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The Journal of Thoracic and... Aug 2023
Topics: Humans; Mesothelioma, Malignant; Mesothelioma; Pleural Neoplasms; Pleura
PubMed: 36732146
DOI: 10.1016/j.jtcvs.2023.01.002 -
Multimedia Manual of Cardiothoracic... Aug 2023This video tutorial is a step-by-step demonstration of the indwelling pleural catheter insertion technique in a patient who was diagnosed with malignant pleural...
This video tutorial is a step-by-step demonstration of the indwelling pleural catheter insertion technique in a patient who was diagnosed with malignant pleural effusions due to multiple metastases. Placing an indwelling pleural catheter is a novel method to treat chronic pleural effusions, especially secondary to malignancies. This method is particularly useful in patients with a trapped lung or with reduced life expectancy in whom more-invasive procedures are contraindicated. Indwelling pleural catheters are well tolerated.
Topics: Humans; Pleura; Pleural Effusion, Malignant; Catheters
PubMed: 37615545
DOI: 10.1510/mmcts.2023.045 -
Annals of the American Thoracic Society Sep 2023The diagnostic yield of traditional ultrasound-guided pleural biopsy remains unsatisfactory, particularly when the pleural thickness is ⩽5 mm and/or no pleural...
The diagnostic yield of traditional ultrasound-guided pleural biopsy remains unsatisfactory, particularly when the pleural thickness is ⩽5 mm and/or no pleural nodules are detected. Pleural ultrasound elastography (UE) has a better diagnostic yield than traditional ultrasound for malignant pleural effusion (MPE). However, studies on UE-guided pleural biopsies are lacking. To evaluate the feasibility and safety of UE-guided pleural biopsy. In this multicenter prospective single-arm trial, patients with pleural effusion whose pleural thickness was ⩽5 mm with no pleural nodules were enrolled between July 2019 and August 2021. The diagnostic yield of UE-guided pleural biopsy for pleural effusion and its sensitivity for detecting MPE were evaluated. Ninety-eight patients (mean age, 62.4 ± 13.2 yr; 65 men) were prospectively enrolled. The diagnostic yield of UE-guided pleural biopsy for making any diagnosis was 92.9% (91/98), and its sensitivity for MPE was 88.7% (55/62). In addition, its sensitivity for pleural tuberculosis was 69.6% (16/23). The rate of postoperative chest pain was acceptable, and there was no pneumothorax. UE-guided pleural biopsy is a novel technique for diagnosing MPE with good diagnostic yield and sensitivity. Clinical trial registered with https://www.chictr.org.cn (ChiCTR2000033572).
Topics: Male; Humans; Middle Aged; Aged; Prospective Studies; Elasticity Imaging Techniques; Ultrasonics; Pleural Effusion; Pleural Effusion, Malignant; Image-Guided Biopsy; Diagnostic Tests, Routine
PubMed: 37098021
DOI: 10.1513/AnnalsATS.202212-1047OC -
African Journal of Thoracic and... 2023
PubMed: 38028244
DOI: No ID Found -
Cells Aug 2023Malignant pleural mesothelioma (MPM) is a lethal and rare cancer, even if its incidence has continuously increased all over the world. Asbestos exposure leads to the... (Review)
Review
Malignant pleural mesothelioma (MPM) is a lethal and rare cancer, even if its incidence has continuously increased all over the world. Asbestos exposure leads to the development of mesothelioma through multiple mechanisms, including chronic inflammation, oxidative stress with reactive oxygen species (ROS) generation, and persistent aberrant signaling. Together, these processes, over the years, force normal mesothelial cells' transformation. Chronic inflammation supported by "frustrated" macrophages exposed to asbestos fibers is also boosted by the release of pro-inflammatory cytokines, chemokines, growth factors, damage-associated molecular proteins (DAMPs), and the generation of ROS. In addition, the hypoxic microenvironment influences MPM and immune cells' features, leading to a significant rewiring of metabolism and phenotypic plasticity, thereby supporting tumor aggressiveness and modulating infiltrating immune cell responses. This review provides an overview of the complex tumor-host interactions within the MPM tumor microenvironment at different levels, i.e., soluble factors, metabolic crosstalk, and oxidative stress, and explains how these players supporting tumor transformation and progression may become potential and novel therapeutic targets in MPM.
Topics: Humans; Mesothelioma, Malignant; Reactive Oxygen Species; Oxidative Stress; Carcinogenesis; Inflammation; Tumor Microenvironment
PubMed: 37626858
DOI: 10.3390/cells12162048 -
American Journal of Clinical Pathology Sep 2023Mesothelioma is a lethal disease that arises from the serosal lining of organ cavities. Several recurrent alterations have been observed in pleural and peritoneal... (Review)
Review
OBJECTIVES
Mesothelioma is a lethal disease that arises from the serosal lining of organ cavities. Several recurrent alterations have been observed in pleural and peritoneal -mesotheliomas, including in BAP1, NF2, and CDKN2A. Although specific histopathologic parameters have been correlated with prognosis, it is not as well known whether genetic alterations correlate with histologic findings.
METHODS
We reviewed 131 mesotheliomas that had undergone next-generation sequencing (NGS) at our institutions after pathologic diagnosis. There were 109 epithelioid mesotheliomas, 18 biphasic mesotheliomas, and 4 sarcomatoid mesotheliomas. All our biphasic and sarcomatoid cases arose in the pleura. Of the epithelioid mesotheliomas, 73 were from the pleura and 36 were from the peritoneum. On average, patients were 66 years of age (range, 26-90 years) and predominantly male (92 men, 39 women).
