava S, Accordino G, Frigerio S, Bortolotto C, Lancia A, Filippi AR, Agustoni F, Pandolfi L, Piloni D, Comoli P, Corsico AG, Stella GM. Local Therapies and Modulation of Tumor Surrounding Stroma in Malignant Pleural Mesothelioma: A Translational Approach. Int J Mol Sci 2021; 22:9014. [PMID: 34445720 PMCID: PMC8396500 DOI: 10.3390/ijms22169014] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 08/06/2021] [Accepted: 08/17/2021] [Indexed: 12/21/2022] Open
Abstract
Malignant Pleural Mesothelioma (MPM) is a rare and aggressive neoplasm of the pleural mesothelium, mainly associated with asbestos exposure and still lacking effective therapies. Modern targeted biological strategies that have revolutionized the therapy of other solid tumors have not had success so far in the MPM. Combination immunotherapy might achieve better results over chemotherapy alone, but there is still a need for more effective therapeutic approaches. Based on the peculiar disease features of MPM, several strategies for local therapeutic delivery have been developed over the past years. The common rationale of these approaches is: (i) to reduce the risk of drug inactivation before reaching the target tumor cells; (ii) to increase the concentration of active drugs in the tumor micro-environment and their bioavailability; (iii) to reduce toxic effects on normal, non-transformed cells, because of much lower drug doses than those used for systemic chemotherapy. The complex interactions between drugs and the local immune-inflammatory micro-environment modulate the subsequent clinical response. In this perspective, the main interest is currently addressed to the development of local drug delivery platforms, both cell therapy and engineered nanotools. We here propose a review aimed at deep investigation of the biologic effects of the current local therapies for MPM, including cell therapies, and the mechanisms of interaction with the tumor micro-environment.
Collapse
Affiliation(s)
- Daniela Lisini
- Cell Therapy Production Unit-UPTC and Cerebrovascular Diseases Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, 20133 Milan, Italy; (D.L.); (S.N.); (S.F.)
| | - Sara Lettieri
- Unit of Respiratory Diseases, Department of Medical Sciences and Infective Diseases, IRCCS Policlinico San Matteo Foundation and University of Pavia Medical School, 27100 Pavia, Italy; (S.L.); (G.A.); (L.P.); (D.P.); (A.G.C.)
| | - Sara Nava
- Cell Therapy Production Unit-UPTC and Cerebrovascular Diseases Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, 20133 Milan, Italy; (D.L.); (S.N.); (S.F.)
| | - Giulia Accordino
- Unit of Respiratory Diseases, Department of Medical Sciences and Infective Diseases, IRCCS Policlinico San Matteo Foundation and University of Pavia Medical School, 27100 Pavia, Italy; (S.L.); (G.A.); (L.P.); (D.P.); (A.G.C.)
| | - Simona Frigerio
- Cell Therapy Production Unit-UPTC and Cerebrovascular Diseases Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, 20133 Milan, Italy; (D.L.); (S.N.); (S.F.)
| | - Chandra Bortolotto
- Unit of Radiology, Department of Intensive Medicine, IRCCS Policlinico San Matteo Foundation and University of Pavia Medical School, 27100 Pavia, Italy;
| | - Andrea Lancia
- Unit of Radiation Therapy, Department of Medical Sciences and Infective Diseases, IRCCS Policlinico San Matteo Foundation and University of Pavia Medical School, 27100 Pavia, Italy; (A.L.); (A.R.F.)
| | - Andrea Riccardo Filippi
- Unit of Radiation Therapy, Department of Medical Sciences and Infective Diseases, IRCCS Policlinico San Matteo Foundation and University of Pavia Medical School, 27100 Pavia, Italy; (A.L.); (A.R.F.)
| | - Francesco Agustoni
- Unit of Oncology, Department of Medical Sciences and Infective Diseases, IRCCS Policlinico San Matteo Foundation and University of Pavia Medical School, 27100 Pavia, Italy;
| | - Laura Pandolfi
- Unit of Respiratory Diseases, Department of Medical Sciences and Infective Diseases, IRCCS Policlinico San Matteo Foundation and University of Pavia Medical School, 27100 Pavia, Italy; (S.L.); (G.A.); (L.P.); (D.P.); (A.G.C.)
