Predictions of mortality from pleural mesothelioma in Italy: A model based on asbestos consumption figures supports results from age‐period‐cohort models

Marinaccio, Alessandro; Montanaro, Fabio; Mastrantonio, Marina; Uccelli, Raffaella; Altavista, Pierluigi; Nesti, Massimo; Costantini, Adele Seniori; Gorini, Giuseppe

doi:10.1002/ijc.20820

Cited by 103 publications

(98 citation statements)

References 31 publications

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“…4,5 Moreover, either the late asbestos ban or the long latency period for full transformation to mesothelioma validate the expected increasing incidence trend and peak within 10-15 years in Italy, as well as in other European countries. 4,6,7 Immunohistochemistry is of definite support to the differential diagnosis between mesothelioma and serosal involvement by extraserosal neoplasms, 8,9 and although the distinction of mesothelioma from reactive mesothelial proliferations remains challenging, it is fundamentally based on the demonstration of stromal invasion, [10][11][12] with limited support by immunohistochemistry. 12 In fact, a variety of markers, such as desmin, epithelial membrane antigen, p53, IMP3, GLUT-1, CD146, and CD147, have been evaluated on both tissue and cytological samples, but none of them appeared to achieve sufficient diagnostic adequacy in the separation between malignant and benign mesothelial lesions.…”

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confidence: 99%

BAP1 (BRCA1-associated protein 1) is a highly specific marker for differentiating mesothelioma from reactive mesothelial proliferations

et al. 2015

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The distinction between malignant mesothelioma and reactive mesothelial proliferation can be challenging both on histology and cytology. Recently, variants of the BRCA1-associated protein 1 (BAP1) gene resulting in nuclear protein loss were reported in hereditary and sporadic mesothelioma. Using immunohistochemistry, we evaluated the utility of BAP1 expression in the differential diagnosis between mesothelioma and other mesothelial proliferations on a large series of biopsies that included 212 mesotheliomas, 12 benign mesothelial tumors, and 42 reactive mesothelial proliferations. BAP1 stain was also performed in 70 cytological samples (45 mesotheliomas and 25 reactive mesothelial proliferations). BAP1 was expressed in all benign mesothelial tumors, whereas 139/212 (66%) mesotheliomas were BAP1 negative, especially in epithelioid/biphasic compared with sarcomatoid/desmoplastic subtypes (69% vs 15%). BAP1 loss was homogeneous in neoplastic cells except for two epithelioid mesotheliomas showing tumor heterogeneity. By fluorescence in situ hybridization, BAP1 protein loss was paralleled by homozygous deletion of the BAP1 locus in the vast majority of BAP1-negative tumors (31/41, 76%), whereas 9/10 BAP1-positive mesotheliomas were normal. In biopsies interpreted as reactive mesothelial proliferation BAP1 loss was 100% predictive of malignancy, as all 6 cases subsequently developed BAP1-negative mesothelioma, whereas only 3/36 (8%) BAP1-positive cases progressed to mesothelioma. On cytology/cell blocks, benign mesothelial cells were invariably positive for BAP1, whereas 64% of mesotheliomas showed loss of protein; all 6 cases showing BAP1 negativity were associated with histological diagnosis of BAP1-negative mesothelioma. BAP1 stain also showed utility in the differential of mesothelioma from most common pleural and peritoneal mimickers, such as lung and ovary carcinomas, with specificity and sensitivity of 99/70% and 100/70%, respectively. Our results show that BAP1 protein is frequently lost in mesothelioma, especially of epithelioid/biphasic subtype and is commonly associated with homozygous BAP1 deletion. BAP1 immunostain represents an excellent biomarker with an unprecedented specificity (100%) in the distinction between benign and malignant mesothelial proliferations. Finding BAP1 loss in mesothelial cells should prompt to immediately reevaluate the patient; moreover, it might be useful in mapping tumor extent and planning surgical resection.

