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Paliogiannis P, Putzu C, Ginesu GC, Cossu ML, Feo CF, Attene F, Scognamillo F, Nonnis R, Cossu A, Palmieri G, Pirina P, Fois A. Deciduoid mesothelioma of the thorax: A comprehensive review of the scientific literature. CLINICAL RESPIRATORY JOURNAL 2017; 12:848-856. [PMID: 28026144 DOI: 10.1111/crj.12599] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/17/2016] [Revised: 11/25/2016] [Accepted: 12/20/2016] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Deciduoid mesothelioma is a rare variant of malignant epithelioid mesothelioma. It often involves the peritoneum, but also thoracic cases have been reported. The aim of the present review is to describe the demographic, clinical, radiological, and pathological features of such a rare variant of thoracic mesothelioma, and the state of the art regarding the therapeutic approaches currently available. DATA SOURCE English-language articles published from 1985 to June 2016, and related to thoracic deciduoid mesothelioma cases were retrieved using the Pubmed database. STUDY SELECTION The search terms were "mesothelioma," "thoracic mesothelioma," "epithelial mesothelioma," "pleural mesothelioma," and "deciduoid mesothelioma." RESULTS Forty-four cases included in 16 articles, published in the period under investigation, were analyzed in detail. CONCLUSIONS The mean age of the patients was 63 years, and the male to female ratio 1.7:1. Approximately 58% had exposure to asbestos, and 73% had a smoking history; familiarity was rarely reported. The most common anatomical site of origin was the right pleura, and the most frequent clinical manifestations were chest pain, dyspnea, cough, and weight loss. Thoracic X-ray and computed tomography were the imaging techniques most employed for diagnosis and surgical planning. The pathological diagnosis was obtained by examination of surgical or biopsy specimens in most cases. The best treatment strategy of deciduoid mesothelioma is a matter of debate; nevertheless a multidisciplinary approach is currently the best option for the choice of the adequate therapeutic scheme.
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Affiliation(s)
- Panagiotis Paliogiannis
- Experimental Pathology and Oncology, Department of Clinical and Experimental Medicine, University of Sassari, Viale San Pietro 43, Sassari, 07100, Italy
| | - Carlo Putzu
- Oncology Unit, Department of Clinical and Experimental Medicine, University of Sassari, Viale San Pietro 43, Sassari, 07100, Italy
| | - Giorgio Carlo Ginesu
- Surgical Clinic, Department of Clinical and Experimental Medicine, University of Sassari, Viale San Pietro 43, 07100, Sassari, Italy
| | - Maria Laura Cossu
- Surgical Clinic, Department of Clinical and Experimental Medicine, University of Sassari, Viale San Pietro 43, 07100, Sassari, Italy
| | - Claudio Francesco Feo
- Surgical Clinic, Department of Clinical and Experimental Medicine, University of Sassari, Viale San Pietro 43, 07100, Sassari, Italy
| | - Federico Attene
- Experimental Pathology and Oncology, Department of Clinical and Experimental Medicine, University of Sassari, Viale San Pietro 43, Sassari, 07100, Italy
| | - Fabrizio Scognamillo
- Experimental Pathology and Oncology, Department of Clinical and Experimental Medicine, University of Sassari, Viale San Pietro 43, Sassari, 07100, Italy
| | - Rita Nonnis
- Experimental Pathology and Oncology, Department of Clinical and Experimental Medicine, University of Sassari, Viale San Pietro 43, Sassari, 07100, Italy
| | - Antonio Cossu
- Experimental Pathology and Oncology, Department of Clinical and Experimental Medicine, University of Sassari, Viale San Pietro 43, Sassari, 07100, Italy
| | - Giuseppe Palmieri
- Institute of Biomolecular Chemistry, Cancer Genetics Unit, C.N.R, Traversa La Crucca 3, Sassari, 07040, Italy
| | - Pietro Pirina
