MUC1 in the diagnosis and pathogeneis of malignant mesothelioma

[Truncated abstract] Malignant mesothelioma is a highly aggressive tumour arising from the serosal surfaces of the pleural, peritoneal and occasionally pericardial cavities. Despite the universal ban of asbestos use in mining and in many industries, the incidence of mesothelioma is expected to increase in Australia until 2020, mainly because of the long latency period between initial asbestos exposure to development of disease, making it an extremely important health issue for our society. The new wave of asbestos related disease is now seen from individuals in the construction industries and the everyday home handy man. The diagnosis of mesothelioma is an extremely difficult process and is usually made in conjunction with clinical, radiological and pathological findings. It is therefore understandable that the interest to identify a technique to aid in the early diagnosis of mesothelioma is extensive. Several biomarkers and combinations of biomarkers have been evaluated to aid in the non-invasive diagnosis of malignant mesothelioma. Pleural effusion is one of the earliest signs and symptoms that patients present with, however, despite recurrent pleural effusions and serial chest x-rays including computed tomography (CT) scans, it is not unusual that a definite diagnosis is not possible until tumour burden increases where it is more visible on radiology while the patient’s symptoms become more debilitating and the overall prognosis becomes worse. One of the main diagnostic difficulties is the ability to differentiate between benign reactive mesothelial proliferation and mesothelioma. Currently, the ‘gold standard’ for a diagnosis of mesothelioma requires a histological biopsy specimen with invasion being the only reliable marker between benign reactive mesothelial proliferation and malignant mesothelioma. Unlike epithelial adenocarcinomas, there are no sensitive and specific tumour markers available to detect mesothelioma.