Doctors looking for a reliable way to diagnose mesothelioma symptoms may soon have two new tools to grasp for. Researchers in Denmark have identified what they believe to be four key biomarkers to distinguish mesothelioma cancer from benign conditions, while Spanish doctors have shown that a procedure known as FDG-PET can reliably diagnose and track the cancer.
Danish Biomarkers May Provide More Accurate, Earlier Diagnosis
Mesothelioma remains difficult to diagnose because mesothelioma symptoms tend to only appear after decades, and even then they are similar to common diseases. This means that so far, getting an authoritative diagnosis has required invasive surgery — which in turn usually means diagnosis is not done until almost too late.
Danish scientists aim to change this, by identifying biomarkers that could be used for earlier diagnosis.
The Danish research looked for microRNAs which would help doctors diagnose malignant pleural mesothelioma and distinguish it from reactive mesothelial proliferations. MicroRNAs, or miRNAS, are small components that tend to work as master switches turning on and off protein synthesis in a cell. The absence or presence of certain miRNAs is known to predict how certain cells function.
The Danish research team screened 742 miRNAs, pinpointing four which they believed to be best suited for diagnosing pleural mesothelioma. The team then tested all four on tissue samples taken from both confirmed benign and confirmed mesothelioma cases to see whether they would in fact act as markers.
The four miRNAs which the Danish scientists chose were able to identify mesothelioma cancer at a 94% accuracy rate, which is significantly higher than the 80% accuracy rate recommended by the International Mesothelioma Interest Group for any prospective diagnostic test.
The researchers suggested it would be possible to increase accuracy further by combining analysis of miRNA with immunohistochemical tests of tissue samples from suspected mesothelioma. At this point, the test might be accurate enough to predict patients’ survival.
FDG-PET Shown To Be Accurate for Diagnosing and Tracking Peritoneal Mesothelioma
According to a study performed at a Barcelona hospital, the combination of positron emission tomography and the 18F-FDG radioactive tracer is an effective way of both diagnosing as well as tracking the progression of peritoneal mesothelioma.
The doctors looked at treatment records from 60 patients who had peritoneal mesothelioma, which is the less-common abdominal form of the cancer. The average age of the patients was 53; 34 of them were women and 26 were men.
All patients in the study had received 18F-FDG PET scans as a way of diagnosing or tracking their mesothelioma. 11 had been given an FDG-PET scan before treatment. For all of them, the scans showed patterns that were characteristic of mesothelioma. Four of the 11 also received a scan inside six months following treatment; the researchers reported all those scans were accurate ways of determining how the patients would respond to treatment.
However, the study also showed that FDG-PET could also be used with patients who had not received a scan prior to treatment, as a way of tracking treatment progress. Overall, FDG-PET proved to be 82% accurate when it came to detecting whether mesothelioma was present. 15 of the 60 patients had negative FDG-PET scans, and in all of those cases a second follow-up scan was able to accurately detect recurrence or absence of the disease.
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