Navigating Mesothelioma Diagnosis: The Power of Uroplakin-IIIb

Navigating Mesothelioma Diagnosis: The Power of Uroplakin-IIIb

Figuring out if someone has mesothelioma or lung cancer can be tricky for doctors. They often use special tests called immunohistochemical stains to help them. But sometimes, these tests are not specific enough on their own.

Recently, a big study found a potential new marker called uroplakin-IIIb (UpIIIb). It might be really good at telling if someone has mesothelioma.

Decoding Mesothelioma and Diagnostic Accuracy

Mesothelioma is an aggressive cancer caused by exposure to asbestos. Three different types of mesothelioma are identified based on the shape of the cancer cells. About half of mesothelioma cases are the epithelioid type, and 10% are the sarcomatoid type. The rest of mesothelioma cases are a mix of epithelioid and sarcomatoid, and this type is called biphasic.

Scientists looked at tissue samples from 48 people with epithelioid mesothelioma. The included 26 people with sarcomatoid mesothelioma. And, included 144 people with a type of lung cancer called non-small cell lung carcinoma (NSCLC). They wanted to see if the marker UpIIIb could help tell these apart.

The results showed that UpIIIb did a good job of telling apart epithelioid mesothelioma from lung cancer. Out of the 47 cases the scientists could evaluate, UpIIIb correctly identified 37 as mesothelioma; that is about 79% accuracy. This is important because it means UpIIIb could be a useful tool for doctors to diagnose mesothelioma.

Uroplakin-IIIb Unveiled as a Promising Marker

The scientists also compared UpIIIb to another marker called HEG1, which is already known to be good at spotting mesothelioma. UpIIIb was almost as good as HEG1 in finding epithelioid mesothelioma cases, but it did better in some situations where HEG1 did not work.

But, UpIIIb did not work well for sarcomatoid mesothelioma cases. This means doctors might still need other tests for this type of mesothelioma. Also, UpIIIb could sometimes show positive results in some ovarian cancers. This can make it confusing for doctors when trying to diagnose mesotheliomas.

Overall, this study shows that UpIIIb could be a useful tool for doctors. Especially when they are trying to figure out if someone has mesothelioma or lung cancer. It is especially good at finding the type of mesothelioma called epithelioid mesothelioma. But doctors must be careful when using it in cases involving certain kinds of ovarian cancers or cancers from the bladder, uterus, or pancreas.

Doctors have a new and powerful tool in their toolkit to help diagnose mesothelioma more accurately. This could make a big difference for patients and their families, offering hope for better treatments and outcomes in the future.


van Pel DM, Cheung S, Ionescu DN, Churg A. Uroplakin-IIIb as a Novel Immunohistochemical Marker for Mesothelioma [published online ahead of print, 2023 Sep 28]. Hum Pathol. 2023;S0046-8177(23)00199-5. doi:10.1016/j.humpath.2023.09.006

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