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Current Status of Screening for Malignant Pleural Mesothelioma

  • Harvey I. Pass
    Correspondence
    Address reprint requests to Harvey I. Pass, MD, Division of Thoracic Surgery and Thoracic Oncology, Department of Cardiothoracic Surgery, NYU Langone Medical Center, 530 First Avenue, Suite 9V, New York, NY 10016
    Affiliations
    Division of Thoracic Surgery and Thoracic Oncology, Department of Cardiothoracic Surgery, NYU Langone Medical Center, New York, New York
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  • Michele Carbone
    Affiliations
    Department of Pathology, John A. Burns School of Medicine, University of Hawaii, Honolulu, Hawaii
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      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.

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      References

        • Carroll S.
        • Hensler D.
        • Abrahamse A.
        • et al.
        Asbestos litigation costs and compensation: An interim report.
        Rank Organisation publications, 2002 (Report No.: ISBN:0-8330-3294. DB-397-ICJ)
        • Shah N.
        • Williams A.
        Surviving the asbestos epidemic.
        Insur Digest (Eur). 2001; 15: 14-18
      1. Leigh J: Asbestos-related diseases: International estimates of future liability. Proc Int Cong Work Injuries Prev, Rehab, Compensation (Workcongress5); Adelaide, 2001, p. 102

        • Wagner J.C.
        • Sleggs C.A.
        • Marchand P.
        Diffuse pleural mesothelioma and asbestos exposure in the North Western Cape Province.
        Br J Ind Med. 1960; 17: 260-271
        • Roggli V.L.
        • Sharma A.
        • Butnor K.J.
        • et al.
        MM and occupational exposure to asbestos: A clinicopathological correlation of 1445 cases.
        Ultrastruct Pathol. 2002; 26: 55-65
        • Schottenfeld D.
        • Fraumeni J.F.
        Cancer Epidemiology and Prevention.
        WB Saunders, Philadelphia, PA1982
        • U.S. Department of Labor OSaHA
        Safety and Health Topics: Asbestos.
        2003 ([Internet Communication])
        • Selikoff I.J.
        • Hammond E.C.
        • Seidman H.
        Latency of asbestos disease among insulation workers in the United States and Canada.
        Cancer. 1980; 46: 2736-2740
        • National Academy of Sciences
        Asbestiform Fibers: Non-Occupational Health Risks.
        National Academies Press, Washington, DC1984
        • Mossman B.T.
        • Bignon J.
        • Corn M.
        • et al.
        Scientific developments and implications for public policy.
        Science. 1990; 247: 294-301
        • Lange J.H.
        Cough and bronchial responsiveness in firefighters at the World Trade Center site.
        N Engl J Med. 2003; 348: 76-77
        • Lioy P.J.
        • Weisel C.P.
        • Millette J.R.
        • et al.
        Characterization of the dust/smoke aerosol that settled east of the World Trade Center (WTC) in lower Manhattan after the collapse of the WTC 11 September 2001.
        Environ Health Perspect. 2002; 110: 703-714
        • Wallingford K.M.
        • Snyder E.M.
        Occupational exposures during the World Trade Center disaster response.
        Toxicol Ind Health. 2001; 17: 247-253
        • Dodson R.F.
        • Williams M.G.
        • Satterley J.D.
        Asbestos burden in two cases of mesothelioma where the work history included manufacturing of cigarette filters.
        J Toxicol Environ Health A. 2002; 65: 1109-1120
        • Harries P.G.
        • Mackenzie F.A.
        • Sheers G.
        • et al.
        Radiological survey of men exposed to asbestos in naval dockyards.
        Br J Ind Med. 1972; 29: 274-279
        • Koskinen K.
        • Rinne J.P.
        • Zitting A.
        • et al.
        Screening for asbestos-induced diseases in Finland.
        Am J Ind Med. 1996; 30: 241-251
        • Karjalainen A.
        • Pukkala E.
        • Kauppinen T.
        • et al.
        Incidence of cancer among Finnish patients with asbestos-related pulmonary or pleural fibrosis.
        Cancer Causes Control. 1999; 10: 51-57
        • Barnhart S.
        • Keogh J.
        • Cullen M.R.
        • et al.
