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Diagnostic and Therapeutic Challenges of Malignant Pleural Mesothelioma. Diagnostics (Basel) 2022; 12:diagnostics12123009. [PMID: 36553016 PMCID: PMC9776695 DOI: 10.3390/diagnostics12123009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 10/30/2022] [Accepted: 11/15/2022] [Indexed: 12/03/2022] Open
Abstract
Malignant pleural mesothelioma is a rare cancer characterized by a very poor prognosis. Exposure to asbestos is the leading cause of malignant pleural mesothelioma. The preinvasive lesions, the mesothelial hyperplasia and its possible evolution are the focus of the majority of the studies aiming to identify the treatable phase of the disease. The role of BAP-1 and MTAP in the diagnosis of mesothelioma in situ and in the prognosis of malignant pleural mesothelioma is the main topic of recent studies. The management of preinvasive lesions in mesothelioma is still unclear and many aspects are the subject of debate. The diagnosis, the disease staging and the accurate, comprehensive assessment of patients are three key instants for an appropriate management of patients/the disease.
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Rrapaj E, Trisolini E, Bertero L, Salvo M, Indellicato R, Andorno S, Garcia-Manteiga JM, Rena O, Boldorini RL. Expression analysis of HMGB1 in histological samples of malignant pleural mesothelioma. Histopathology 2018; 72:1039-1050. [PMID: 29356044 DOI: 10.1111/his.13470] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2017] [Accepted: 01/17/2018] [Indexed: 01/12/2023]
Abstract
AIMS High mobility group box 1 (HMGB1) is a chromatin structural protein, expressed ubiquitously in the nuclei of mammalian cells. When transported extracellularly, it acts as a tumour suppressor and oncogenic protein. In malignant pleural mesothelioma (MPM), high serum levels of HMGB1 have been related to a poor prognosis. Conversely, the significance of HMGB1 expression in MPM tissues is still unclear. METHODS AND RESULTS Biopsy samples from 170 patients with MPM were assessed by immunohistochemistry and reverse transcription-polymerase chain reaction (RT-PCR) to evaluate HMGB1 protein and gene expression. The expression level of HMGB1 protein was scored using a semiquantitative system that sums the intensity (0-3) and the percentage (from 0 to 4) of positively stained cells in nuclei, cytoplasm and in both. The final score was considered as high (>3) or low (<3) expression. Gene expression levels were calculated using the ΔΔCt method. High expression levels of HMGB1 as total (P = 0.0011) and cytoplasmic score (P = 0.0462) were related to a worse disease-specific survival (DSS) in the entire cohort and in the clinicopathological subgroups. No significant correlation was found between HMGB1 gene expression and DSS. CONCLUSIONS These findings indicate that HMGB1 may be a useful prognostic biomarker in MPM when detected by immunohistochemistry. Conversely, as it is also expressed in normal and reactive mesothelial cells, HMGB1 cannot be considered a diagnostic biomarker in histological samples of mesothelioma.
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Affiliation(s)
- Eltjona Rrapaj
- Department of Health Sciences, University of Eastern Piedmont, Novara, Italy
| | - Elena Trisolini
- Department of Health Sciences, University of Eastern Piedmont, Novara, Italy
| | - Luca Bertero
- Division of Pathology, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Michela Salvo
- Department of Health Sciences, University of Eastern Piedmont, Novara, Italy
| | | | - Silvano Andorno
- Department of Health Sciences, University of Eastern Piedmont, Novara, Italy
| | - Jose M Garcia-Manteiga
- Center For Translational Genomics and Bioinformatics, IRCCS San Raffaele Hospital, Milan, Italy
| | - Ottavio Rena
- Unit of Thoracic Surgery, Maggiore della Carità Hospital, Novara, Italy
| | - Renzo L Boldorini
- Department of Health Sciences, University of Eastern Piedmont, Novara, Italy.,Unit of Pathology, Maggiore della Carità Hospital, Novara, Italy
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Salemi R, Marconi A, Di Salvatore V, Franco S, Rapisarda V, Libra M. Epigenetic alterations and occupational exposure to benzene, fibers, and heavy metals associated with tumor development. Mol Med Rep 2017; 15:3366-3371. [DOI: 10.3892/mmr.2017.6383] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2016] [Accepted: 02/16/2017] [Indexed: 11/05/2022] Open
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Rapisarda V, Salemi R, Marconi A, Loreto C, Graziano AC, Cardile V, Basile MS, Candido S, Falzone L, Spandidos DA, Fenga C, Libra M. Fluoro-edenite induces fibulin-3 overexpression in non-malignant human mesothelial cells. Oncol Lett 2016; 12:3363-3367. [PMID: 27900005 PMCID: PMC5103952 DOI: 10.3892/ol.2016.5051] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Accepted: 08/18/2016] [Indexed: 01/23/2023] Open
Abstract
Exposure to asbestos is associated with the development of mesothelioma. In addition to asbestos, other fibers have been identified as risk factors for malignant and non-malignant diseases of the lungs. Among these, fluoro-edenite (FE) was found in patients from Biancavilla (Sicily, Italy) with pleural and lung disease, suggesting its role for tumor expansion. In this context, the identification of early biomarkers useful for the diagnosis of cancer is mandatory. Fibulin-3 represents an important marker for the diagnosis of mesothelioma. However, it remains to be determined whether it is directly associated with exposure to asbestos-like fibers. In the present study, peripheral blood levels of fibulin-3 from 40 asbestos-exposed workers were compared with those detected in 27 street cleaners from Biancavilla. Intriguingly, the results showed that fibulin-3 levels were higher in the group of street cleaners compared with those of the asbestos-exposed workers, suggesting that these workers used the personal protective equipment according to the current regulations. These data suggest that subjects exposed to FE should be monitored for the risk of mesothelioma. FE and volcanic particulates are probably contained within dust inhaled by street cleaners from Biancavilla during their work activities. Based on these criteria, in this study, such fibers were used to treat mesothelial cells (MeT5A) in order to verify whether fibulin-3 levels are affected by these treatments. The results showed that only treatment with FE was associated with fibulin-3 overexpression at both the transcript and protein levels. It was previously demonstrated that mesothelial cells exhibited low levels of p27 following treatment with FE. Notably, p27 downregulation is associated with stathmin upregulation in cancer, conferring an aggressive phenotype of tumor cells. This observation prompted us to perform a computational evaluation demonstrating the activation of stathmin in lung cancer in patients exposed to asbestos. Overall, it can be speculated that both fibulin-3 and stathmin overexpression may be associated with the malignant transformation of mesothelial cells following exposure to asbestos-like fibers.
