pleural mesothelioma : Diagnostic problems and evaluation of prognostic factors

الملخص EN

Background : Malignant pleural mesothelioma (MPM) in Egypt is mainly attributed to an environmental origin i.e exposure to asbestos, with a high incidence in women and young adults.

Immunohislochcmistry and ultraslruc-tural features aid in the diagnosis.

The p27Kipl is a kinase inhibitor protein acting as a cell cycle regulator and a putative tumor suppressor gene playing a critical role in the pathogenesis of several human neoplasms.

Aim : A clinicopathologic, immunohistochemical and ultrastruclural study of mesothelioma in Egyptian patients, with identification of different prognostic factors.

Material and Methods ; Sixty-one cases of MPM were collected from the department of pathology at the NCI, Cairo.

Cases were stained by monoclonal antibodies against CK.

5 / 6.

calretinin, vimentin, CD 15, CEAand p27.

Results : More than half (57.4 %) of the patients were residents in endemic areas; 50.8 % were of epithelioid type.

CK5 / 6 was positive in 45 (73.8 %) cases, 39 (63.9 %) cases were positive for vimentin, 49 (80.3 %) cases were positive for calretinin.

One case showed a focal weak positive reaction to CD15.

None of the cases stained for CEA.

There was a statistically significant relation between p27 expression and the histopathologic type (p = 0.02) between overall survival and age (p = 0.01), histopathologic type (p = 0.02) and stage (p = 0.006).

Conclusion : MPM is an increasing disaster in Egypt which is underestimated and neglected.

A panel of immu¬nohistochemical markers should be used for proper eval¬uation.

p27 has proven to be a potential biologic prognostic marker for mesothelioma and more studies as regard its significance arc recommended on a larger number.