Mar 4, 2010 - Importance of Early Diagnosis of Mesothelioma
Mesothelioma is a malignancy that begins in the lining of the mesothelium, or protective sacs surrounding the pleural (lung), peritoneal (abdomen) or pericardial (heart) cavities. The incidences of mesothelioma are expected to continue to rise over the next two decades. Malignant pleural mesothelioma (MPM) is the most common form of mesothelioma. Mesothelioma is directly linked to exposure to asbestos, with most exposure occurring occupationally, although also known to happen second hand or environmentally.
Early diagnosis of mesothelioma is critical to increasing effectiveness of therapeutic interventions and overall survival times. To date, life expectancy for mesothelioma is poor, with a median survival of 6-9 months following diagnosis. This is often true because of the difficulty in diagnosing mesothelioma before it has reached advanced stages.
Research into immunohistochemical markers that could make diagnosis easier and more accurate is ongoing. Mesothelioma tumors can exhibit a broad range of symptoms and grow in a wide variety of histologic patterns. This causes mesotheliomas to sometimes be confused with other types of malignancies and adenocarcinomas. Some markers are believed to have a greater potential for identifying mesothelioma accurately, however this is constantly changing as new markers are being discovered.
Positive mesothelioma markers for accurate diagnosis that have been and currently being used are:
- Podoplanin, a type of protein first identified in 1996 that is frequently expressed in epitheliod mesotheliomas
- Calretinin, one of the first markers discovered and considered to be the most sensitive and specific and often expressed in all histologic types of mesothelioma
- Keratins 5/6, also expressed in other serous carcinomas, keratin 5/6 has ability to diagnose tumors but not necessarily distinguish mesothelioma specifically
- Thrombomodulin (CD141), first of the markers recognized as being useful in diagnosing mesothelioma tumors, however other markers that are more specific have now taken it’s place
- Mesothelin, a 40-kd cell surface glycoprotein, serum mesothelin related protein (SMRP) found to be highly expressed in mesotheliomas and useful as a serum marker for monitoring disease progression and as a target for immunotherapy
- Monoclonal Antibodies, a variety of types derived from single, cloned antibody-producing cells, these are used to identify tumor-cell membrane antigens , has some limitations in distinguishing mesothelioma from other carcinomas
- Osteopontin, noninvasive marker where raised levels in serum are associated with mesothelioma
Despite these markers, and new ones being discovered that are even more sensitive and specific, an absolute marker for mesothelioma is yet to be identified. The type, location, and histologic pattern of mesothelioma tumors as well as a variety of other factors play a role in making a differential diagnosis between mesothelioma and other types of cancer. Scientists continue to search for tumor markers that could help with diagnosis and ongoing management of mesothelioma.
Diagnosis of mesothelioma malignancy is critical not only for medical intervention but also to help patients get the financial compensation settlement for those who have a known history of exposure to asbestos. Mesothelioma attorneys who specialize in asbestos lawsuits will use diagnostic information to help patients get the right amount of settlement more quickly, easing the financial burdens that come with this terminal illness. If you are experiencing any symptoms of mesothelioma, and have a known history of exposure to asbestos, speak to an oncologist right away. Someone who specializes in mesothelioma and occupational disease should be able to help you find out which type of diagnostic tool would be best given the specifics of your medical condition. Remember, early diagnosis of mesothelioma is key.
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