        The CARET asbestos-exposed cohort: Baseline characteristics and comparison to other asbestos-exposed cohorts.
        Am J Ind Med. 1997; 32: 573-581
        • Omenn G.S.
        • Goodman G.
        • Thornquist M.
        • et al.
        The beta-carotene and retinol efficacy trial (CARET) for chemoprevention of lung cancer in high risk populations: Smokers and asbestos-exposed workers.
        Cancer Res. 1994; 54: 2038s-2043s
        • Henschke C.I.
        • McCauley D.I.
        • Yankelevitz D.F.
        • et al.
        Early lung cancer action project: Overall design and findings from baseline screening.
        Lancet. 1999; 354: 99-105
        • Tiitola M.
        • Kivisaari L.
        • Huuskonen M.S.
        • et al.
        Computed tomography screening for lung cancer in asbestos-exposed workers.
        Lung Cancer. 2002; 35: 17-22
        • Vierikko T.
        • Jarvenpaa R.
        • Autti T.
        • et al.
        Chest CT screening of asbestos-exposed workers: Lung lesions and incidental findings.
        Eur Respir J. 2007; 29: 78-84
        • Fasola G.
        • Belvedere O.
        • Aita M.
        • et al.
        Low-dose computed tomography screening for lung cancer and pleural mesothelioma in an asbestos-exposed population: Baseline results of a prospective, nonrandomized feasibility trial—An Alpe-adria Thoracic Oncology Multidisciplinary Group Study (ATOM 002).
        Oncologist. 2007; 12: 1215-1224
        • Das M.
        • Muhlenbruch G.
        • Mahnken A.H.
        • et al.
        Asbestos Surveillance Program Aachen (ASPA): Initial results from baseline screening for lung cancer in asbestos-exposed high-risk individuals using low-dose multidetector-row CT.
        Eur Radiol. 2007; 17: 1193-1199
        • Roberts H.C.
        • Patsios D.A.
        • Paul N.S.
        • et al.
        Screening for malignant pleural mesothelioma and lung cancer in individuals with a history of asbestos exposure.
        J Thorac Oncol. 2009; (in press)
        • Egedahl R.D.
        • Olsen G.W.
        • Coppock E.
        • et al.
        An historical prospective mortality study of the Sarnia Division of Dow Chemical Canada Inc., Sarnia, Ontario (1950-1984).
        Can J Pub Health. 1989; 80: 441-446
        • Robinson M.
        • Wiggins J.
        Statement on MM in the UK.
        Thorax. 2002; 57: 187
        • Scherpereel A.
        Guidelines of the French Speaking Society for chest medicine for management of malignant pleural mesothelioma.
        Respir Med. 2006; 101: 1265-1276
        • Ebert W.
        • Hoppe M.
        • Muley T.
        • et al.
        Monitoring of therapy in inoperable lung cancer patients by measurement of CYFRA 21-1, TPA-TP Cea, and NSE.
        Anticancer Res. 1997; 17: 2875-2878
        • Pettersson T.
        • Fröseth B.
        • Riska H.
        • et al.
        Concentration of hyaluronic acid in pleural fluid as a diagnostic aid for MM.
        Chest. 1988; 94: 1037-1039
        • Frebourg T.
        • Lerebours G.
        • Delpech B.
        • et al.
        Serum hyaluronate in malignant pleural mesothelioma.
        Cancer. 1987; 59: 2104-2107
        • Roboz J.
        • Greaves J.
        • Silides D.
        • et al.
        Hyaluronic acid content of effusions as a diagnostic aid for MM.
        Cancer Res. 1985; 45: 1850-1854
        • Chiu B.
        • Churg A.
        • Tengblad A.
        • et al.
        Analysis of hyaluronic acid in the diagnosis of MM.
        Cancer. 1984; 54: 2195-2199
        • Boersma A.
        • Degand P.
        • Biserte G.
        Hyaluronic acid analysis and the diagnosis of pleural mesothelioma.
        Bull Physiol Pathol Respir (Nancy). 1980; 16: 41-45
        • Hellstrom P.E.
        • Friman C.
        • Teppo L.
        Of 17 years' duration with high pleural fluid concentration of hyaluronate.
        Scand J Respir Dis. 1977; 58: 97-102
        • Thylen A.
        • Wallin J.
        • Martensson G.
