Mesothelioma from Metastatic Adenocarcinoma by anamaulida

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									Another interesting study is called, -œValue of the Mesothelium-
Associated Antibodies Thrombomodulin, Cytokeratin 5/6, Calretinin, and
CD44H in Distinguishing Epithelioid Pleural Mesothelioma from
Adenocarcinoma Metastatic to the Pleura-• by P M Cury M.D., D N Butcher,
C Fisher M.D., B Corrin M.D. and A G Nicholson D.M. - Mod Pathol
2000;13(2):107-112. Here is an excerpt: -œAbstract - Until recently, the
standard approach of most laboratories in distinguishing epithelioid
pleural mesothelioma from metastatic adenocarcinoma has been a negative
result from a panel of adeno-carcinoma-associated antibodies. However,
several "mesothelium-associated" antibodies have been proposed as useful
in this situation, and we have applied four of these putative
mesothelioma markers-”thrombomodulin, cytokeratin 5/6, calretinin, and
CD44H-”to a series of 61 epithelioid pleural mesotheliomas and 63
metastatic adenocarcinomas with known primary sites (lung = 19; breast =
21; ovary = 6; colon = 10; kidney = 4; uterus, epididymis, pancreas = 1
case each). Of the mesotheliomas, 55 of 61 (90%) stained for
thrombomodulin, 56 of 61 (92%) for cytokeratin 5/6, 47 of 51 cases (92%)
were positive for calretinin, and 39 of 43 (91%) were positive for CD44H.
Of the metastatic adenocarcinomas, 12 of 63 (19%) cases were positive for
thrombomodulin, 9 of 63 (14%) were positive for CK5/6, and 27 of 60 (45%)
were positive for CD44H. With calretinin, only 1 case of 59 (2%) showed
positive nuclear staining. All four antibodies stained reactive
mesothelium; thrombomodulin also stained endothelium; and CD44H variably
stained lymphocytes, macrophages, and fibroblasts. We conclude that all
four antibodies show high sensitivity for epithelioid mesothelioma, but
only calretinin (98%), cytokeratin 5/6 (86%), and thrombomodulin (81%)
show sufficient specificity for practical use in this situation.-•
Another interesting study is called, -œSurgical treatment of pleural
Mesothelioma-• by PM McCormack, F Nagasaki, BS Hilaris and N Martini -
The Journal of Thoracic and Cardiovascular Surgery, Vol 84, 834-842.
Here is an excerpt: -œFrom 1939 through 1981, 170 patients were seen and
treated for pleural mesothelioma. Twenty-one tumors were benign, 47 were
fibrosarcomatous, and 102 were epithelioma. Resection was the main mode
of treatment in benign and fibrosarcomatous mesothelioma. Treatment of
diffuse epithelial mesothelioma presented the greatest challenge.
Surgical therapy, radiation therapy, and chemotherapy were used in
combination in these patients. The review of our patients treated prior
to 1972 had shown no benefit from including pulmonary resection in the
surgical treatment of these tumors. Since then, all patients with diffuse
mesothelioma were treated by pleurectomy without pulmonary resection.
Both internal and external radiation therapy were also used to enhance
local control. Forty-nine percent of patients with epithelial
mesothelioma lived 1 year. The median survival in patients whose disease
was controlled by these methods was 21 months. Despite the poor prognosis
in malignant mesothelioma, better controlled by these methods was 21
months. .-•


  Another interesting study is called, -œRB protein status and clinical
correlation from 171 cell lines representing lung cancer, extrapulmonary
small cell carcinoma, and mesothelioma.-• By Shimizu E, Coxon A, Otterson
GA, Steinberg SM, Kratzke RA, Kim YW, Fedorko J, Oie H, Johnson BE,
Mulshine JL, et al. - National Cancer Institute-Navy Oncology Branch,
National Cancer Institute, Bethesda, Maryland 20889. - Oncogene. 1994
Sep;9(9):2441-8. Here is an excerpt: -œAbstract - We have studied RB
protein expression in 171 cell lines derived from patients with small
cell lung cancer (SCLC), non-small cell lung cancer (NSCLC), pulmonary
carcinoid, mesothelioma, and extrapulmonary small cell cancer (EPSC) and
have correlated this data with clinical outcome. We detected absent or
aberrant RB protein expression in 66/75 SCLC, 12/80 NSCLC, 1/6 carcinoid,
0/5 mesothelioma, and 4/5 EPSC samples. In addition, we observed
integration of human papilloma virus (HPV) DNA in the single EPSC cell
line that retained wildtype RB protein. We did not detect integration of
HPV, SV40 or adenoviral DNA in other tumor samples with wildtype RB
status. We also noted a stable, hypophosphorylated mutant RB in 12 SCLC
and 3 NSCLC samples which might have been falsely interpreted as wildtype
by current immunohistochemical techniques. Analysis of the matched
clinical data showed no associations between RB status and age, sex,
extent of disease, performance status, smoking history, and previous
treatment. In addition, retrospective analyses showed no consistent
correlation of RB protein expression with either best clinical response,
overall survival, or in vitro chemotherapeutic drug sensitivity. The
stable expression of RB after gene transfection into RB(-) SCLC cells,
however, resulted in a trend toward increased in vitro resistance to
etoposide, cisplatin and doxorubicin.-•      We all owe a debt of
gratitude to these fine researchers. If you found any of these excerpts
interesting, please read the studies in their entirety.      Monty
Wrobleski is the author of this article. For more information please
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