| | - Davide Piloni
- Unit of Respiratory Diseases, Department of Medical Sciences and Infective Diseases, IRCCS Policlinico San Matteo Foundation and University of Pavia Medical School, 27100 Pavia, Italy; (S.L.); (G.A.); (L.P.); (D.P.); (A.G.C.)
| | - Patrizia Comoli
- Cell Factory and Pediatric Hematology-Oncology Unit, IRCCS Fondazione Policlinico San Matteo, 27100 Pavia, Italy;
| | - Angelo Guido Corsico
- Unit of Respiratory Diseases, Department of Medical Sciences and Infective Diseases, IRCCS Policlinico San Matteo Foundation and University of Pavia Medical School, 27100 Pavia, Italy; (S.L.); (G.A.); (L.P.); (D.P.); (A.G.C.)
| | - Giulia Maria Stella
- Unit of Respiratory Diseases, Department of Medical Sciences and Infective Diseases, IRCCS Policlinico San Matteo Foundation and University of Pavia Medical School, 27100 Pavia, Italy; (S.L.); (G.A.); (L.P.); (D.P.); (A.G.C.)
| |
Collapse
|
40
|
Benzerdjeb N, Dartigues P, Kepenekian V, Valmary-Degano S, Mery E, Averous G, Chevallier A, Laverriere MH, Villa I, Sallé FG, Villeneuve L, Glehen O, Isaac S, Hommell-Fontaine J. Combined grade and nuclear grade are prognosis predictors of epithelioid malignant peritoneal mesothelioma: a multi-institutional retrospective study. Virchows Arch 2021; 479:927-936. [PMID: 34169365 DOI: 10.1007/s00428-021-03144-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 06/15/2021] [Accepted: 06/17/2021] [Indexed: 12/29/2022]
Abstract
Epithelioid mesothelioma is the most prevalent subtype of diffuse malignant peritoneal mesothelioma. A recently described nuclear-grading system predicted survival in patients with epithelioid malignant pleural mesothelioma. The present study was undertaken to validate this grading system in epithelioid malignant peritoneal mesothelioma (EMPM) and to compare to combined grade, including nuclear atypia, mitotic count, and tumor necrosis. Cases of EMPM, from 1995 to 2018, were analyzed from 7 French institutions from RENAPE network. Solid growth, tumor necrosis, nuclear atypia, and mitotic count were evaluated by at least 3 pathologists from the RENAPATH group. The predictions in terms of OS and PFS of nuclear grade and combined grade were analyzed. Nuclear grade was computed combining nuclear atypia score and mitotic count into a grade of I-III. Another system combining nuclear atypia score, mitotic score, and tumor necrosis was evaluated and defined as a combined grade I-III. A total of 138 cases were identified. The median follow-up was 38.9 months (range: 1.1-196.6). Nuclear and combined grades III were independently associated with a shorter OS (p < 0.05), and a shorter PFS (p < 0.05). Patients with combined grade I tumors had the best overall and progression-free survivals, in comparison to nuclear grade I. In this large multicentric study, combined grade and nuclear grade were the best independent predictors of OS and PFS in EMPM. These systems should be easily described by pathologists involved into the management of malignant peritoneal mesothelioma, because of their potential therapeutic implications.
Collapse
Affiliation(s)
- Nazim Benzerdjeb
- Department of Pathology, Institut de Pathologie Multisite, Groupement Hospitalier Sud, Hospices Civils de Lyon, 165 Chemin du Grand-Revoyet, 69310, Pierre-Bénite, France.
