The Value of Thrombo Modulin as a Positive Marker for Mesothelioma

The Value of Thrombo Modulin as a Positive Marker for Mesothelioma

Another interesting study is called, “Value of thrombomodulin immunostaining in the diagnosis of Mesothelioma” by N.G. ORDÓÑEZ Histopathology Volume 31, Issue 1, pages 25–30, July 1997.  Here is an excerpt: “Aims: Even with the benefit of immunohistochemistry and electron microscopy, the differential diagnosis between epithelial mesothelioma and pulmonary adenocarcinoma is often difficult. In most instances, the diagnosis of mesothelioma must be reached by the use of immunohistochemical markers that react with adenocarcinomas, but not with mesotheliomas. The purpose of this study is to determine the value of thrombo-modulin (TM) as a positive marker for mesothelioma when distinguishing epithelial pleural mesothelioma from pulmonary adenocarcinoma. Methods and results: TM was expressed in 28 (80%) of 35 epithelial pleural mesotheliomas, but only five (10.9%) of 46 pulmonary adenocarcinomas had appreciable reactivity for this marker. Conclusion: It is concluded that TM can be useful in separating pulmonary adenocarcinoma from epithelial mesothelioma, but it should be used only in conjunction with other immunohistochemical markers that are currently employed in distinguishing between these two types of malignancies.”

Another interesting study is called, “Observations on benign mesothelioma of the genital tract (adenomatoid tumor).A comparative ultrastructural study” by Alex Ferenczy MD, John Fenoglio MD, Ralph M. Richart MD, – Cancer Volume 30, Issue 1, pages 244–260, July 1972.  Here is an excerpt: “Abstract – The purpose of this study was to compare the fine structure of the genital adenomatoid tumor with extragenital mesotheliomas. The pertinent electron microscopic and histochemical literature on normal and neoplastic mesothelia, müllerian and mesonephric epithelia, has been reviewed to provide additional comparative data. The results of this combined investigation strongly suggest a mesothelial origin of the “adenomatoid tumor,” and the term “benign mesothelioma of the genital tract,” proposed by Masson et al., would appear to be the preferable designation.”

Another interesting study is called, “The role of PET in the surgical management of malignant pleural Mesothelioma” by Raja M. Flores – Volume 49, Supplement 1, Pages S27-S32 (July 2005) Lung Cancer – Here is an excerpt: “Summary – Current imaging modalities fail to define precisely the extent of disease in MPM and are inaccurate in selecting patients for treatment. Previous studies have shown that CT and MRI provide anatomical information that is often imprecise in the preoperative staging of MPM. Consequently, about 25% of patients are found to have unresectable tumor at the time of exploratory thoracotomy. PET is now widely recognized as an important staging modality in many cancers, and PET SUV is reported as a prognostic indicator in several malignancies. However, only a few previous studies have investigated the utility of FDG PET scan in MPM. From 1998 to 2003, 65 patients with MPM underwent PET scans. Median PET SUV in the primary tumor was 6.6 (range, 2–23). The median follow-up for all surviving patients was 16 months. Median survivals were 14 and 24 months for the high and low SUV groups, respectively. In a multivariable analysis, high SUV tumors were associated with a 3.3 times greater risk of death than low SUV tumors (p = 0.03). Mixed histology carried a 3.2 times greater risk of death than epithelial histology (p = 0.03). SUV of >4 and mixed histology are poor risk factors in malignant pleural mesothelioma. These findings suggest that FDG-PET can be used to stratify patients for treatment and clinical trials”

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