Mesothelioma laboratory tests: Difference between revisions
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{{Mesothelioma}} | {{Mesothelioma}} | ||
{{CMG}} | {{CMG}}{{AE}}{{SR}} | ||
==Overview== | ==Overview== | ||
Laboratory findings consistent with the diagnosis of mesothelioma include abnormal [[pleural fluid]] analysis (decreased pH and [[pleural fluid]]/[[serum glucose]] ratio). The presence of [[serum]] biomarkers such as soluble [[mesothelin]] (SM) and megakaryocyte potentiating factor (MPF) is suggestive of malignant mesothelioma. Additional laboratory tests include immunophenotypic analysis to identify cell lines of mesothelioma. | |||
==Laboratory Findings== | ==Laboratory Findings== | ||
===Pleural Fluid Analysis=== | ===Pleural Fluid Analysis=== | ||
*Pleural fluid analysis, via [[thoracentesis]], may be performed to help in the diagnosis of pleural mesothelioma.<ref name="pmid1914546">{{cite journal| author=Gottehrer A, Taryle DA, Reed CE, Sahn SA| title=Pleural fluid analysis in malignant mesothelioma. Prognostic implications. | journal=Chest | year= 1991 | volume= 100 | issue= 4 | pages= 1003-6 | pmid=1914546 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1914546 }} </ref> | *[[Pleural fluid]] analysis, via [[thoracentesis]], may be performed to help in the diagnosis of pleural mesothelioma.<ref name="pmid1914546">{{cite journal| author=Gottehrer A, Taryle DA, Reed CE, Sahn SA| title=Pleural fluid analysis in malignant mesothelioma. Prognostic implications. | journal=Chest | year= 1991 | volume= 100 | issue= 4 | pages= 1003-6 | pmid=1914546 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1914546 }} </ref> | ||
*Pleural mesothelioma is associated with decreased pleural pH (< 7.30) and decreased pleural fluid/serum glucose ratios. | *[[Pleural]] mesothelioma is associated with decreased [[pleural]] pH (< 7.30) and decreased [[pleural fluid]]/[[serum glucose]] ratios. | ||
*Pleural fluid cytology may or | *[[Pleural fluid]] [[cytology]] may or may not be positive for mesothelioma.<ref name="pmid24920946">{{cite journal| author=Na MJ| title=Diagnostic tools of pleural effusion. | journal=Tuberc Respir Dis (Seoul) | year= 2014 | volume= 76 | issue= 5 | pages= 199-210 | pmid=24920946 | doi=10.4046/trd.2014.76.5.199 | pmc=PMC4050067 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24920946 }} </ref> | ||
===Serum Biomarker=== | |||
The presence of [[serum]] biomarkers such as soluble [[Mesothelin|mesothelin (SM)]] and megakaryocyte potentiating factor (MPF) is suggestive of malignant mesothelioma.<ref name="pmid10232421">{{cite journal |vauthors=Orengo AM, Spoletini L, Procopio A, Favoni RE, De Cupis A, Ardizzoni A, Castagneto B, Ribotta M, Betta PG, Ferrini S, Mutti L |title=Establishment of four new mesothelioma cell lines: characterization by ultrastructural and immunophenotypic analysis |journal=Eur. Respir. J. |volume=13 |issue=3 |pages=527–34 |date=March 1999 |pmid=10232421 |doi= |url=}}</ref> | |||
===Immunophenotypic analysis=== | |||
*All cell lines of mesothelioma express surface [[human leukocyte antigen]] ([[Human leukocyte antigen|HLA]]) class I and [[intercellular adhesion molecule-1]] ([[ICAM-1]]).<ref name="pmid20075387">{{cite journal |vauthors=Hollevoet K, Nackaerts K, Thimpont J, Germonpré P, Bosquée L, De Vuyst P, Legrand C, Kellen E, Kishi Y, Delanghe JR, van Meerbeeck JP |title=Diagnostic performance of soluble mesothelin and megakaryocyte potentiating factor in mesothelioma |journal=Am. J. Respir. Crit. Care Med. |volume=181 |issue=6 |pages=620–5 |date=March 2010 |pmid=20075387 |doi=10.1164/rccm.200907-1020OC |url=}}</ref> | |||
*[[Chromosome 6 (human)|Chromosome-6]] abnormalities are commonly found in with mesothelioma cell lines with abnormal [[Karyotype|karyotypes]]. | |||
*In addition these cell lines on immunophenotypic analysis may show: | |||
**[[Vimentin]] | |||
**[[Cytokeratin]] 8 | |||
**[[Cytokeratin]] 18 | |||
**Mesothelial antigen recognized by HBME-1 [[Monoclonal antibodies|monoclonal antibody]] | |||
===Fluorescence In Situ Hybridization (FISH)=== | |||
*[[FISH]] may be helpful in the [[diagnosis]] of [[mesothelioma]]. It helps in distinguishing [[malignant]] [[mesothelioma]] from reactive [[mesothelial]] [[cells]] in effusions.<ref name="pmid20139227">{{cite journal| author=Savic S, Franco N, Grilli B, Barascud Ade V, Herzog M, Bode B et al.| title=Fluorescence in situ hybridization in the definitive diagnosis of malignant mesothelioma in effusion cytology. | journal=Chest | year= 2010 | volume= 138 | issue= 1 | pages= 137-44 | pmid=20139227 | doi=10.1378/chest.09-1951 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20139227 }} </ref> | |||