| | - Peggy Dartigues
- Department of Pathology, Gustave Roussy Institute, Villejuif, France
| | - Vahan Kepenekian
- Department of Digestive Surgery, Lyon University Hospital, 69000, Lyon, France
| | | | - Eliane Mery
- Department of Pathology, Claudius Regaud Institute, IUTC Oncopôle, Toulouse, France
| | - Gerlinde Averous
- Department of Pathology, Hôpital de Hautepierre, Strasbourg, France
| | | | | | - Irène Villa
- Department of Pathology, Gustave Roussy Institute, Villejuif, France
| | | | - Laurent Villeneuve
- Service D'Epidémiologie Et de Recherche Cliniques, Pôle de Santé Publique, Hospices Civils de Lyon, Lyon, France
| | - Olivier Glehen
- Department of Digestive Surgery, Lyon University Hospital, 69000, Lyon, France
| | - Sylvie Isaac
- Department of Pathology, Institut de Pathologie Multisite, Groupement Hospitalier Sud, Hospices Civils de Lyon, 165 Chemin du Grand-Revoyet, 69310, Pierre-Bénite, France
| | - Juliette Hommell-Fontaine
- Department of Pathology, Institut de Pathologie Multisite, Groupement Hospitalier Sud, Hospices Civils de Lyon, 165 Chemin du Grand-Revoyet, 69310, Pierre-Bénite, France
| |
Collapse
|
41
|
Vymetalova K, Tomasov P, Polasek R. Malignant mesothelioma associated with localized myocardial fibrosis: a case report. BMC Cardiovasc Disord 2021; 21:282. [PMID: 34098884 PMCID: PMC8186214 DOI: 10.1186/s12872-021-02079-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 05/24/2021] [Indexed: 11/10/2022] Open
Abstract
Left ventricular dysfunction is a common reason for patients' referral to cardiology departments for examination. Cardiac involvement is one of the possible yet rare presentations of malignant mesothelioma. We present a case of a patient in whom a routine cardiac examination and imaging revealed malignant mesothelioma. We discuss a possible association between a malignant tumor and myocardial scarring and how the oncologic treatment is influenced by concomitant heart failure. This article aims to raise awareness of the importance of multidisciplinary cooperation and thinking beyond the daily routine of our specialty to ensure the quality care of our patients. It also forced us to think about the possible causes of the association between malignant mesothelioma and myocardial fibrosis.
Collapse
Affiliation(s)
- Kristyna Vymetalova
- Department of Cardiology, Liberec Regional Hospital, Husova 357/10, 460 63, Liberec, Czech Republic.
| | - Pavol Tomasov
- Department of Cardiology, Liberec Regional Hospital, Husova 357/10, 460 63, Liberec, Czech Republic
- Faculty of Health Studies, Technical University of Liberec, Liberec, Czech Republic
| | - Rostislav Polasek
- Department of Cardiology, Liberec Regional Hospital, Husova 357/10, 460 63, Liberec, Czech Republic
- Faculty of Health Studies, Technical University of Liberec, Liberec, Czech Republic
| |
Collapse
|
42
|
Schlueter AH, Dehghanpir SD, Boudreaux B, Robinson C, Menk P Lima JC, Langohr IM. Feline mesothelioma: case report and review of cytologic, immunocytochemical, histopathologic, and immunohistochemical findings. J Vet Diagn Invest 2021; 33:753-757. [PMID: 34047215 DOI: 10.1177/10406387211017489] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Mesotheliomas are uncommon neoplasms that arise from mesothelial cells in either the abdominal or thoracic cavities and are rarely diagnosed in cats. A 10-y-old spayed female domestic shorthair cat was presented to the Louisiana State University oncology service for evaluation of a large amount of abdominal effusion. Abdominal ultrasound identified a large mesenteric mass with numerous ill-defined nodules. An abdominocentesis was performed with cytologic and immunocytochemical findings consistent with a neoplastic effusion, with large clusters of epithelioid cells that exhibited strong cytoplasmic expression of pancytokeratin, vimentin, and Wilms tumor 1 antigens. Further testing was declined, and meloxicam was prescribed until the cat died 23 d after initial presentation. Upon postmortem examination, the omentum was contracted into a firm mass adhered to multiple organs and accompanied by numerous small white nodules throughout the abdominal cavity. On histopathology and immunohistochemistry, neoplastic cells were found throughout the abdominal cavity; 60-95% exhibited moderate-to-strong cytoplasmic immunoreactivity for cytokeratin, vimentin, and Wilms tumor 1 protein. The final diagnosis was an epithelioid mesothelioma. Our case illustrates the utility of cytology, immunocytochemistry, and its relation to histology and immunohistochemistry. We also reviewed the reported cases of feline mesothelioma.
