Pleural mesothelioma: diagnostic problems and evaluation of prognostic factors

J Egypt Natl Canc Inst. 2006 Dec;18(4):303-10.


Background: Malignant pleural mesothelioma (MPM) in Egypt is mainly attributed to an environmental origin i.e exposure to asbestos, with a high incidence in women and young adults. Immunohistochemistry and ultrastructural features aid in the diagnosis. The p27Kip1 is a kinase inhibitor protein acting as a cell cycle regulator and a putative tumor suppressor gene playing a critical role in the pathogenesis of several human neoplasms.

Aim: A clinicopathologic, immunohistochemical and ultrastructural study of mesothelioma in Egyptian patients, with identification of different prognostic factors.

Material and methods: Sixty-one cases of MPM were collected from the department of pathology at the NCI, Cairo. Cases were stained by monoclonal antibodies against CK5/6, calretinin, vimentin, CD15, CEA and p27.

Results: More than half (57.4%) of the patients were residents in endemic areas; 50.8% were of epithelioid type. CK5/6 was positive in 45 (73.8%) cases, 39 (63.9%) cases were positive for vimentin, 49 (80.3%) cases were positive for calretinin. One case showed a focal weak positive reaction to CD15. None of the cases stained for CEA. There was a statistically significant relation between p27 expression and the histopathologic type (p=0.02) between overall survival and age (p=0.01), histopathologic type (p=0.02) and stage (p=0.006).

Conclusion: MPM is an increasing disaster in Egypt which is underestimated and neglected. A panel of immunohistochemical markers should be used for proper evaluation. p27 has proven to be a potential biologic prognostic marker for mesothelioma and more studies as regard its significance are recommended on a larger number.

Publication types

  • Evaluation Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Biomarkers, Tumor / analysis*
  • Biomarkers, Tumor / metabolism
  • Calbindin 2
  • Carcinoembryonic Antigen / metabolism
  • Female
  • Humans
  • Immunohistochemistry
  • Keratin-5 / metabolism
  • Keratin-6 / metabolism
  • Male
  • Mesothelioma / diagnosis*
  • Mesothelioma / metabolism
  • Mesothelioma / mortality
  • Middle Aged
  • Pleural Neoplasms / diagnosis*
  • Pleural Neoplasms / metabolism
  • Pleural Neoplasms / mortality
  • Prognosis
  • Proliferating Cell Nuclear Antigen / metabolism
  • S100 Calcium Binding Protein G / metabolism
  • Survival Analysis


  • Biomarkers, Tumor
  • CALB2 protein, human
  • Calbindin 2
  • Carcinoembryonic Antigen
  • Keratin-5
  • Keratin-6
  • Proliferating Cell Nuclear Antigen
  • S100 Calcium Binding Protein G
  • p27 antigen