Malignant Pleural Mesothelioma : Current Perspectives in Early Detection and Diagnosis

The objectives of this study are to review epidemiology, novel methods of detection, and novel diagnostics of malignant pleural mesothelioma (MPM) in the literature that were published between 1977 and 2019. Malignant pleural mesothelioma associated with prolonged respirable-asbestosfiber exposure is a rare cancer with constantly increasing incidence and poor prognosis due to lacking the effective treatment options. The median survival ranges from 8 to 14 months. Sarcomatoid histological subtype has the worst prognosis. Video-assisted thoracoscopy plus mediastinoscopy is the current gold standard for staging malignant pleural mesothelioma and is superior to computerized tomography of the chest for assessing the tumor size and suspected nodal metastases. Several circulating biomarkers are detected in MPM patients, such as mesothelin, osteopontin, fibulin-3, high mobility group B1, vascular endothelial growth factor, reactive oxygen species, reactive nitrogen species, micro-ribonucleic acids, tumor deoxyribonucleic acid, etc. In conclusion, there is potential for the development of biomarkers and radiological imaging in the years to come. Its incidence is expected to decrease in the next decade.

Keywords: Pleural; Mesothelioma; Malignant; Diagnosis; Epidemiology

Abbreviations: BALF : Bronchoalveolar lavage; BAP1 : BRCA-associated protein 1; CFAP45 : Cilia and flagella associated protein 45; CT : Computed tomography; CTCs : Circulating tumor cells; ctDNA : circulating tumor Deoxyribonucleic acid; DNA : Deoxyribonucleic acid; FDG : 18-fluoro-deoxyglucose; HMGB1 : High Mobility Group B1 ; miRNAs : micro-Ribonucleic acids; MPM : Malignant pleural mesothelioma; MRI : Magnetic resonance imaging ; MSLN : Mesothelin; PDGF : Platelet-derived growth factor; PET-CT : Positron-emission technology-computed tomography; RNS : Reactive nitrogen species; ROS : Reactive oxygen species; RR2 : Ryanodine receptor 2; SETDB1 : Set domain bifurcated 1; SETD2 : Set domain containing 2; SMRP : Soluble mesothelin-related peptide; TGF-β : Tumor growth factor-β ; TNM : Tumor-nodes-metastases; UICC : the Union for International Cancer Control ; UK : United Kingdom; ULK2 : Unc-like autophagy activating kinase; USA : United States of America; US FDA : United States Food and Drug Administration; VATS : Video-assisted thoracoscopic surgery; VEGF : Vascular endothelial growth factor