2024 World Conference on Lung Cancer (WCLC) - Posters-P4.14C.07 A Combination of Routine and Novel Immunohistochemical Markers to Improve the Histological Diagnosis of Mesothelioma in Challenging Biopsies

P4.14C.07 A Combination of Routine and Novel Immunohistochemical Markers to Improve the Histological Diagnosis of Mesothelioma in Challenging Biopsies

Back to course

Pdf Summary

Malignant mesothelioma (MM) is a severe pleural cancer characterized by poor survival rates, making early diagnosis crucial for effective treatment. Typical indicators include unilateral haemorrhagic effusion and pleural thickening or nodularity. However, diagnosing MM through cytomorphological criteria remains challenging due to the lack of clear guidelines, especially when sufficient tissue is unavailable.<br /><br />The study aimed to enhance the diagnostic process by examining the efficacy of combining routine markers like BAP1, MTAP, p16, p53, with novel markers such as Merlin, in identifying MM in limited samples. Researchers analyzed 37 pleural biopsies diagnosed with mesothelioma and 22 that were negative for malignancy, employing an immunohistochemical panel to formulate a diagnostic algorithm. This was statistically analyzed using IBM SPSS Statistics and results will also be tested on an additional 20 biopsies.<br /><br />Key findings include that 64.9% of MM biopsies showed loss of BAP1 and 59.5% showed loss of MTAP, while 32.4% showed loss of Merlin. Notably, all three markers (BAP1, MTAP, Merlin) were retained in 100% of biopsies that were negative for malignancy. P53 and p16 were largely negative regardless of diagnosis. A significant correlation was found between diagnosis type and marker expression, notably BAP1 (p=0.001), MTAP (p=0.001), and Merlin (p=0.002).<br /><br />These results indicate that incorporating both established and novel immunohistochemical markers can significantly aid in the histological diagnosis of MM, especially under limited tissue conditions. If validated by further studies, this immunohistochemistry panel could become a valuable tool for diagnosing mesothelioma, offering a promising approach to overcoming diagnostic challenges and potentially improving patient outcomes.

Asset Subtitle

Patrizia Viola

Meta Tag

Speaker Patrizia Viola

Topic Mesothelioma, Thymoma & Other Thoracic Tumors

Keywords

Malignant mesothelioma

Pleural cancer

Early diagnosis

Cytomorphological criteria

Immunohistochemical markers

BAP1

MTAP

Merlin

Diagnostic algorithm

Histological diagnosis