        Hyaluronan in serum as an indicator of progressive disease in hyaluronan-producing MM.
        Cancer. 1999; 86: 2000-2005
        • Pluygers E.
        • Baldewyns P.
        • Minette P.
        • et al.
        Biomarker assessments in asbestos-exposed workers as indicators for selective prevention of mesothelioma or bronchogenic carcinoma: Rationale and practical implementations.
        Eur J Cancer Prev. 1992; 1: 129-138
        • Hedman M.
        • Arnberg H.
        • Wernlund J.
        • et al.
        Tissue polypeptide antigen (TPA), hyaluronan and ca 125 as serum markers in MM.
        Anticancer Res. 2003; 23: 531-536
        • Paganuzzi M.
        • Onetto M.
        • Marroni P.
        • et al.
        Diagnostic value of CYFRA 21-1 tumor marker and CEA in pleural effusion due to mesothelioma.
        Chest. 2001; 119: 1138-1142
        • Lee Y.C.
        • Knox B.S.
        • Garrett J.E.
        Use of cytokeratin fragments 19.1 and 19.21 (Cyfra 21-1) in the differentiation of malignant and benign pleural effusions.
        Aust NZ J Med. 1999; 29: 765-769
        • Schouwink H.
        • Korse C.M.
        • Bonfrer J.M.
        • et al.
        Prognostic value of the serum tumour markers Cyfra 21-1 and tissue polypeptide antigen in MM.
        Lung Cancer. 1999; 25: 25-32
        • Marukawa M.
        • Hiyama J.
        • Shiota Y.
        • et al.
        The usefulness of CYFRA 21-1 in diagnosing and monitoring malignant pleural mesothelioma.
        Acta Med Okayama. 1998; 52: 119-123
        • Cremades M.J.
        • Menendez R.
        • Pastor A.
        • et al.
        Diagnostic value of cytokeratin fragment 19 (CYFRA 21-1) in bronchoalveolar lavage fluid in lung cancer.
        Respir Med. 1998; 92: 766-771
        • Bonfrer J.M.
        • Schouwink J.H.
        • Korse C.M.
        • et al.
        21-1 And TPA as markers in MM.
        Anticancer Res. 1997; 17: 2971-2973
        • Almudevar B.E.
        • Garcia-Rostan Perez G.M.
        • Garcia B.F.
        • et al.
        Prognostic value of high serum levels of ca-125 in malignant secretory peritoneal mesotheliomas affecting young women.
        Histopathology. 1997; 31: 267-273
        • Chang K.
        • Pai L.H.
        • Pass H.
        • et al.
        Monoclonal antibody K1 reacts with epithelial mesothelioma but not with lung adenocarcinoma.
        Am J Surg Pathol. 1992; 16: 259-268
        • Brinkmann U.
        • Webber K.
        • Di Carlo A.
        • et al.
        Cloning and expression of the recombinant FAb fragment of monoclonal antibody K1 that reacts with mesothelin present on mesotheliomas and ovarian cancers.
        Int J Cancer. 1997; 71: 638-644
        • Ordonez N.G.
        Value of mesothelin immunostaining in the diagnosis of mesothelioma.
        Mod Pathol. 2003; 16: 192-197
        • Ordonez N.G.
        Application of mesothelin immunostaining in tumor diagnosis.
        Am J Surg Pathol. 2003; 27: 1418-1428
        • Hassan R.
        • Remaley A.T.
        • Sampson M.L.
        • et al.
        Detection and quantitation of serum mesothelin, a tumor marker for patients with mesothelioma and ovarian cancer.
        Clin Cancer Res. 2006; 12: 447-453
        • Wali A.
        • Morin P.J.
        • Hough C.D.
        • et al.
        Identification of intelectin overexpression in malignant pleural mesothelioma by serial analysis of gene expression (SAGE).
        Lung Cancer. 2005; 48: 19-29
        • Onda M.
        • Nagata S.
        • Ho M.
        • et al.
        Megakaryocyte potentiation factor cleaved from mesothelin precursor is a useful tumor marker in the serum of patients with mesothelioma.
        Clin Cancer Res. 2006; 12: 4225-4231
        • Scherpereel A.
        • Grigoriu B.
        • Conti M.
        • et al.
