The usefulness of CYFRA 21-1 in diagnosing and monitoring malignant pleural mesothelioma.

Department of Internal Medicine, Kure Kyosai Hospital, Hiroshima, Japan.
Acta medica Okayama (Impact Factor: 0.75). 05/1998; 52(2):119-23.
Source: PubMed

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: 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. · 2.62 Impact Factor
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    ABSTRACT: Malignant mesothelioma has a very dismal prognosis with very few patients surviving one year after diagnosis. Early multimodal treatment, however, is expected to improve the outcome. Today, there is a strong need to have disease markers which could be used for screening, diagnosing, and/or monitoring tumour response to treatment. Old markers such as hyaluronic acid, various cytokeratin fragments (CYFRA 21.1, TPA) and other cancer antigens (CA 15.3, CA 125 or CA 19.9 or CEA) are not sensitive or specific enough and cannot be used in practice. More recently new molecules, such as soluble mesothelin and osteopontin, have been proposed for diagnostic purposes. Soluble mesothelin has a good specificity but has a sub-optimal sensitivity being negative in all sarcomatoid and in up to one half of epithelioid mesothelioma. On the contrary osteopontin has an inadequate specificity. Combining different markers together does not lead to an improvement in diagnostic accuracy. Neither marker can be used for screening purposes, the main limitation being the very low incidence of the disease in the at-risk, asbestos exposed population. Mesothelin is also a promising marker for monitoring response to treatment but published data is still insufficient to make recommendations. There is still a strong need for research is this area both in order to discover new markers as well as to correct the positioning of each existing molecule (alone or in combination) is the evaluation of the patients with a mesothelioma.
    Monaldi archives for chest disease = Archivio Monaldi per le malattie del torace / Fondazione clinica del lavoro, IRCCS [and] Istituto di clinica tisiologica e malattie apparato respiratorio, Università di Napoli, Secondo ateneo 04/2009; 71(1):31-8.
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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.
    European Journal of Clinical Microbiology & Infectious Diseases - EUR J CLIN MICROBIOL INFECT D. 01/2006;