Collapse
Affiliation(s)
- Andrew H Schlueter
- Departments of Veterinary Clinical Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge, LA, USA
| | - Shannon D Dehghanpir
- Departments of Veterinary Clinical Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge, LA, USA
| | - Bonnie Boudreaux
- Departments of Veterinary Clinical Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge, LA, USA
| | - Christopher Robinson
- Departments of Veterinary Clinical Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge, LA, USA
| | - Jose Cesar Menk P Lima
- Pathobiological Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge, LA, USA
| | - Ingeborg M Langohr
- Pathobiological Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge, LA, USA
| |
Collapse
|
43
|
Gutierrez-Sainz L, Cruz P, Martinez-Recio S, Higuera O, Esteban-Rodriguez MI, Arias-Lotto F, Gonzalez RA, De Castro-Carpeño J. Malignant pleural mesothelioma: clinical experience and prognostic value of derived neutrophil-to-lymphocyte ratio and PD-L1 expression. Clin Transl Oncol 2021; 23:2030-2035. [PMID: 33837910 DOI: 10.1007/s12094-021-02605-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 03/22/2021] [Indexed: 01/09/2023]
Abstract
BACKGROUND Malignant pleural mesothelioma (MPM) is a rare and aggressive tumor, with a poor prognosis. MPM needs to find prognostic factors of survival. We provided the management of patients with MPM and sought to determine whether pre-treatment levels of derived neutrophil-to-lymphocyte ratio (dNLR) as well as PD-L1 expression were reliable prognostic factors of survival. METHODS We conducted a single-institution retrospective study, including all patients with MPM treated at La Paz University Hospital between December 2009 and March 2018. Baseline disease, demographics, clinical data, treatment characteristics and complete blood cell counts were collected. We examined dNLR at baseline and data for PD-L1 expression were analyzed in tumor cells by immunohistochemistry. RESULTS We included 25 patients. The median overall survival (OS) was 15.7 months (95% CI 11.3-20.0). 5 patients had a dNLR greater than 3 (20%). Patients with a dNLR greater than 3 had shorter median OS (8.5 months), than patients with a dNLR less than 3 (17.0 months), with statistically significant differences (p = 0.038). Ten patients (40%) had positive PD-L1 expression (≥ 1%). Patients with positive PD-L1 expression had shorter median OS (8.5 months) than patients with negative PDL1 expression (15.7 months), but without statistically significant association (p = 0.319). CONCLUSION The survival data obtained in our sample are consistent with those previously reported. Pretreatment levels of dNLR greater than 3 and positive PD-L1 expression could be significant prognostic factors for poor survival in patients with MPM. Further and prospective studies are needed to explore this relationship and to derive definitive conclusions.
Collapse
Affiliation(s)
- L Gutierrez-Sainz
- Medical Oncology Department, Hospital Universitario La Paz, IdiPAZ, Paseo de la Castellana 261, 28046, Madrid, Spain.
| | - P Cruz
- Medical Oncology Department, Hospital Universitario La Paz, IdiPAZ, Paseo de la Castellana 261, 28046, Madrid, Spain
| | - S Martinez-Recio
- Medical Oncology Department, Hospital Universitario La Paz, IdiPAZ, Paseo de la Castellana 261, 28046, Madrid, Spain
| | - O Higuera
- Medical Oncology Department, Hospital Universitario La Paz, IdiPAZ, Paseo de la Castellana 261, 28046, Madrid, Spain
| | - M I Esteban-Rodriguez
- Pathology Department, Hospital Universitario La Paz, Madrid, Spain
- Translational Oncology Group, IdiPAZ, Madrid, Spain
| | - F Arias-Lotto
- Pathology Department, Hospital Universitario La Paz, Madrid, Spain
| | - R A Gonzalez
- De La Salle Medical and Health Sciences Institute, Dasmariñas, Philippines
| | - J De Castro-Carpeño
- Medical Oncology Department, Hospital Universitario La Paz, IdiPAZ, Paseo de la Castellana 261, 28046, Madrid, Spain
