Asbestos Cancer Update 2008

Università Politecnica delle Marche, Dipartimento di Patologia Molecolare e Terapie Innovative, Clinica di Medicina del Lavoro, Tronto 10/a, 0020 Torrette, AN. m.amati@univpm.it

Improved detection methods for diagnosis of asymptomatic malignant pleural mesothelioma (MPM) are essential for an early and reliable detection and treatment of this disease. Thus, focus has been on finding tumour markers in the blood. 94 asbestos-exposed subjects, 22 patients with MM, and 54 healthy subjects were recruited for evaluation of the significance of 8-hydroxy-2′-deoxy-guanosine (80HdG) in white blood cells and plasma concentrations of soluble mesothelin-related peptides (SMRPs), angiogenic factors (PDGFbeta, HGF, bFGF, VEGFbeta), and matrix proteases (MMP2, MMP9, TIMP1, TIMP2) for potential early detection of MM. The area under ROC curves (AUC) indicates that 80HdG levels can discriminate asbestos-exposed subjects from controls but not from MPM patients. Significant AUC values were found for SMRP discriminating asbestos-exposed subjects from MPM patients but not from controls. VEGFbeta can significantly differentiate asbestos-exposed subjects from control and cancer groups. No diagnostic value was observed for MMP2, MMP9, TIMP1, TIMP2. The sensitivity and specificity results of markers were calculated at defined cut-offs. The combination of 80HdG, VEGFbeta and SMRPs best distinguished the individual groups, suggesting a potential indicator of early and advanced MPM cancers. The combination of blood biomarkers and radiographic findings could be used to stratify the risk of mesothelioma in asbestos-exposed populations.

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SCDU Epidemiologia dei Tumori, Università di Torino, Via Santena 7, 10126, Torino, Italia. fbaroneadesi@yahoo.it

The multistage theory of carcinogenesis assumes rates of mesothelioma increasing monotonically as a function of time since first exposure (TSFE) to asbestos. However, some authors have suggested that the increase in mesothelioma rate with TSFE might be attenuated by clearance of asbestos from the lungs. We estimated mortality time trends from pleural and peritoneal cancer in a cohort of 3443 asbestos-cement workers. The role of asbestos clearance was explored using the traditional mesothelioma multistage model, generalized to include a term representing elimination over time. We observed 139 deaths from pleural and 56 from peritoneal cancer during the period 1950-2003. The rate of pleural cancer increased during the first 40 years of TSFE and reached a plateau thereafter. In contrast, the rate of peritoneal cancer increased monotonically with TSFE. The model allowing for asbestos elimination fitted the data better than the traditional model for pleural (p = 0.02) but not for peritoneal cancer (p = 0.22). The risk for pleural cancer, rather than showing an indefinite increase, might reach a plateau when a sufficiently long time has elapsed since exposure. The different trends for pleural and peritoneal cancer might be related to clearance of the asbestos from the workers’ lungs.

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Health Informatics Research Group, Department of Information Studies, University of Sheffield, Sheffield, UK.

The aim of this study was to develop a tool for evaluating the quality of breast cancer information on the Internet from the perspective of patients and their families. A specific tool, Breast Cancer tool (BC tool), was developed based on the information needs of women with breast cancer and their families reported in the literature. The BC tool and other 3 generic tools (HON, IQ tool, Discern) were used to assess 40 breast cancer websites. The reliability and validity of each tool was examined and the time spent reviewing the websites was measured. The four tools were shown to have acceptable reliability (Cronbach’s alpha>0.7), convergent validity, especially the BC tool which was capable of distinguishing whether a website offers sufficient information for women and their families. However, the BC tool took more time than the other tools to use, suggesting relatively low feasibility. The results of this study reinforce the importance of developing specific tools from perspectives of patients and their family members.

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Department of Pathology, School of Dentistry, Universidad de Concepción, Concepción, Chile. esepulve@udec.cl

OBJECTIVE: The objective of this study was to assess if there is increased herpes simplex virus type 1 (HSV-1) salivary shedding in oncology pediatric patients with severe cytopenia (SC). STUDY DESIGN: HSV-1 was detected by real time PCR in saliva samples from oncology pediatric patients (n = 30) during SC and relative cytopenia (RC), and from healthy children (n = 27). RESULTS: The frequency of HSV-1 positive saliva samples was higher in patients with SC as compared to controls (P < .05), and this frequency presented a significant reduction during RC periods (P < .02). The SC group positive for HSV-1 presented both a twofold increase in the neutrophil-to-lymphocyte ratio as compared with SC patients negative for HSV-1 (P < .05), and a positive correlation between neutrophil and lymphocyte counts (P < .05, R = 0.82, R(2) = 0.67). This correlation was not found in oncology patients negative for HSV-1 during SC and RC. CONCLUSION: Severe cytopenia in oncology pediatric patients could be an important susceptibility factor for increased HSV-1 salivary shedding.

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Department of 2nd General cancer Surgery, Sisli Etfal Training and Research Hospital, Sisli, Istanbul, Turkey.

The malignancy risk is low in hot thyroid nodules verified by cancer scintigraphy. We present a rare cancer case of papillary carcinoma, initially treated as an autonomous hot nodule. Case cancer report. A 36-year old male cancer patient with a hot thyroid nodule and cancer subclinical hyperthyroidism was treated with 10mCi 131I. On admission, both 99mTc and 131I thyroid scintigraphic imaging revealed a hot nodule at the right lobe cancer accompanied by lower uptake in the remaining cancer thyroid tissue. After treatment, there was a cancer progressive increase in the nodule size; a fine needle aspiration biopsy was thus performed which showed findings cancer compatible with papillary thyroid cancer. The patient was referred to our department for further management. Total cancer thyroidectomy with right central neck dissection was performed. The pathologic examination showed that the whole nodule (1.5 cm diameter) was a columnary type papillary thyroid cancer. Conclusion: In the case of a small-sized toxic thyroid nodule, the possiblility of malignancy cannot be totally ruled out. Suspicious hot nodules should be cytologically evaluated before cancer radioactive iodine treatment to determine the existing malignancy risk. Fine needle aspiration biopsy should be performed in all hot thyroid nodules that increase in size after radioactive iodine treatment.

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