Value in Distinguishing Mesotheliomas from other Tumors

Another interesting study is called, "Value of the Ber-EP4 antibody in differentiating epithelial pleural mesothelioma from adenocarcinoma : The M.D. Anderson experience and a critical review of the literature" - American Society of Clinical Pathologists, Chicago, IL, ETATS-UNIS  (1931) (Revue) by ORDONEZ N. G. (1) ; 1998, vol. 109, no1, pp. 85-89 (21 ref.)  Here is an excerpt: "Abstract - Although most studies have indicated that Ber-EP4 immunostaining can assist in differentiating epithelial pleural mesotheliomas from adenocarcinomas that metastasize to the pleura, the percentage of positive cases has varied greatly among different studies. Authors of a recent publication concluded that Ber-EP4 has no diagnostic utility in separating these conditions. To determine whether Ber-EP4 has any value in distinguishing mesothelioma from adenocarcinoma, 70 formalin-fixed epithelial pleural mesotheliomas, 20 pulmonary adenocarcinomas, 59 nonpulmonary adenocarcinomas, 4 squamous cell carcinomas of the lung, 6 transitional cell carcinomas, and 31 adenocarcinomas of unknown origin that metastasized to the pleura were stained with this antibody. Reactivity was observed in 18 (26%) of 70 mesotheliomas and in all 20 (100%) of the pulmonary adenocarcinomas, in 55 (93%) of the 59 nonpulmonary adenocarcinomas, in 4 (100%) of 4 squamous cell carcinomas of the lung, in 4 (67%) of 6 transitional cell carcinomas, and in 26 (84%) of 31 adenocarcinomas of unknown origin that metastasized to the pleura. The staining in the mesotheliomas was focal and restricted to a limited number of cells, in contrast with staining in the pulmonary adenocarcinomas in which it was invariably diffuse. The extent of the staining in the nonpulmonary adenocarcinomas and the metastatic adenocarcinomas of unknown origin was less consistent-negative or focal in some cases and diffuse in others. Therefore, while Ber-EP4 seems to be helpful in separating epithelial pleural mesotheliomas from lung adenocarcinomas, its value in distinguishing mesotheliomas from other tumors metastatic to the pleura is more limited and depends largely on the site of origin of the metastatic tumor."

Another interesting study is called, "Pleurectomy/decortication in the setting of multimodality treatment for diffuse malignant pleural mesothelioma." By Rusch VW.
Memorial Sloan-Kettering Cancer Center, Department of Surgery and Cornell University Medical College, New York, NY 10021.  Semin Thorac Cardiovasc Surg. 1997 Oct;9(4):367-72.  Here is an excerpt: "Abstract - Pleurectomy/decortication is a frequently performed operation for patients with diffuse malignant pleural mesothelioma (DMPM). It has a low surgical mortality rate (less than 5%), but is associated with a significant risk of local recurrence. To date, intensive adjuvant radiation or chemotherapy has not diminished that risk. Despite these disappointing results, pleurectomy/decortication may still be the best treatment option for some patients, particularly those with early stage disease whose medical condition precludes pneumonectomy. The role of pleurectomy/decortication in conjunction with newer treatment strategies such as neoadjuvant therapy or gene therapy warrants investigation."

Another interesting study is called, "The presence of simian-virus 40 sequences in mesothelioma and mesothelial cells is associated with high levels of vascular endothelial growth factor." By Cacciotti P, Strizzi L, Vianale G, Iaccheri L, Libener R, Porta C, Tognon M, Gaudino G, Mutti L - Am J Respir Cell Mol Biol. 2002 Feb;26(2):189-93.
Here is an excerpt: "Abstract - The aim of this study was to evaluate whether the presence of simian virus-40 (SV40) is associated with increased release of vascular endothelial growth factor (VEGF) in human malignant mesothelioma (MM) cells. We studied nine cell lines derived from pleural effusion (PE) of patients with MM, and three different cultures of normal human mesothelial cells (NHMC) derived from pleural fluid of patients with congestive heart failure. NHMC were transfected with full length SV40 (NHMC-FL) or large T antigen (NHMC Tag) DNAs. High levels of VEGF were detected in conditioned media of each of two MM cells that tested positive for SV40 by PCR amplification and Southern blot hybridization and for Tag transcript by reverse transcription- polymerase chain reaction (RT-PCR) and immunoprecipitation. We also found that NHMC-FL released high amounts of VEGF. Conditioned media from SV40-positive MM cells and from FL-NHMC increased proliferation of human umbilical vein cells (HUVEC) and this effect was partially abrogated by adding specific blocking antibodies against VEGF. These results offer the first evidence that SV40 can cause VEGF release in SV40-positive MM cells and that entire viral genome is required for this effect."

We all owe a debt of gratitude to these fine researchers for their work.  If you found any of these excerpts helpful, please read the studies in their entirety.