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Affiliation(s)
- Venerando Rapisarda
- Section of Occupational Medicine, Department of Clinical and Experimental Medicine, University of Catania, I-95124 Catania, Italy
| | - Rossella Salemi
- Section of General and Clinical Pathology and Oncology, Department of Biomedical and Biotechnological Sciences, University of Catania, I-95124 Catania, Italy
| | - Andrea Marconi
- Section of Occupational Medicine, Department of Clinical and Experimental Medicine, University of Catania, I-95124 Catania, Italy
| | - Carla Loreto
- Section of Human Anatomy and Histology, Department of Biomedical and Biotechnological Sciences, University of Catania, I-95124 Catania, Italy
| | - Adriana C. Graziano
- Section of Physiology, Department of Biomedical and Biotechnological Sciences, University of Catania, I-95124 Catania, Italy
| | - Venera Cardile
- Section of Physiology, Department of Biomedical and Biotechnological Sciences, University of Catania, I-95124 Catania, Italy
| | - Maria S. Basile
- Section of General and Clinical Pathology and Oncology, Department of Biomedical and Biotechnological Sciences, University of Catania, I-95124 Catania, Italy
| | - Saverio Candido
- Section of General and Clinical Pathology and Oncology, Department of Biomedical and Biotechnological Sciences, University of Catania, I-95124 Catania, Italy
| | - Luca Falzone
- Section of General and Clinical Pathology and Oncology, Department of Biomedical and Biotechnological Sciences, University of Catania, I-95124 Catania, Italy
| | - Demetrios A. Spandidos
- Department of Virology, Faculty of Medicine, University of Crete, 71003 Heraklion, Crete, Greece
| | - Concettina Fenga
- Section of Occupational Medicine, Department of the Environment, Safety, Territory, Food and Health Sciences, University of Messina, I-98125 Messina, Italy
| | - Massimo Libra
- Section of General and Clinical Pathology and Oncology, Department of Biomedical and Biotechnological Sciences, University of Catania, I-95124 Catania, Italy
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Falzone L, Marconi A, Loreto C, Franco S, Spandidos DA, Libra M. Occupational exposure to carcinogens: Benzene, pesticides and fibers (Review). Mol Med Rep 2016; 14:4467-4474. [PMID: 27748850 PMCID: PMC5101963 DOI: 10.3892/mmr.2016.5791] [Citation(s) in RCA: 59] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2016] [Accepted: 09/20/2016] [Indexed: 01/01/2023] Open
Abstract
It is well known that the occupational exposure to contaminants and carcinogens leads to the development of cancer in exposed workers. In the 18th century, Percivall Pott was the first to hypothesize that chronic exposure to dust in the London chimney sweeps was associated with an increased risk of developing cancer. Subsequently a growing body of evidence indicated that other physical factors were also responsible for oncogenic mutations. Over the past decades, many carcinogens have been found in the occupational environment and their presence is often associated with an increased incidence of cancer. Occupational exposure involves several factors and the association between carcinogens, occupational exposure and cancer is still unclear. Only a fraction of factors is recognized as occupational carcinogens and for each factor, there is an increased risk of cancer development associated with a specific work activity. According to the International Agency for Research on Cancer (IARC), the majority of carcinogens are classified as 'probable' and 'possible' human carcinogens, while, direct evidence of carcinogenicity is provided in epidemiological and experimental studies. In the present review, exposures to benzene, pesticides and mineral fibers are discussed as the most important cancer risk factors during work activities.
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Affiliation(s)
- Luca Falzone
- Department of Biomedical and Biotechnological Sciences, Section of General and Clinical Pathology and Oncology, University of Catania, I-95124 Catania, Italy
| | - Andrea Marconi
- Section of Occupational Medicine, Department of Clinical and Experimental Medicine, University of Catania, I-95124 Catania, Italy
| | - Carla Loreto
- Department of Biomedical and Biotechnological Sciences, Human Anatomy and Histology Section, School of Medicine, University of Catania, I-95124 Catania, Italy
| | - Sabrina Franco
- Department of Medical, Surgical and Advanced Technology Sciences ‘G.F. Ingrassia’, University of Catania, I-95124 Catania, Italy
| | - Demetrios A. Spandidos
- Laboratory of Clinical Virology, Medical School, University of Crete, Heraklion 71003, Greece
| | - Massimo Libra
- Department of Biomedical and Biotechnological Sciences, Section of General and Clinical Pathology and Oncology, University of Catania, I-95124 Catania, Italy
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