Mesothelioma laboratory tests

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Sujit Routray, M.D. [2]

## Overview[edit | edit source]

Laboratory findings consistent with the diagnosis of mesothelioma include abnormal pleural fluid analysis (decreased pH and pleural fluid/serum glucose ratio). The presence of serum biomarkers such as soluble mesothelin (SM) and megakaryocyte potentiating factor (MPF) is suggestive of malignant mesothelioma. Additional laboratory tests include immunophenotypic analysis to identify cell lines of mesothelioma.

## Laboratory Findings[edit | edit source]

### Pleural Fluid Analysis[edit | edit source]

* Pleural fluid analysis, via thoracentesis, may be performed to help in the diagnosis of pleural mesothelioma.[1]
* Pleural mesothelioma is associated with decreased pleural pH (< 7.30) and decreased pleural fluid/serum glucose ratios.
* Pleural fluid cytology may or may not be positive for mesothelioma.[2]

### Serum Biomarker[edit | edit source]

The presence of serum biomarkers such as soluble mesothelin (SM) and megakaryocyte potentiating factor (MPF) is suggestive of malignant mesothelioma.[3]

### Immunophenotypic analysis[edit | edit source]

* All cell lines of mesothelioma express surface human leukocyte antigen (HLA) class I and intercellular adhesion molecule-1 (ICAM-1).[4]
* Chromosome-6 abnormalities are commonly found in with mesothelioma cell lines with abnormal karyotypes.
* In addition these cell lines on immunophenotypic analysis may show:
* Vimentin
* Cytokeratin 8
* Cytokeratin 18
* Mesothelial antigen recognized by HBME-1 monoclonal antibody

### Fluorescence In Situ Hybridization (FISH)[edit | edit source]

* FISH may be helpful in the diagnosis of mesothelioma. It helps in distinguishing malignant mesothelioma from reactive mesothelial cells in effusions.[5]
* Mutlitarget FISH assay may be used to detect chromosomal abberations (chromosomes 3, 7, 17, and 9p21).
* FISH technique may also be used to explore the alternative mechanism of tumor suppressor gene inactivation by methylation of p16, p14, and p15 gene in the pathogenesis of mesothelioma.[5]

## References[edit | edit source]

1. ↑ Gottehrer A, Taryle DA, Reed CE, Sahn SA (1991). "Pleural fluid analysis in malignant mesothelioma. Prognostic implications". Chest. 100 (4): 1003–6. PMID 1914546.CS1 maint: Multiple names: authors list (link)
2. ↑ Na MJ (2014). "Diagnostic tools of pleural effusion". Tuberc Respir Dis (Seoul). 76 (5): 199–210. doi:10.4046/trd.2014.76.5.199. PMC 4050067. PMID 24920946.CS1 maint: PMC format (link)
3. ↑ Orengo AM, Spoletini L, Procopio A, Favoni RE, De Cupis A, Ardizzoni A, Castagneto B, Ribotta M, Betta PG, Ferrini S, Mutti L (March 1999). "Establishment of four new mesothelioma cell lines: characterization by ultrastructural and immunophenotypic analysis". Eur. Respir. J. 13 (3): 527–34. PMID 10232421.
4. ↑ Hollevoet K, Nackaerts K, Thimpont J, Germonpré P, Bosquée L, De Vuyst P, Legrand C, Kellen E, Kishi Y, Delanghe JR, van Meerbeeck JP (March 2010). "Diagnostic performance of soluble mesothelin and megakaryocyte potentiating factor in mesothelioma". Am. J. Respir. Crit. Care Med. 181 (6): 620–5. doi:10.1164/rccm.200907-1020OC. PMID 20075387.
5. ↑ 5.0 5.1 Savic S, Franco N, Grilli B, Barascud Ade V, Herzog M, Bode B; et al. (2010). "Fluorescence in situ hybridization in the definitive diagnosis of malignant mesothelioma in effusion cytology". Chest. 138 (1): 137–44. doi:10.1378/chest.09-1951. PMID 20139227.CS1 maint: Explicit use of et al. (link) CS1 maint: Multiple names: authors list (link)

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