Medicus, Vol. 30 No. 2 Astma i KOPB, 2021.
Review article
Clinical and Molecular Features of Pleural Mesothelioma
Darko Katalinić
Ivan Alerić
Aleksandar Včev
Abstract
Mesothelioma is an aggressive tumor caused by neoplastic transformation of mesothelial cells of the serous membranes. Although it can occur at any anatomical localization that contains a mesothelium, it most often occurs in the pleura. In 2018, a total of 97 cases were recorded in Croatia with an average incidence rate of 2.4/100.000 persons. Most cases of mesothelioma are caused by occupational and environmental exposure to asbestos compounds, and are diagnosed with a latency period of several decades, very often in an advanced clinical stage when therapeutic options are significantly limited, and the overall survival rate is extremely unfavorable. The pathophysiology of mesothelioma is based on the development of a chronic inflammatory process potentiated by the influence of mutagenic oxygen ion radicals and the protein molecule HMGB1 (High Mobility Group Protein B1), which leads to activation of the NF-κB (Enhancer of Activated B-Cells) signaling pathway within mesothelial cells. The resulting microenvironment leads to neoplastic transformation of mesothelial cells, especially those with previously accumulated genetic damage. The present article summarizes the epidemiology, etiopathogenesis and clinical course of mesothelioma, and additionally discusses the roles of different imaging techniques as well as application of serum and molecular biomarkers on top of standard diagnostic modalities. Finally, the article presents currently available treatment options that include a surgical approach, chemoimmunotherapy, radiotherapy, and multimodality treatment.
Keywords
pleural mesothelioma; clinical and molecular features; diagnostics, therapy
Hrčak ID:
264165
URI
Publication date:
18.10.2021.
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