الفهرس 
Malignant Pleural MesotheliomaOnly 14 pages are availabe for public view
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Abstract
alignant mesothelioma is a rare aggressive tumour arising from mesothelial cells of the pleural, peritoneal cavity, pericardium andtunica vaginalisofthetestis. Mesothelioma is estimated to occur in approximately 2500 people in the United States every year, malignant pleural mesothelioma occur mainly in older men (median age of 72 years), median overall survival is approximatly 1 year. A lot of data indicate a relationship between mesothelioma and asbestos, the latency periods elapsing between first exposure to asbestos and development of mesothelioma are mostly longer than 40Years, Some recent studies show that the risk increases with the duration of exposure, Possible co-factors in the pathogenesis of asbestos- related mesothelioma include genetic predisposition, diets poor in fruit and vegetables, viruses, immune impairment, recurrent serosal inflammation. Although the mechanism of carcinogenesis is not fully understood, Several molecular pathways involved in malignant pleural mesothelioma have been identified; these include cell cycle regulation, apoptosis, growth factor pathways, and angiogenesis. The tumours require the continuous formation of new blood vessels inorder to grow. Malignant mesothelioma cells produce angiogenic factors,such as vascular endothelial growth factor (VEGF) زMacrophage migration inhibitory factor (MIF) and its recptor CD74 found to be associated with angiogenic activity. Malignant pleural mesothelioma clinically manifests after decades of initial exposure to etiologic agents, such as asbestos, and presents with nonspecific symptoms such as dyspnea, pain, or weight loss.The definite diagnosis can only be established by diagnostic laparoscopy or open surgery along with biopsy to obtain histological examination and immunocytochemical analysis.The type of mesotheliomas and stage at diagnosis remain the cornerstone for treatment approach. Targeted therapy used in MPM such as antiangiogesis agents,immunotherapy, signaling pathway inhibitors still has an important role in mesothelioma in controlling the symptom and improve quality of life Aim of the work The aim of the work is: To assess the correlation between the predictive factor of vascularity (CD74) in malignant pleural mesothelioma and treatment results (response rate, and overall survival), in patients presented to Ain Shams Clinical Oncology Department (ASCOD). Patients and methods The study started by a review the cases with malignant pleural mesotheliomas presented and treated in the Clinical Oncology and Nuclear Medicine Department, Ain Shams University Hospital during the period from 2009 to 2014. Examination of paraffin blocks of the patient selected to be included in the study for assessment of the selected vascularity marker of malignant pleural mesothelioma of both types. The CD74 (LN2) antibody is intended for qualified laboratories to qualitatively identify by light microscopy the presence of associated antigens in sections of formalin-fixed paraffin-embedded tissue sections using IHC test methods.Then we will correlate the result of vasularity test done on paraffin blocks on both types of malignant pleural mesothelioma patients diagnosed and treated in Ain Shams hospital with treatment results (response rate, overall survival). The material used: 50 cases with malignant pleural mesotheliomas had been studied, using CD74 marker on the paraffin blocks, our result show that 32 (64%)of cases with high to moderate expression of CD74,while the low to no expression appeared in 18 (34%) of cases. When correlation done between the result of CD74 expression and overall survival and progression free survival we found that the longer survival in cases with low and no expression, in contrast to cases with high to medium expression showed shorter survival. these result may support the use of targeted therapy in pleural mesothelioma. We found that the median age of cases between 39-84 years. The females affected more than the males. Stage three most common among the cases. Eventually all cases had been progressed either up front or after transient response.