title: Malignant Pleural Mesothelioma: Accuracy of CT Against Immunohistochemical Test Among the Mexican Population.
abstract: OBJECTIVE
  Malignant pleural mesothelioma (MPM) is associated with occupational and environmental exposure to asbestos. The incidence is expected to increase as the use of asbestos is not prohibited in many countries, such as in Mexico. We undertook this study to determine sensitivity, specificity, predictive values and likelihood ratios of computed tomography (CT) in a sample from Mexican population with suspected MPM and other pleuropulmonary diseases.
  
  
  METHODS
  CT films of 38 patients suspected of having MPM were analyzed. A single observer was blinded to MPM diagnoses. The frequencies of ten CT findings were identified. A cut-off point of ≥5 CT findings was established to determine high MPM probability. Sensitivity, specificity, predictive values and likelihood ratio of the CT against biopsy using immunohistochemical testing (IHC) for MPM were calculated.
  
  
  RESULTS
  Of the 38 patients, 31 had MPM and seven had lung adenocarcinoma. The five key findings were mediastinal pleural thickening 96.7% (n = 30), nodular pleural thickening 93.3% (n = 29), pleural mass 83.9% (n = 26), diminished lung 70.9% (n = 22) and contracted hemithorax 70.9% (n = 22). Sensitivity 96.8% (83.2-99.4), specificity 85.7% (42.2-97.6), positive likelihood ratio 6.7 (1.1-41.6), and negative likelihood ratio of 0.04 (0.01-0.2) were reported.
  
  
  CONCLUSIONS
  Sensitivity and specificity in this study was greater than previously reported, 96.8% and 85.7 vs. 93.2 and 65.6%, respectively. CT is an easily accessible and useful tool that should be incorporated into the medical education of general physicians to improve MPM diagnosis of suspected cases.
authors.affiliation: Occupational Health Research Unit, Health Research Coordination, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, México, D.F., México.
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Gopar-Nieto
authors.affiliation: Occupational Health Research Unit, Health Research Coordination, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, México, D.F., México. Electronic address: gpeaguilarm@gmail.com.
authors.forename: Guadalupe
authors.initials: G
authors.lastname: Aguilar-Madrid
authors.affiliation: Department of Radiology, México, D.F., México.
authors.forename: León
authors.initials: L
authors.lastname: Sotelo-Martínez
authors.affiliation: Occupational Health Research Unit, Health Research Coordination, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, México, D.F., México.
authors.forename: Cuauhtémoc Arturo
authors.initials: CA
authors.lastname: Juárez-Pérez
authors.affiliation: Department of Thoracic Surgery, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, México, D.F., México.
authors.forename: Javier
authors.initials: J
authors.lastname: Kelly-García
authors.affiliation: Department of Experimental Surgery, Instituto Nacional de Ciencias Médicas y Nutrición, Secretaría de Salud, México, D.F., México.
authors.forename: Luis
authors.initials: L
authors.lastname: Argote-Greene
authors.affiliation: Department of Neumology, Hospital General, CMN La Raza, Instituto Mexicano del Seguro Social, México, D.F., México.
authors.forename: María Dolores
authors.initials: MD
authors.lastname: Ochoa-Vázquez
authors.affiliation: Department of Thoracic Surgery, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, México, D.F., México.
authors.forename: Eric Marco
authors.initials: EM
authors.lastname: García-Bazán
authors.affiliation: Department of Radiology, Hospital General, CMN La Raza, Instituto Mexicano del Seguro Social, México, D.F., México.
authors.forename: Jorge
authors.initials: J
authors.lastname: Ramírez-Pérez
authors.affiliation: Occupational Health Research Unit, Health Research Coordination, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, México, D.F., México.
authors.forename: Luis
authors.initials: L
authors.lastname: Haro-García
authors.affiliation: Clinical Analysis Laboratory, Unidad Médica de Alta Especialidad, Hospital de Traumatología "Dr. Victorio de la Fuente Narvaez", Instituto Mexicano del Seguro Social, México, D.F., México.
authors.forename: Carmina
authors.initials: C
authors.lastname: Jiménez-Ramírez
authors.affiliation: Occupational Health Research Unit, Health Research Coordination, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, México, D.F., México.
authors.forename: Alejandro
authors.initials: A
authors.lastname: Cabello-López
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis / Q000000981:diagnostic imaging*; D000077192:Adenocarcinoma of Lung; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001194:Asbestos / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007150:Immunohistochemistry / Q000379:methods; D015994:Incidence; D008168:Lung / Q000000981:diagnostic imaging / Q000473:pathology; D008175:Lung Neoplasms / Q000175:diagnosis / Q000000981:diagnostic imaging*; D008297:Male; D008482:Mediastinum / Q000000981:diagnostic imaging; D008654:Mesothelioma / Q000175:diagnosis / Q000000981:diagnostic imaging*; D000086002:Mesothelioma, Malignant; D008800:Mexico; D008875:Middle Aged; D016273:Occupational Exposure; D010997:Pleural Neoplasms / Q000175:diagnosis / Q000000981:diagnostic imaging*; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D001194:Asbestos
keywords: Mesothelioma; Sensitivity; Specificity; Tomography