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Differential Diagnosis
ОглавлениеThe diagnostic performances of miR-130a expression analysis and immunohistochemistry appear to be similar. miR-130a quantification could be used reliably as a second-level diagnostic tool to differentiate MM from lung adenocarcinoma in pleural effusion cytology, mainly in those cases with ambiguous or negative immunohistochemistry (Cappellesso et al. 2017).
Multiple miRNAs were combined to diagnose a MM and can better distinguish it from other tumors or from pleural metastatic carcinoma.
Benjamin et al. (2010) were the first to find that eleven miRNAs were differentially expressed by gene chip in MPM patients and in twelve tumor patients—namely patients with bladder cancer, breast cancer, intestinal cancer, endometrial cancer, esophageal cancer, renal cancer, liver cancer, lung cancer, ovarian cancer, pancreatic cancer, prostate cancer, and gastric cancer. Among these miRNAs, four (in the miR-193 family, which includes miR-193a-3p/5p and -193b and miR-152) are highly expressed in MPM tissues, whereas seven (in the miR-200 family, which includes miR-141, miR-200a/b/c and miR-429, miR-192, and miR-194) are highly expressed in other tumor tissues. Further validation results showed that the combination of miR-200c/193a-3p was sufficient to distinguish MPM from most tumors except renal cell carcinoma, while miR-192 could be used to distinguish MPM from renal cell carcinoma, liver cancer, and gastrointestinal cancer. Subsequent double-blind experiments showed that the combination of miR-200c/193a-3p could make the accuracy of distinguishing MPM from breast cancer, intestinal cancer, endometrial cancer, renal cancer, lung cancer, ovarian cancer, and other tumors reach 95%. In pleural effusion cells, combining miR-143, miR-210, and miR-200c could discriminate MPM from a further adenocarcinoma with an AUC of 0.9887 (Birnie et al. 2019).
Gee et al. (2010) also found that miR-141, miR-200a/b/c, and miR-429 were downregulated in MPM samples and that miR-203 and miR-205 were downregulated as well. All seven miRNA markers can effectively distinguish MPM from lung adenocarcinoma, and their sensitivity or specificity exceeds the 80% recommended by the International Mesothelioma Interest Group. All members of the miR-200 family had AUCs above 0.9, while the remaining markers had AUCs between 0.83 and 0.89. In addition, these seven miRNA markers are only suitable for differential diagnosis, but cannot classify histological subtypes.