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BAP1 (BRCA1-associated protein 1) is a highly specific marker for differentiating mesothelioma from reactive mesothelial proliferations

et al. 2015

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“…Despite marked variations from one country to another, a rise of mesothelioma incidence and mortality has been observed in European countries, including Great Britain, Denmark, Norway, Italy, and in Canada and Japan. [1][2][3][4][5][6][7] Incidence calculated projections suggest a peak in men around 2017 in the Netherlands, around 2014 in Australia and between 2011 and 2015 in Great Britain. [8][9][10][11][12] Nevertheless, mesothelioma incidence in men in the United States and in the population of Sweden seems to have levelled off in the 1990s.…”

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Evolution of pleural cancers and malignant pleural mesothelioma incidence in France between 1980 and 2005

Stang

Belot

Ilg

et al. 2009

Intl Journal of Cancer

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The evolution of pleural cancers and malignant pleural mesothelioma incidence in France between 1980 and 2005 was analysed using data derived from the French network of cancer registries (FRANCIM) and the French National Mesothelioma Surveillance Program (PNSM). Mesothelioma proportions in pleural cancers were calculated by diagnosis year in the 1980-2000 period. Our results suggest that the incidences of pleural cancer and mesothelioma levelled off in French men since 2000 and continued to increase in French women. A decrease of the annual pleural cancer incidence average in men was noticed (23.4% of annual rate of change) between 2000 and 2005. The proportion of pleural cancers that were mesothelioma was unchanged between 1980 and 2003 with an average of 86%. The age standardised incidence rate of pleural mesothelioma remained relatively stable between 1998 and 2005 with a slight falling trend. For women, the age standardised incidence rate of pleural cancers and mesothelioma increased during the period 1998-2005. Additionally, the proportion of pleural cancers that were mesothelioma increased during the same period of time. Finally, the increased trend observed in the incidence of pleural mesothelioma and cancers in women is credibly due to their under diagnosis in the 1980-1997 period. The comparison between the French incidence and the American and British ones shows that the decreasing trend in incidence of mesothelioma and pleural cancers in French men since 2000 is potentially associated with a lower amphibole consumption and by the implementation of safety regulations at work from 1977.The incidence of pleural cancers, specifically malignant pleural mesothelioma in men, has shown a consistent increase in many industrialised countries for several decades. Despite marked variations from one country to another, a rise of mesothelioma incidence and mortality has been observed in European countries, including Great Britain, Denmark, Norway, Italy, and in Canada and Japan. [1][2][3][4][5][6][7] Incidence calculated projections suggest a peak in men around

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“…Considering only the asbestos production, 3,748,550 tons of raw asbestos were produced in Italy, with a peak between 1976 and 1980 (20).…”

Section: Discussionmentioning

confidence: 99%

Health surveillance for former asbestos exposed worker: a specific programme developed in an Italian region

Chellini¹,

Battisti²,

Cristaudo³

et al. 2018

J. Thorac. Dis.

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Asbestos-related diseases usually have a long latency since first exposure and this legitimates a health surveillance programme addressed to asbestos workers after the cessation of their occupational exposure. After a brief history of health surveillance initiatives performed in Italy as well as in other countries, we describe a regional programme for former asbestos-exposed workers, focusing on organizational features.A regional group of experts defined its operational and economical aspects. The Regional Council supported the whole programme, making it free of charge for all subjects who fulfil the predefined enrolment criteria (being resident in the region, being younger than 80 years old with cessation of occupational asbestos exposure within the last 30 years). The programme activities are classified in two levels: a first level for a basic health evaluation and a second level for in-depth analyses. In order to guarantee an homogeneous delivery in the whole region, the programme has to be performed by public health services with a quality control of activities. The involvement of specific public health services and the cooperation of social stakeholders are expected to play a major role in overcoming still open critical issues, such as the lack of programme existence awareness and adhesion, the correct stratification of subjects for the follow-up, and the real homogeneous delivery of the health surveillance in whole region.

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Predictions of mortality from pleural mesothelioma in Italy: A model based on asbestos consumption figures supports results from age‐period‐cohort models

Cited by 103 publications

References 31 publications

BAP1 (BRCA1-associated protein 1) is a highly specific marker for differentiating mesothelioma from reactive mesothelial proliferations

BAP1 (BRCA1-associated protein 1) is a highly specific marker for differentiating mesothelioma from reactive mesothelial proliferations

Evolution of pleural cancers and malignant pleural mesothelioma incidence in France between 1980 and 2005

Health surveillance for former asbestos exposed worker: a specific programme developed in an Italian region

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