*Mutlitarget [[Fluorescence in situ hybridization|FISH]] [[Assays|assay]] may be used to detect [[chromosomal]] abberations ([[chromosome 3|chromosomes 3]], [[chromosome 7|7]], [[chromosome 17|17]], and [[chromosome 9|9p21]]). | |||
*[[Fluorescence in situ hybridization|FISH]] technique may also be used to explore the alternative [[Mechanism (biology)|mechanism]] of [[tumor suppressor gene]] inactivation by [[methylation]] of ''[[p16]]'', ''p14'', and ''p15'' [[gene]] in the [[pathogenesis]] of mesothelioma.<ref name="pmid20139227">{{cite journal| author=Savic S, Franco N, Grilli B, Barascud Ade V, Herzog M, Bode B et al.| title=Fluorescence in situ hybridization in the definitive diagnosis of malignant mesothelioma in effusion cytology. | journal=Chest | year= 2010 | volume= 138 | issue= 1 | pages= 137-44 | pmid=20139227 | doi=10.1378/chest.09-1951 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20139227 }} </ref> | |||
==References== | ==References== | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Sujit Routray, M.D. [2]
Overview
Laboratory findings consistent with the diagnosis of mesothelioma include abnormal pleural fluid analysis (decreased pH and pleural fluid/serum glucose ratio). The presence of serum biomarkers such as soluble mesothelin (SM) and megakaryocyte potentiating factor (MPF) is suggestive of malignant mesothelioma. Additional laboratory tests include immunophenotypic analysis to identify cell lines of mesothelioma.
Laboratory Findings
Pleural Fluid Analysis
- Pleural fluid analysis, via thoracentesis, may be performed to help in the diagnosis of pleural mesothelioma.[1]
- Pleural mesothelioma is associated with decreased pleural pH (< 7.30) and decreased pleural fluid/serum glucose ratios.
- Pleural fluid cytology may or may not be positive for mesothelioma.[2]
Serum Biomarker
The presence of serum biomarkers such as soluble mesothelin (SM) and megakaryocyte potentiating factor (MPF) is suggestive of malignant mesothelioma.[3]
Immunophenotypic analysis
- All cell lines of mesothelioma express surface human leukocyte antigen (HLA) class I and intercellular adhesion molecule-1 (ICAM-1).[4]
- Chromosome-6 abnormalities are commonly found in with mesothelioma cell lines with abnormal karyotypes.
- In addition these cell lines on immunophenotypic analysis may show:
- Vimentin
- Cytokeratin 8
- Cytokeratin 18
- Mesothelial antigen recognized by HBME-1 monoclonal antibody
Fluorescence In Situ Hybridization (FISH)
- FISH may be helpful in the diagnosis of mesothelioma. It helps in distinguishing malignant mesothelioma from reactive mesothelial cells in effusions.[5]
- Mutlitarget FISH assay may be used to detect chromosomal abberations (chromosomes 3, 7, 17, and 9p21).
- FISH technique may also be used to explore the alternative mechanism of tumor suppressor gene inactivation by methylation of p16, p14, and p15 gene in the pathogenesis of mesothelioma.[5]
References
- ↑ Gottehrer A, Taryle DA, Reed CE, Sahn SA (1991). "Pleural fluid analysis in malignant mesothelioma. Prognostic implications". Chest. 100 (4): 1003–6. PMID 1914546.
- ↑ Na MJ (2014). "Diagnostic tools of pleural effusion". Tuberc Respir Dis (Seoul). 76 (5): 199–210. doi:10.4046/trd.2014.76.5.199. PMC 4050067. PMID 24920946.
- ↑ Orengo AM, Spoletini L, Procopio A, Favoni RE, De Cupis A, Ardizzoni A, Castagneto B, Ribotta M, Betta PG, Ferrini S, Mutti L (March 1999). "Establishment of four new mesothelioma cell lines: characterization by ultrastructural and immunophenotypic analysis". Eur. Respir. J. 13 (3): 527–34. PMID 10232421.
- ↑ Hollevoet K, Nackaerts K, Thimpont J, Germonpré P, Bosquée L, De Vuyst P, Legrand C, Kellen E, Kishi Y, Delanghe JR, van Meerbeeck JP (March 2010). "Diagnostic performance of soluble mesothelin and megakaryocyte potentiating factor in mesothelioma". Am. J. Respir. Crit. Care Med. 181 (6): 620–5. doi:10.1164/rccm.200907-1020OC. PMID 20075387.
- ↑ 5.0 5.1 Savic S, Franco N, Grilli B, Barascud Ade V, Herzog M, Bode B; et al. (2010). "Fluorescence in situ hybridization in the definitive diagnosis of malignant mesothelioma in effusion cytology". Chest. 138 (1): 137–44. doi:10.1378/chest.09-1951. PMID 20139227.