- Translational Oncology Group, IdiPAZ, Madrid, Spain
- Faculty of Medicine, Universidad Autónoma de Madrid, Madrid, Spain
| |
Collapse
|
44
|
Du XM, Wei YP, Gao Y, Li Z, Zhang JM, Chang H, Li Y. Clinicopathological characteristics of primary peritoneal epithelioid mesothelioma of clear cell type: A case report. Medicine (Baltimore) 2021; 100:e25264. [PMID: 33761726 PMCID: PMC9281963 DOI: 10.1097/md.0000000000025264] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 03/04/2021] [Indexed: 01/05/2023] Open
Abstract
RATIONALE Primary peritoneal epithelioid mesothelioma of clear cell type is an extremely rare entity composed of clear cytoplasm. It is challenging to diagnose because of the morphological resemblance to clear cell tumor. PATIENTS CONCERNS A 69-year-old male patient had swollen lymph nodes in the right inguinal region for 7 months and was constipated for 1 month. DIAGNOSIS The patient was diagnosed as peritoneal epithelioid mesothelioma of clear cell type based on computed tomography scan, pathology, immunohistochemistry, special staining and whole-exome sequencing. This patient harbored VHL gene alteration in exon 1 and homologous recombination defect (with a score of 45). This finding indicated that this patient might be sensitive to platinum-based therapy and Poly ADP-ribose Polymerase (PARP) inhibitor. This patient carried no microsatellite instability, a low level of tumor mutation burden, and a high extent of intratumoral heterogeneity. Eighteen neoantigens were detected. INTERVENTIONS The patient received surgery-based multidisciplinary treatment by integrating cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC). HIPEC was administered with docetaxel 120 mg plus cisplatin 120 mg, at 43°C, for 60 minutes. After operation, the patient received intravenous (IV) chemotherapy with docetaxel 60 mg, pemetrexed 750 mg and cisplatin 100 mg, and then intraperitoneal (IP) chemotherapy with docetaxel 40 mg. The patient received interventional therapy of hepatic artery embolization for 5 times. OUTCOMES Regular follow-up was performed until Oct 14, 2020. The patient died 31.6 months later owing to incomplete intestinal obstruction. LESSONS Primary peritoneal epithelioid mesothelioma of clear cell type needs to be differentiated from a variety of clear cell tumors. This disease is characterized by specific genetic alteration. Whole-exome sequencing contributes to guide individualized therapy. CRS-HIPEC helps achieve long-term overall survival.
Collapse
Affiliation(s)
| | | | | | | | | | | | - Yan Li
- Department of Pathology
- Department of Peritoneal Cancer Surgery, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
| |
Collapse
|
45
|
Nadal E, Bosch-Barrera J, Cedrés S, Coves J, García-Campelo R, Guirado M, López-Castro R, Ortega AL, Vicente D, de Castro-Carpeño J. SEOM clinical guidelines for the treatment of malignant pleural mesothelioma (2020). Clin Transl Oncol 2021; 23:980-987. [PMID: 33538989 PMCID: PMC8057959 DOI: 10.1007/s12094-020-02532-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Accepted: 11/21/2020] [Indexed: 11/25/2022]
Abstract
Mesothelioma is a rare and aggressive tumour with dismal prognosis arising in the pleura and associated with asbestos exposure. Its incidence is on the rise worldwide. In selected patients with early-stage MPM, a maximal surgical cytoreduction in combination with additional antitumour treatment may be considered in selected patients assessed by a multidisciplinary tumor board. In patients with unresectable or advanced MPM, chemotherapy with platinum plus pemetrexed is the standard of care. Currently, no standard salvage therapy has been approved yet, but second-line chemotherapy with vinorelbine or gemcitabine is commonly used. Novel therapeutic approaches based on dual immunotherapy or chemotherapy plus immunotherapy demonstrated promising survival benefit and will probably be incorporated in the future.
