2023 World Conference on Lung Cancer (Posters)-EP14.01. Cytologic Predictors and Novel Markers of Malignant Mesothelial Proliferation (mesothelioma) in Pleural Effusion

EP14.01. Cytologic Predictors and Novel Markers of Malignant Mesothelial Proliferation (mesothelioma) in Pleural Effusion - PDF(Slides)

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This study focuses on the early diagnosis of malignant mesothelioma (MM) in pleural effusion, which is a common clinical manifestation in 90% of patients. The current histologic criteria for MM are not effective in identifying the disease in its early stages, and it is not applicable to cytology samples. The aim of this research is to establish a reliable and reproducible set of morphological criteria, confirmed by immunocytochemistry markers, to enable confident cytological diagnosis of MM.<br /><br />The study will evaluate 37 pleural effusions diagnosed with MM and 20 cases of benign mesothelial proliferation. It will assess various morphological criteria such as chromatin change, location of the nucleus, pleomorphism, presence of 2 cell populations, presence of 3D cluster, high N:C ratio, vacuoles, presence of single cells, prominent nucleoli, moulding, and abnormal mitoses.<br /><br />Simultaneously, an immunocytochemical panel including BAP1, MTAP, p16, p53, and Merlin will be performed on 37 pleural biopsies diagnosed with mesothelioma and 20 biopsies negative for malignancy. This panel will be used to develop a diagnostic algorithm. Any suspicious cases identified morphologically will undergo immunocytochemistry using the algorithm.<br /><br />A panel of 10 individuals, including cytopathology consultants, registrars, and biomedical scientists, will review and score the pleural effusions based on the morphological criteria. Statistical analyses are ongoing to analyze the results.<br /><br />The study concludes that early detection of MM using cytology and molecular approaches can have a significant impact on patient survival. A conclusive positive MM cytology, established through robust morphological criteria and an immunocytochemistry algorithm, should lead to timely treatment. This research aims to provide a reliable and accessible method for diagnosing MM in pleural effusion, as molecular studies are often not widely available.

Asset Subtitle

Patrizia Viola

Meta Tag

Speaker Patrizia Viola

Topic Mesothelioma, Thymoma & Other Thoracic Tumors

Keywords

malignant mesothelioma

pleural effusion

early diagnosis

cytology samples

morphological criteria

immunocytochemistry markers

diagnostic algorithm

pleural biopsies

molecular approaches

patient survival