title: Pathological and molecular biological approaches to early mesothelioma.
abstract: Malignant mesothelioma is an asbestos-related malignancy that arises primarily from mesothelial cells on the serosal surfaces of the pleural, peritoneal, and pericardial cavities. Malignant pleural mesothelioma (MPM) is most common, and its incidence is dramatically increasing worldwide as a result of widespread use of asbestos. Morphological discrimination between MPM and reactive mesothelial hyperplasia is difficult, and the most reliable pathological criterion for malignancy is mesothelial proliferation invading deeply into subpleural adipose tissues. To establish radical cure of MPM, it is crucial to find early-stage MPM of epithelial type, in which mesothelial proliferation is localized on the serosal surface of parietal pleura or limited within the submesothelial fibrous tissues of parietal pleura. The initial clinical presentation for patients with MPM is frequently dyspnea and/or chest pain due to large pleural effusion, and cytological analysis of pleural effusions is valuable to find patients with early-stage MPM of epithelial type. Recently, cytological features of MPM in pleural effusion, molecular markers for MPM, and genetic alternations of MPM have been reported. In this review, we discuss major issues on pathological and molecular biological approaches for diagnosis of early-stage MPM of epithelial type.
authors.affiliation: Department of Pathology, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo, 663-8501, Japan. tohru@hyo-med.ac.jp
authors.forename: Tohru
authors.initials: T
authors.lastname: Tsujimura
authors.forename: Ikuko
authors.initials: I
authors.lastname: Torii
authors.forename: Ayuko
authors.initials: A
authors.lastname: Sato
authors.forename: Misa
authors.initials: M
authors.lastname: Song
authors.forename: Kazuya
authors.initials: K
authors.lastname: Fukuoka
authors.forename: Seiki
authors.initials: S
authors.lastname: Hasegawa
authors.forename: Takashi
authors.initials: T
authors.lastname: Nakano
mesh_terms: D014408:Biomarkers, Tumor / Q000235:genetics / Q000378:metabolism*; D055088:Early Detection of Cancer; D019942:Genes, p16; D006801:Humans; D008654:Mesothelioma / Q000235:genetics / Q000378:metabolism* / Q000473:pathology*; D009367:Neoplasm Staging; D025581:Neurofibromin 2 / Q000235:genetics / Q000378:metabolism; D016066:Pleural Effusion, Malignant / Q000473:pathology; D010997:Pleural Neoplasms / Q000235:genetics / Q000378:metabolism* / Q000473:pathology*; D025521:Tumor Suppressor Proteins / Q000235:genetics / Q000378:metabolism; D043222:Ubiquitin Thiolesterase / Q000235:genetics / Q000378:metabolism
chemical_list: C400134:BAP1 protein, human; D014408:Biomarkers, Tumor; D025581:Neurofibromin 2; D025521:Tumor Suppressor Proteins; D043222:Ubiquitin Thiolesterase