Collapse
Affiliation(s)
- E. Nadal
- Department of Medical Oncology, Catalan Institute of Oncology, Hospital Duran i Reynals, Avda Gran Via 199-203, l’Hospitalet de Llobregat, Barcelona, Spain
| | - J. Bosch-Barrera
- Department of Medical Oncology, Catalan Institute of Oncology, Hospital Josep Trueta, Girona, Spain
| | - S. Cedrés
- Department of Medical Oncology, Vall d’Hebron Institute of Oncology, Hospital Universitari Vall d’Hebron, Barcelona, Spain
| | - J. Coves
- Department of Medical Oncology, Hospital Son Llatzer, Palma de Mallorca, Spain
| | - R. García-Campelo
- Department of Medical Oncology, Complejo Hospitalario Universitario A Coruña, Coruña, Spain
| | - M. Guirado
- Department of Medical Oncology, Hospital General Universitario de Elche, Elche, Spain
| | - R. López-Castro
- Department of Medical Oncology, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | - A. L. Ortega
- Department of Medical Oncology, Complejo Hospitalario de Jaén, Jaén, Spain
| | - D. Vicente
- Department of Clinical Oncology, Hospital Universitario Virgen de Macarena, Sevilla, Spain
| | | |
Collapse
|
46
|
White MG, Schulte JJ, Xue L, Berger Y, Schuitevoerder D, Vining CC, Kindler HL, Husain A, Turaga KK, Eng OS. Heterogeneity in PD-L1 expression in malignant peritoneal mesothelioma with systemic or intraperitoneal chemotherapy. Br J Cancer 2021; 124:564-566. [PMID: 33100328 PMCID: PMC7851380 DOI: 10.1038/s41416-020-01130-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 10/05/2020] [Accepted: 10/08/2020] [Indexed: 11/09/2022] Open
Abstract
Programmed death-ligand 1 (PD-L1) expression has been described in patients with malignant peritoneal mesothelioma (MPM), but treatment strategies utilising immune checkpoint inhibition are yet to be defined. Here, we examine levels of PD-L1 expression in MPM patients treated with systemic and/or intraperitoneal chemotherapy using tissue from patient tumour biopsies or resections at multiple time points. We found the mean PD-L1 expression was higher in those with a germline mutation and/or those with a higher somatic mutation burden. Moreover, PD-L1 expression was lower in patients who had received prior chemotherapy as compared to the treatment-naive cohort. Twenty patients who received chemotherapy, either systemic and/or peritoneal, between PD-L1 measurements showed marked heterogeneity. Six (30%) patients demonstrated upregulation of PD-L1, while eight (40%) demonstrated downregulation. Heterogeneity in PD-L1 expression in MPM before and after cytotoxic therapies may present an additional consideration when initiating immune checkpoint inhibition in this rare and challenging disease.
Collapse
Affiliation(s)
- Michael G White
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Jefree J Schulte
- Department of Pathology, University of Chicago, Chicago, IL, USA
| | - Lai Xue
- Department of Surgery, Section of General Surgery and Surgical Oncology, University of Chicago, Chicago, IL, USA
| | - Yaniv Berger
- Department of Surgery, Section of General Surgery and Surgical Oncology, University of Chicago, Chicago, IL, USA
| | - Darryl Schuitevoerder
- Department of Surgery, Section of General Surgery and Surgical Oncology, University of Chicago, Chicago, IL, USA
| | - Charles C Vining
- Department of Surgery, Section of General Surgery and Surgical Oncology, University of Chicago, Chicago, IL, USA
| | - Hedy L Kindler
- Department of Medicine, Section of Hematology/Oncology, University of Chicago, Chicago, IL, USA
| | - Aliya Husain
- Department of Pathology, University of Chicago, Chicago, IL, USA
| | - Kiran K Turaga
- Department of Surgery, Section of General Surgery and Surgical Oncology, University of Chicago, Chicago, IL, USA
| | - Oliver S Eng
- Department of Surgery, Section of General Surgery and Surgical Oncology, University of Chicago, Chicago, IL, USA.
