Source: Avemar Research

The proper identification of the histologic subtype of malignant pleural mesothelioma is an important element both in the diagnosis of the disease and the treatment regimen that a patient is given. There are three histological subtypes of the disease, each with a different average prognosis. The most common subtype is epithelial mesothelioma; this is also the type that tends to respond most favorably to treatment. The other two subtypes are sarcomatous mesothelioma and biphasic mesothelioma. The sarcomatous subtype generally has the worst prognosis, while biphasic mesothelioma tends to be somewhere in between epithelial and sarcomatous mesothelioma in terms of treatability.

A study was recently completed that looked at the ability of thoracoscopy to accurately diagnose the histological subtype of malignant pleural mesothelioma, specifically if it could be used to diagnose the difference between epithelial and biphasic mesothelioma. The results were not very favorable. 95 patients were enrolled in the study. Regarding those diagnosed with epithelial subtype by thoracoscopy before surgery, the positive predictive value was 86% and the negative predictive value of 37%. Regarding those with a biphasic diagnosis by thoracoscopy, the positive predictive value was 75% and the negative predictive value was 87%.

The study has concluded that while thoracoscopy is an integral procedure for the diagnosis and staging of pleural mesothelioma, it does not appear to be an efficient method of differentiating between the epithelial and biphasic subtypes of mesothelioma.

Labels: mesothelioma