Accuracy of diagnostic biopsy for the histological subtype of malignant pleural mesothelioma.
INTRODUCTION: Histological subtype is an established prognostic factor in malignant pleural mesothelioma (MPM). We retrospectively investigated the accuracy of classifying histological subtype on diagnostic biopsies and examined the impact of different diagnostic procedures on the outcome. METHODS:...
| Publicado en: | Journal of Thoracic Oncology Vol. 6; no. 3; pp. 602 - 606 |
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| Autores principales: | , , , , , , , , , , |
| Formato: | research Journal Article |
| Publicado: |
Elsevier B.V.
2011 Mar
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=104847684&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 104847684 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 15560864 4Z2B jtl: Journal of Thoracic Oncology issn: 15560864 maglogo: N pubinfo: dt: 2011 Mar vid: 6 iid: 3 pid: 467 pub: Elsevier B.V. place: New York, New York artinfo: ui: 104847684 104847684 2010981734 10.1097/JTO.0b013e31820ce2c7 NLM21266919 104847684 ppf: 602 ppct: 4 formats: tig: atl: Accuracy of diagnostic biopsy for the histological subtype of malignant pleural mesothelioma. aug: au: Kao SC Yan TD Lee K Burn J Henderson DW Klebe S Kennedy C Vardy J Clarke S van Zandwijk N McCaughan BC affil: Asbestos Diseases Research Institute, Bernie Banton Centre, Sydney, Australia. sug: subj: Mesothelioma, Malignant Classification Mesothelioma, Malignant Diagnosis Pleural Neoplasms Classification Pleural Neoplasms Diagnosis Adult Aged Female Prospective Studies Human Male Mesothelioma, Malignant Surgery Middle Age Neoplasm Staging Pleural Neoplasms Surgery Pneumonectomy Prognosis Retrospective Design Sensitivity and Specificity Survival Thoracoscopy Thoracotomy Tomography, X-Ray Computed Young Adult Adult: 19-44 years Aged: 65+ years Middle Aged: 45-64 years Female Male ab: INTRODUCTION: Histological subtype is an established prognostic factor in malignant pleural mesothelioma (MPM). We retrospectively investigated the accuracy of classifying histological subtype on diagnostic biopsies and examined the impact of different diagnostic procedures on the outcome. METHODS: Consecutive patients with histologically confirmed MPM who underwent extrapleural pneumonectomy (EPP) from 1994 to 2009 were included. Patient records were reviewed, and the initial diagnoses of histological subtype were obtained. The archival EPP specimens were reviewed by a panel of pathologists. The histological subtype obtained at review was compared with the initial diagnosis. RESULTS: Eighty-five patients underwent EPP. Two patients achieved a pathological complete response after neoadjuvant chemotherapy, leaving 83 patients to be included in this review. Different diagnostic methods were used before EPP: 81% thoracoscopy; 7% thoracotomy; 11% computed tomography-guided procedure; and 1% other. Patients determined to have an epithelial subtype (n = 64) at EPP were diagnosed correctly at initial diagnostic biopsy in 84% of cases, whereas patients considered to have a biphasic subtype (n = 19) at EPP were diagnosed correctly at diagnostic biopsy in 26% of cases. The sensitivity and specificity of diagnostic biopsy for epithelial MPM was 93% and 31%, respectively. The overall subtype misclassification rate was 20%. Biopsy by thoracotomy was most accurate in subtype classification (83%) compared with thoracoscopy (74%) and computed tomography-guided procedure (44%). CONCLUSIONS: The determination of histological subtype from a diagnostic biopsy is difficult due to sampling error, but an adequate specimen obtained from surgical biopsy increases the accuracy of subtype classification compared with radiological-guided biopsies. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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