| |
Collapse
|
47
|
Malpica A, Euscher ED, Marques-Piubelli ML, Ferrufino-Schmidt MC, Miranda RN, Sams R, Royal RE, Raghav KPS, Fournier KF, Ramalingam P. Malignant Mesothelioma of the Peritoneum in Women: A Clinicopathologic Study of 164 Cases. Am J Surg Pathol 2021; 45:45-58. [PMID: 32769428 DOI: 10.1097/pas.0000000000001545] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Malignant mesothelioma of the peritoneum in women is an uncommon tumor. In this study, we present the clinicopathologic features of 164 such cases seen in our institution over a period of 42 years (1974-2016). Clinical information, pathologic findings, immunohistochemical results, and follow-up were recorded. Hematoxylin and eosin-stained slides were reviewed in all cases. Patients ranged in age from 3 to 85 years, median: 49 years. Most patients presented with abdominal/pelvic pain, although some were asymptomatic, presented with paraneoplastic syndromes or cervical lymphadenopathy. Overall, 9% of patients had a history of direct or indirect exposure to asbestos. In total, 31% and 69% of patients had either a personal or family history of other tumors; most of these tumors are currently recognized as part of a syndrome. Genetic testing information was available in 5 patients: BAP-1 germline mutation (1), type 2 neurofibromatosis (1), Lynch syndrome (1), McCune-Albright syndrome (1), no BAP-1 or TP53 mutation (1). Most cases had gross and microscopic features typical of malignant mesothelioma of the peritoneum in women; however, some had confounding features such as gelatinous appearance, signet ring or clear cells, and well-differentiated papillary mesothelioma-like areas. Calretinin and WT-1 were the markers more frequently expressed, and up to 23% of the cases showed PAX-8 expression. Patients' treatments predominantly included: chemotherapy, cytoreductive surgery, and hyperthermic intraperitoneal chemotherapy. On multivariate analysis, the predominance of deciduoid cells, nuclear grade 3, and the absence of surgical treatment were associated with worse overall survival (OS). For all patients, the 3- and 5-year OS were 74.3% and 57.4%, respectively. The 3- and 5-year OS for patients treated with cytoreductive surgery, and hyperthermic intraperitoneal chemotherapy were 88.9% and 77.8%, respectively.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | - Kanwal P S Raghav
- Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | | | | |
Collapse
|
48
|
Askan G, Basturk O. Expression of Calretinin, Marker of Mesothelial Differentiation, in Pancreatic Ductal Adenocarcinoma: A Potential Diagnostic Pitfall. Turk Patoloji Derg 2021; 37:115-120. [PMID: 33432559 PMCID: PMC10512685 DOI: 10.5146/tjpath.2020.01519] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Accepted: 11/16/2020] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE Pancreatic ductal adenocarcinoma is one of the most common causes of "peritoneal carcinomatosis" and has an insidious growth pattern. Thus, it falls into the differential diagnosis of other peritoneal malignancies including malignant mesothelioma. Recently, we have encountered an undifferentiated pancreatic carcinoma presenting with peritoneal disease and exhibiting immunoreactivity to calretinin, mimicking mesothelioma. In this study, we explored the incidence of calretinin expression in pancreatic ductal adenocarcinoma. MATERIALS AND METHODS Calretinin immunohistochemical staining was performed on the tissue microarrays (TMAs), which were created using three 0.6 mm diameter punches per tumor (n=113). Distribution and intensity of expression were evaluated. RESULTS The TMAs contained 86 well/moderately differentiated and 27 poorly differentiated/undifferentiated carcinomas. Calretinin was positive in nine tumors (8%); six with diffuse and strong staining, three with focal and/or weak staining. The incidence of calretinin expression was 15% in poorly differentiated/undifferentiated carcinomas (vs. 6% in well/moderately differentiated carcinomas, p=0.03). CONCLUSIONS Pancreatic ductal adenocarcinomas, especially when poorly differentiated/undifferentiated, may be diffusely and strongly positive for calretinin creating a potential diagnostic challenge with malignant mesothelioma. Therefore, caution should be exercised when using this marker to explore a diagnosis of malignant mesothelioma. Tumors expressing calretinin without other mesothelial markers should prompt a careful evaluation of the morphologic and immunohistochemical features to exclude other malignancies. If the diagnosis of pancreatic ductal adenocarcinoma is considered, ductal differentiation can be demonstrated by using additional immunohistochemical markers such as mucin-related glycoproteins (MUC1, MUC5AC) and/or oncoproteins (CEA, B72.3, CA125).
