The usefulness of CYFRA 21-1 in diagnosing and monitoring malignant pleural mesothelioma.
ABSTRACT Five patients with malignant pleural mesothelioma (MPM) were studied to determine whether CYFRA 21-1 is useful for diagnosis of this disease. In pleural effusions, the median concentration of CYFRA 21-1 from 4 patients with MPM was significantly higher than for 34 patients with benign diseases. The sensitivity of serum CYFRA 21-1 for diagnosis of MPM was 40% and its concentration changed in proportion to disease activity in all cases. Immunohistochemically, anticytokeratin 19 antibody revealed strong staining in both epithelial and sarcomatous MPM tissues. Based on these results, we conclude that measurement of CYFRA 21-1 in pleural effusions and serum may be useful for diagnosing and monitoring MPM.
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ABSTRACT: In late 1960’s, physician Dr. J. Stumphius identified twenty-five cases of a rare aggressive tumor known as mesothelioma among shipyard “Royal Schelde” workers due to asbestos exposure (1,2). Further observations showed an increase of mesothelioma cases among these workers. In 1974, the number of cases totaled 42; in 1978, the number rose to 57. The commercial use of asbestos in the Netherlands peaked in the 1970’s with the import of 50,000 tons of this ‘magic’ mineral and 150,000 tons of products annually (3). Five million tons of asbestos containing material still remains incorporated within our national infrastructure. Eternit, an asbestos cement factory in Goor processed asbestos until a ban on its use was introduced in 1993. For years, the factory dumped its asbestos-containing waste by simply putting the waste at the disposal of anyone who wanted to pave a road or a farmyard. So right now, there are miles of road paved around Goor with asbestos, exposing the local people to asbestos dust each time they use these roads. In The Netherlands, the public is getting increasingly familiar with the word asbestos and asbestos related disease, including mesothelioma. There is media interest during renovation, demolition or fire in buildings containing asbestos and the threat that the dust then poses to the public when carried by wind to surrounding areas. Also persons wearing respiratory and other personal protection equipment while removing asbestos containing materials can easily be encountered. Almost everyone who lives in industrialized areas of the western world has asbestos fibers in their lungs, and many can remember being exposed to asbestos incidentally. In the United States, the gray cloud that covered New York on September 11th, 2001, brought about much more awareness of the public to the word mesothelioma.
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ABSTRACT: Malignant mesothelioma is characterized by its association with asbestos, its long latency period, and the propensity for the diagnosis to be obtained in the later stages of the disease. Because the high-risk cohorts for mesothelioma are fairly well defined by the association with asbestos, and the exposure is usually in the workplace, it is hypothesized that early detection of the disease could (1) find patients at an earlier, more treatable stage and (2) result in prolonged survival over the present median 12 months from the start of therapy. Many studies have used standard chest X-ray to characterize changes associated with asbestos-exposed individuals, but the insensitivity of X-ray in screening patients with mesothelioma has never supported the wide-scale adaptation of such an effort. With the advent of computerized tomography, prospective trials, many of which are chiefly prevalence detection studies, have been performed and stress the importance for proper detailing by carefully qualifying suspicious changes, as well as defining the correct cohort to screen. Most recently, serum biomarkers with the potential to discriminate asbestos-exposed, non-cancer-bearing individuals from those with mesothelioma have been investigated both at single institutions and with multi-institutional-blinded trials. These markers, including soluble mesothelin-related protein, osteopontin, and megakaryocyte potentiating factor, may, in the future, be incorporated into a screening algorithm for high-risk asbestos-exposed individuals to help monitor these cohorts in a noninvasive fashion and guide the use of computerized tomography.Seminars in Thoracic and Cardiovascular Surgery 06/2009; 21(2):97-104. DOI:10.1053/j.semtcvs.2009.06.007
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ABSTRACT: Malignant mesothelioma (MM) is an aggressive tumour affecting the mesothelial surfaces of the pleural and peritoneal cavities and, rarely, the pericardium and the tunica vaginalis testis. Despite a ban of asbestos in many industrialised nations, the present high incidence of MM is expected to continue, due to the long latency period between first asbestos exposure and occurrence of disease, making it an important health issue for the future. The diagnosis of MM can be difficult, both from a clinical and pathological perspective. It is not unusual for patients to undergo several medical investigations without definitive diagnosis early in their course of illness. Understandably, there is intense interest in the discovery of markers that can be assessed in pleural effusions, histological specimens, and serum to assist with the difficult early diagnosis of MM. Considering the primary aetiological role of asbestos, there is theoretically an easily identifiable target population for screening with a biomarker with adequate sensitivity and specificity or with a combination of biomarkers. In this review we focus on biomarkers that have been examined in the setting of either early diagnosis of MM in symptomatic patients or screening of asbestos-exposed individuals.Pathology 04/2011; 43(3):201-12. DOI:10.1097/PAT.0b013e3283445e67 · 2.62 Impact Factor