RESULTS
The most common alterations identified were in BAP1, CDKN2A, NF2, and TP53. Twelve mesotheliomas did not show a pathogenic alteration on NGS. For epithelioid mesotheliomas in the pleura, the presence of an alteration in BAP1 correlated with low nuclear grade (P = .04), but no correlation was found in the peritoneum (P = .62). Similarly, there was no correlation between the amount of solid architecture in epithelioid mesotheliomas and any alterations in the pleura (P = .55) or peritoneum (P = .13). For biphasic mesotheliomas, cases with either no alteration detected or with an alteration in BAP1 were more likely to be epithelioid predominant (>50% of the tumor, P = .0001), and biphasic mesotheliomas with other alterations detected and no alteration in BAP1 were more likely to be sarcomatoid predominant (>50% of the tumor, P = .0001).
CONCLUSIONS
This study demonstrates a significant association between morphologic features associated with a better prognosis and an alteration in BAP1.
Topics: Humans; Male; Female; Adult; Middle Aged; Aged; Aged, 80 and over; Lung Neoplasms; Tumor Suppressor Proteins; Ubiquitin Thiolesterase; Immunohistochemistry; Mesothelioma, Malignant; Mesothelioma; Sarcoma; Biomarkers, Tumor; Pleural Neoplasms
PubMed: 37141416
DOI: 10.1093/ajcp/aqad041 -
Cancer Discovery Oct 2023Cell-free tumor DNA has previously been detected in nonblood sources, including urine, saliva, stool, cerebrospinal fluid, and pleural fluid. In this issue, Saura and...
Cell-free tumor DNA has previously been detected in nonblood sources, including urine, saliva, stool, cerebrospinal fluid, and pleural fluid. In this issue, Saura and colleagues present a novel proof-of-concept study demonstrating that detection of tumor DNA in breast milk is feasible and may be a potential future strategy to screen for postpartum breast cancer. See related article by Saura et al., p. 2180 (14).
Topics: Female; Humans; Milk, Human; Breast Neoplasms; Liquid Biopsy; Circulating Tumor DNA; DNA, Neoplasm
PubMed: 37794840
DOI: 10.1158/2159-8290.CD-23-0836 -
Irish Medical Journal May 2024
Topics: Humans; Peritoneal Neoplasms; Mesothelioma; Male; Mesothelioma, Malignant; Lung Neoplasms; Middle Aged; Female; Aged
PubMed: 38801147
DOI: No ID Found -
Proceedings of the National Academy of... Sep 2023Asbestos is the main cause of malignant mesothelioma. Previous studies have linked asbestos-induced mesothelioma to the release of HMGB1 from the nucleus to the...
Asbestos is the main cause of malignant mesothelioma. Previous studies have linked asbestos-induced mesothelioma to the release of HMGB1 from the nucleus to the cytoplasm, and from the cytoplasm to the extracellular space. In the cytoplasm, HMGB1 induces autophagy impairing asbestos-induced cell death. Extracellularly, HMGB1 stimulates the secretion of . Jointly, these two cytokines kick-start a chronic inflammatory process that over time promotes mesothelioma development. Whether the main source of extracellular HMGB1 were the mesothelial cells, the inflammatory cells, or both was unsolved. This information is critical to identify the targets and design preventive/therapeutic strategies to interfere with asbestos-induced mesothelioma. To address this issue, we developed the conditional mesothelial HMGB1-knockout () and the conditional myelomonocytic-lineage HMGB1-knockout () mouse models. We establish here that HMGB1 is mainly produced and released by the mesothelial cells during the early phases of inflammation following asbestos exposure. The release of HMGB1 from mesothelial cells leads to atypical mesothelial hyperplasia, and in some animals, this evolves over the years into mesothelioma. We found that , whose mesothelial cells cannot produce HMGB1, show a greatly reduced inflammatory response to asbestos, and their mesothelial cells express and secrete significantly reduced levels of . Moreover, the tissue microenvironment in areas of asbestos deposits displays an increased fraction of M1-polarized macrophages compared to M2 macrophages. Supporting the biological significance of these findings, mice showed a delayed and reduced incidence of mesothelioma and an increased mesothelioma-specific survival. Altogether, our study provides a biological explanation for HMGB1 as a driver of asbestos-induced mesothelioma.
Topics: Animals; Mice; Mesothelioma, Malignant; Tumor Necrosis Factor-alpha; HMGB1 Protein; Mesothelioma; Asbestos; Inflammation; Tumor Microenvironment
PubMed: 37729199
DOI: 10.1073/pnas.2307999120 -
Journal of Thoracic Oncology : Official... Sep 2023Considering the established contribution of environmental factors to the development of thoracic malignancies, the inherited susceptibility of these tumors has rarely... (Review)
Review
Considering the established contribution of environmental factors to the development of thoracic malignancies, the inherited susceptibility of these tumors has rarely been explored. However, the recent introduction of next-generation sequencing-based tumor molecular profiling in the real-word setting enabled us to deeply characterize the genomic background of patients with lung cancer with or without smoking-related history, increasing the likelihood of detecting germline mutations with potential prevention and treatment implications. Pathogenic germline variants have been detected in 2% to 3% of patients with NSCLC undergoing next-generation sequencing analysis, whereas the proportion of germline mutations associated with the development of pleural mesothelioma widely varies across different studies, ranging between 5% and 10%. This review provides an updated summary of emerging evidence about germline mutations in thoracic malignancies, focusing on pathogenetic mechanisms, clinical features, therapeutic implications, and screening recommendations for high-risk individuals.
Topics: Humans; Germ-Line Mutation; Lung Neoplasms; Mesothelioma, Malignant; Mesothelioma; Carcinoma, Non-Small-Cell Lung; Genetic Predisposition to Disease
PubMed: 37331604
DOI: 10.1016/j.jtho.2023.05.028