Collapse
Affiliation(s)
- Gokce Askan
- Department of Pathology, Rize University Training and Research Hospital, Rize, Turkey
| | - Olca Basturk
- Memorial Sloan Kettering Cancer Center, New York, USA
| |
Collapse
|
49
|
Mlika M, Mezni F. Interobserver Agreement in Histopathological Subtyping of Malignant Pleural Mesotheliomas. Turk Patoloji Derg 2021; 37:56-62. [PMID: 32692400 PMCID: PMC10508922 DOI: 10.5146/tjpath.2020.01498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Accepted: 06/20/2020] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE Many recent studies are pointing out the heterogeneity between pathologists in the classification of malignant pleural mesotheliomas. Besides, they reported the prognostic impact of classifying epithelioid mesotheliomas according to the predominant architectural features and the nuclear grade. The authors assessed the interobserver and the intraobserver agreement of subtyping mesotheliomas between 2 pathologists used to thoracic pathology. MATERIAL AND METHOD The observers reviewed all the slides of the malignant pleural mesotheliomas diagnosed during the period ranging from 2004 to 2017. The Cohen Kappa was performed in order to evaluate the agreement between both observers into classifying mesotheliomas, subtyping and grading epithelioid mesotheliomas. Two rounds of examination were planned with a delay period of one month. After the first round, the reviewers discussed the different difficulties and challenges they faced. All the statistic tests were performed using the SPSS software version 12.0. RESULTS After the first round, a fair agreement between both observers was reported. After the second round, an improvement of the concordance rate with a good agreement in subtyping epithelioid mesotheliomas was noticed. Concerning the grading of mesotheliomas, the interobserver agreement was poor even after the second round examination. The intraobserver reproducibility of epithelioid mesothelioma subtyping was fair or moderate for both reviewers. The intraobserver agreement was poor concerning the grading of epithelioid mesothelioma. CONCLUSION Integrating subtyping and grading of epithelioid mesotheliomas into a new classification necessitates an important training of the pathologists. The architectural features' definitions have to be clarified in order to avoid using own subjective opinions and habits by pathologists.
Collapse
Affiliation(s)
- Mona Mlika
- Department of Pathology, Abderrahman Mami Hospital, University of Medicine of Tunis, University of Tunis El Manar, Research Laboratory: LR18SP06, Tunis, Tunisia
| | - Faouzi Mezni
- Department of Pathology, Abderrahman Mami Hospital, University of Medicine of Tunis, University of Tunis El Manar, Research Laboratory: LR18SP06, Tunis, Tunisia
| |
Collapse
|
50
|
Kaur K, Patel T, Samanta S, Patra S, Trivedi P. Role of Cytology in the Current Guidelines for Malignant Mesothelioma: Largest Study from India. Acta Cytol 2020; 65:175-185. [PMID: 33316798 DOI: 10.1159/000512011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Accepted: 09/24/2020] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Cytology provides crucial window for early diagnosis of malignant mesothelioma (MM) since it is often the first and easily available material for evaluation, resulting in early treatment. Still, its role is overlooked in the current treatment guidelines. The aim of this study is to determine the sensitivity of cytomorphology and role of subsequent ancillary techniques in diagnosing MM. METHODS This is a 5-year retrospective analysis of MM in the tertiary oncology center to determine sensitivity of cytomorphology and subsequent role of immunohistochemistry (IHC) in final diagnosis of MM according to the guidelines for cytopathologic diagnosis of epithelioid and mixed-type malignant mesothelioma (GCDMM) laid by International Mesothelioma Interest Group. Cytomorphology and immunocytochemistry from effusions and fine needle aspirations were analyzed. RESULTS Sixty-two of 128 cases of MM had cytology and cytomorphological criteria described in GCDMM were fulfilled in 61.3% cases. Architectural atypia was useful in identifying cases with low cytological atypia. Overall sensitivity of cytomorphology was 73.01%. Sensitivity of effusion cytology was 77.8%. Subsequent IHC on cell blocks revealed the sensitivity as 100% for mesothelin, calretinin, and cytokeratin 5/6; 87.5% for thrombomodulin; and 50% for WT1, while CEA and TTF1 showed 100% specificity. Treatment was given based on final diagnosis of MM given after IHC on cytology material in only 25.8% cases. However, it was possible in additional 35.5% cases. Mean survival was 10 months when diagnosed by cytology, compared to 7 months by histology. CONCLUSIONS Rather than ignoring the role of cytology in the diagnosis and treatment guidelines for MM, it is important to understand its strengths and limitations. Standardized guidelines in future can play an important role in more streamlined communication between cytopathologist and clinician.
Collapse
Affiliation(s)
- Kanwalpreet Kaur
- Department of Oncopathology, Gujarat Cancer and Research Institute, Ahmedabad, India
| | - Trupti Patel
- Department of Oncopathology, Gujarat Cancer and Research Institute, Ahmedabad, India,
| | - Satrupa Samanta
- Department of Oncopathology, Gujarat Cancer and Research Institute, Ahmedabad, India
| | - Sanjiban Patra
- Department of Oncopathology, Gujarat Cancer and Research Institute, Ahmedabad, India
| | - Priti Trivedi
- Department of Oncopathology, Gujarat Cancer and Research Institute, Ahmedabad, India
| |
Collapse
|