- Pulmonology Clinic, Department of Clinical and Experimental Medicine, University of Sassari, Vle V.le San Pietro 43, Sassari 07100, Italy
| | - Alessandro Fois
- Pulmonology Clinic, Department of Clinical and Experimental Medicine, University of Sassari, Vle V.le San Pietro 43, Sassari 07100, Italy
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Thies S, Friess M, Frischknecht L, Korol D, Felley-Bosco E, Stahel R, Vrugt B, Weder W, Opitz I, Soltermann A. Expression of the Stem Cell Factor Nestin in Malignant Pleural Mesothelioma Is Associated with Poor Prognosis. PLoS One 2015; 10:e0139312. [PMID: 26421614 PMCID: PMC4589394 DOI: 10.1371/journal.pone.0139312] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2015] [Accepted: 09/11/2015] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND The epithelioid and sarcomatoid histologic variants of malignant pleural mesothelioma (MPM) can be considered as E- and M-parts of the epithelial-mesenchymal transition (EMT) axis; the biphasic being an intermediate. EMT is associated with an increase of stem cell (SC) traits. We correlated the neural crest SC marker nestin and the EMT marker periostin with histology, type of neo-adjuvant chemotherapy (CT) and overall survival (OS) of MPM patients. PATIENTS AND METHODS Tumor tissues of a historic cohort 1 (320 patients) and an intended induction chemotherapy followed by extrapleural pneumonectomy (EPP) cohort 2 (145 patients) were immunohistochemically H-scored (intensity of immunoreactivity multiplied by frequency of stained cells). Paired chemo-naïve biopsies and -treated surgical specimens were available for 105/145 patients. CT included platinum/gemcitabine (Pla/Gem) or platinum/pemetrexed (Pla/Pem). RESULTS Expression of any cytosolic nestin progressively increased from epithelioid to biphasic to sarcomatoid MPM in cohort 1, whereas the diagnostic markers calretinin and podoplanin decreased. In cohort 2, Pla/Pem CT increased the expression level of nestin in comparison to Pla/Gem, whereas the opposite was found for periostin. In Pla/Pem treated patients, nestin was higher in biphasic MPM compared to epithelioid. In addition to non-epithelioid histology, any expression of nestin in chemo-naïve biopsies (median overall survival: 22 vs. 17 months) and chemo-treated surgical specimens (18 vs. 12 months) as well as high periostin in biopsies (23 vs. 15 months) were associated with poor prognosis. In the multivariate survival analysis, any nestin expression in chemo-naïve biopsies proved to be an independent prognosticator against histology. In both pre- and post-CT situations, the combination of nestin or periostin expression with non-epithelioid histology was particularly/ dismal (all p-values <0.05). CONCLUSIONS The SC marker nestin and the EMT marker periostin allow for further prognostic stratification among histologic variants of MPM. Their expression level is influenced by neo-adjuvant chemotherapy.
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Affiliation(s)
- Svenja Thies
- Institute of Surgical Pathology, University Hospital Zurich, Zurich, Switzerland
| | - Martina Friess
- Division of Thoracic Surgery, University Hospital Zurich, Zurich, Switzerland
| | - Lukas Frischknecht
- Institute of Surgical Pathology, University Hospital Zurich, Zurich, Switzerland
| | - Dimitri Korol
- Cancer Registry, University Hospital Zurich, Zurich, Switzerland
| | | | - Rolf Stahel
- Clinic of Oncology, University Hospital Zurich, Zurich, Switzerland
| | - Bart Vrugt
- Institute of Surgical Pathology, University Hospital Zurich, Zurich, Switzerland
| | - Walter Weder
- Division of Thoracic Surgery, University Hospital Zurich, Zurich, Switzerland
| | - Isabelle Opitz
- Division of Thoracic Surgery, University Hospital Zurich, Zurich, Switzerland
| | - Alex Soltermann
- Institute of Surgical Pathology, University Hospital Zurich, Zurich, Switzerland
- * E-mail:
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