Following up on the largest case-control study of malignant mesothelioma yet performed, investigators at the London School of Hygiene and Tropical Medicine assessed 1732 male and 670 female cases as of May 2013. Epidemiological findings of a subset of these were published previously, excluding patients who died or who refused to be interviewed. Pathology reports were collected for subjects, including those both eligible and ineligible for epidemiology study based on vital status. The current investigation examined 860 cases having pathology reports available. Sixty-one cases were diagnosed using cytology only, often with equivocal diagnoses, while 799 reported at least a biopsy of the tumor. Of these, 748 had pathology sufficiently detailed for evaluation. These reports were examined for basis of diagnosis, differences between study cases and ineligible cases, pathology characteristics, and immunohistochemical and other tests used. The most prominent subtype was epithelioid (64% of study cases but only 49% of ineligible cases). Biphasic subtype was present in 10% of study cases and 16% of those ineligible. Sarcomatoid subtype was present in 7% of study cases and 19% of ineligible cases, most of whom died. Twelve percent of study cases displayed no specified subtype, versus 7% of ineligible cases. Of recorded immunohistochemical stains specific for mesothelial cell origin, calretinin (95%) and CK 5/6 or CK5 alone (84%) were by far the most common. Calretinin and CK 5/6 or CK 5 alone were also most sensitive and positive in 92% of cases presenting with surgical pathology report. Ninety percent of cases had at least one immunohistochemical marker for possible lung carcinoma applied, with BER-Ep4 and TTF-1 the most frequent at 68% and CEA at 58%. TTF-1 and CEA were positive in 1% or less of cases. Patterns of use and positive and negative results for each of these as well as other immunohistochemical stains are presented and discussed, along with a brief historical description of their development and use. Possible effects of the pathologic analysis on the results of previously published and future epidemiological studies are discussed.

中文翻译：

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英国间皮瘤研究的病理分析：当前实践和历史发展。

继进行的最大的恶性间皮瘤病例对照研究之后，伦敦卫生与热带医学学院的研究人员截至2013年5月评估了1732例男性和670例女性病例。先前已出版了其中一部分的流行病学发现，其中不包括患者谁死了或谁拒绝接受采访。收集了针对受试者的病理报告，包括符合生命状态的符合条件和不符合流行病学研究条件的受试者。当前的调查检查了860例具有病理报告的病例。仅通过细胞学诊断出61例，通常诊断不明确，而799例至少报告了肿瘤活检。其中748例病理学足够详细，可以进行评估。对这些报告进行了检查，以确定其诊断依据，研究病例与不合格病例之间的差异，病理特征以及所使用的免疫组织化学和其他检查。最突出的亚型是上皮样细胞（占研究病例的64％，但不合格病例中只有49％）。在10％的研究病例和16％的不合格病例中存在双相亚型。7％的研究病例和19％的不合格病例中存在肉瘤样亚型，其中大多数死亡。12％的研究病例未显示特定亚型，而不合格病例为7％。在记录的对间皮细胞起源特异性的免疫组织化学染色中，钙网蛋白（95％）和单独的CK 5/6或CK5（84％）是最常见的。单独的钙调蛋白和CK 5/6或CK 5在92％的有手术病理报告的病例中也是最敏感和阳性的。90％的病例至少应用了一种可能应用的肺癌免疫组化标记物，其中BER-Ep4和TTF-1最常见，为68％，CEA为58％。在1％或更少的病例中，TTF-1和CEA呈阳性。介绍并讨论了使用方式以及每种以及其他免疫组化染色剂的阳性和阴性结果，以及对其发展和使用的简要历史描述。讨论了病理分析对先前发表和未来流行病学研究结果的可能影响。以及对其开发和使用的简要历史描述。讨论了病理分析对先前发表和未来流行病学研究结果的可能影响。以及对其发展和使用的简要历史描述。讨论了病理分析对先前发表和未来流行病学研究结果的可能影响。