        Soluble mesothelin-related peptides in the diagnosis of malignant pleural mesothelioma.
        Am J Respir Crit Care Med. 2006; 173: 1155-1160
        • Scholler N.
        • Fu N.
        • Yang Y.
        • et al.
        Soluble member(s) of the mesothelin/megakaryocyte potentiating factor family are detectable in sera from patients with ovarian carcinoma.
        Proc Natl Acad Sci USA. 1999; 96: 11531-11536
        • Robinson B.W.
        • Creaney J.
        • Lake R.
        • et al.
        Mesothelin-family proteins and diagnosis of mesothelioma.
        Lancet. 2003; 362: 1612-1616
        • Creaney J.
        • Yeoman D.
        • Demelker Y.
        • et al.
        Comparison of osteopontin, megakaryocyte potentiating factor, and mesothelin proteins as markers in the serum of patients with MM.
        J Thorac Oncol. 2008; 3: 851-857
        • Park E.K.
        • Sandrini A.
        • Yates D.H.
        • et al.
        Soluble mesothelin-related protein in an asbestos-exposed population: The dust diseases board cohort study.
        Am J Respir Crit Care Med. 2008; 178: 832-837
        • Creaney J.
        • van Bruggen I.
        • Hof M.
        • et al.
        Combined CA125 and mesothelin levels for the diagnosis of MM.
        Chest. 2007; 132: 1239-1246
        • Robinson B.W.
        • Creaney J.
        • Lake R.
        • et al.
        Soluble mesothelin-related protein—A blood test for mesothelioma.
        Lung Cancer. 2005; 49: S109-S111
        • Portal J.R.
        • Becerra E.R.
        • Rodriguez D.R.
        • et al.
        Serum levels of soluble mesothelin-related peptides in malignant and nonmalignant asbestos-related pleural disease: Relation with past asbestos exposure.
        Cancer Epidemiol Biomarkers Prev. 2009; 18: 646-650
        • Pass H.I.
        • Wali A.
        • Tang N.
        • et al.
        Soluble mesothelin-related peptide level elevation in mesothelioma serum and pleural effusions.
        Ann Thorac Surg. 2008; 85: 265-272
        • Creaney J.
        • Yeoman D.
        • Naumoff L.
        • et al.
        Soluble mesothelin in effusions—A useful tool for the diagnosis of MM.
        Thorax. 2007; 62: 569-576
        • Grigoriu B.D.
        • Chahine B.
        • Scherpereel A.
        Kinetics of soluble mesothelin in patients with malignant pleural mesothelioma during treatment.
        Am J Respir Crit Care Med. 2009; 179: 950-954
        • Ivanov S.V.
        • Ivanova A.V.
        • Goparaju C.M.
        • et al.
        Tumorigenic properties of alternative osteopontin isoforms in mesothelioma.
        Biochem Biophys Res Commun. 2009; 382: 514-518
        • Sandhu H.
        • Dehnen W.
        • Roller M.
        • et al.
        mRNA expression patterns in different stages of asbestos-induced carcinogenesis in rats.
        Carcinogenesis. 2000; 21: 1023-1029
        • Pass H.I.
        • Lott D.
        • Lonardo F.
        • et al.
        Asbestos exposure, pleural mesothelioma, and serum osteopontin levels.
        N Engl J Med. 2005; 353: 1564-1573
        • Park E.K.
        • Thomas P.S.
        • Johnson A.R.
        • et al.
        Levels in an asbestos-exposed population.
        Clin Cancer Res. 2009; 15: 1362-1366
        • Grigoriu B.D.
        • Scherpereel A.
        • Devos P.
        • et al.
        Utility of osteopontin and serum mesothelin in malignant pleural mesothelioma diagnosis and prognosis assessment.
        Clin Cancer Res. 2007; 13: 2928-2935
        • Beck A.
        • Ivanova A.
        • Pass H.I.
        Evaluation of plasma osteopontin as early detection and prognostic marker in malignant pleural mesothelioma.
        J Clin Oncol. 2008; 26 (abstract): A11074
        • Carbone M.
        • Emri S.
        • Dogan A.U.
        • et al.
        A mesothelioma epidemic in Cappadocia: Scientific developments and unexpected social outcomes.
        Nat Rev Cancer. 2007; 7: 147-154