Diagnostic performance of immunohistochemistry markers for malignant pleural mesothelioma diagnosis and subtypes. A systematic review and meta-analysis.

BACKGROUND: Malignant pleural mesothelioma (MPM) poses diagnostic challenges due to its resemblance to benign pleural pathologies and different histological subtypes. Several immunohistochemistry markers have been employed to aid in accurate diagnosis. METHODS: The present systematic review and meta-analysis aimed to assess the diagnostic performance of various immunohistochemistry markers in malignant pleural mesothelioma diagnosis and its histological subtypes. Following the PRISMA guidelines, we systematically searched the literature for articles on using different immunohistochemical markers in MPM and its histological subtypes. EMBASE, LILACS, MEDLINE, and Virtual Health Library were searched for studies published up to August 2023. We used the QUADAS-2 (Quality Assessment of Diagnostic Accuracy Studies) criteria to assess the quality of the included articles. Meta-analyses were performed to determine prevalence using a random-effects model. RESULTS: 103 studies met the inclusion criteria, comprising a diverse range of immunohistochemistry markers. EMA and desmin-loss exhibited high sensitivity (96% and 92%, respectively) in distinguishing malignant pleural mesothelioma from benign pleural pathologies. Specificity was notably high for both BAP1-loss and survivin expression at 100%. Subtype-specific analyses demonstrated that EMA and HEG1 were sensitive markers for epithelioid mesothelioma, while GLUT1 showed high sensitivity for sarcomatoid mesothelioma. In cases comparing epithelioid mesothelioma and lung adenocarcinoma, CAM5.2 and calretinin displayed high sensitivity, while WT1 and BAP1-loss demonstrated exceptional specificity for malignant epithelioid mesothelioma. In the case of sarcomatoid mesothelioma and sarcomatoid lung carcinoma, GATA3 exhibited the most heightened sensitivity, while GATA3 and D2-40 displayed the best specificity for sarcomatoid malignant mesothelioma diagnosis. CONCLUSION: Immunohistochemistry markers are essential in accurately diagnosing malignant pleural mesothelioma and its histological subtypes. This systematic review and meta-analysis provide a comprehensive insight into the diagnostic performance of these markers, facilitating their potential clinical utility in the discrimination of malignant pleural mesothelioma from other pleural pathologies and the differentiation of malignant pleural mesothelioma subtypes.

A postmortem study of patients vaccinated for SARS-CoV-2 in Colombia.

INTRODUCTION AND OBJECTIVE: A new coronavirus produces a disease designated as coronavirus disease 2019 (COVID-19). Vaccination against COVID-19 has resulted in decreased mortality. Postmortems of vaccinated patients play an important part in the forensic analysis of adverse effects after vaccination, which is essential for determining its efficacy and security. The main objective of this study was to describe the results of autopsies of patients vaccinated for SARS-CoV-2 carried out in two major centers in Colombia. MATERIALS AND METHODS: A descriptive cross-sectional study of 121 autopsies was performed following Colombian regulations in two main hospitals in Bogotá, Colombia, between March 1st and April 31st, 2021. RESULTS: 118 of the 121 patients (97.52%) had been vaccinated with CoronaVac (Sinovac); only 3 had received other vaccines. Sudden cardiac death was the leading cause of death, with pulmonary embolism another critical finding. No relation between the cause of death and vaccination against SARS-CoV-2 was found. CONCLUSIONS: A clinical autopsy is a vital for an accurate post-mortem diagnosis. Any relation between the SARS-CoV-2 vaccine and the cause of death should be carefully studied in order to provide the general public with evidence-based information about the safety of the vaccination.

A postmortem study of patients vaccinated for SARS-CoV-2 in Colombia / Autopsias clínicas en pacientes vacunados contra el SARS-CoV-2: estudio post mortem en una población colombiana

Introduction and objective: A new coronavirus produces a disease designated as coronavirus disease 2019 (COVID-19). Vaccination against COVID-19 has resulted in decreased mortality. Postmortems of vaccinated patients play an important part in the forensic analysis of adverse effects after vaccination, which is essential for determining its efficacy and security. The main objective of this study was to describe the results of autopsies of patients vaccinated for SARS-CoV-2 carried out in two major centers in Colombia. Materials and methods: A descriptive cross-sectional study of 121 autopsies was performed following Colombian regulations in two main hospitals in Bogotá, Colombia, between March 1st and April 31st, 2021. Results: 118 of the 121 patients (97.52%) had been vaccinated with CoronaVac (Sinovac); only 3 had received other vaccines. Sudden cardiac death was the leading cause of death, with pulmonary embolism another critical finding. No relation between the cause of death and vaccination against SARS-CoV-2 was found. Conclusions: A clinical autopsy is a vital for an accurate post-mortem diagnosis. Any relation between the SARS-CoV-2 vaccine and the cause of death should be carefully studied in order to provide the general public with evidence-based information about the safety of the vaccination.(AU)

Introducción y objetivo: Un nuevo virus del linaje de los coronavirus produce una enfermedad que se designó como enfermedad por coronavirus 2019 (COVID-19). Actualmente se están aplicando vacunas contra la COVID-19 y han mostrado disminución de la mortalidad en pacientes infectados. El análisis de los efectos adversos tras la vacunación ha sido fundamental para conocer la eficacia y la seguridad tras la administración. El examen forense y patológico de las muertes después de la vacunación representa un componente crítico. El objetivo principal del estudio fue describir una serie de casos de pacientes con inmunización previa contra el SARS-CoV-2 que fallecieron y a los que se les realizó una autopsia clínica en dos centros de referencia en Colombia para estudios post mortem. Materiales y métodos: Se realizó un estudio descriptivo transversal basado en autopsias siguiendo la normatividad colombiana en dos hospitales de alta complejidad de la ciudad de Bogotá, Colombia, durante el período comprendido entre el 1 de marzo de 2021 y el 31 de abril de 2021. Se analizaron un total de 121 autopsias. Resultados: Un total de 118 pacientes (97,52%) fueron vacunados con CoronaVac (Sinovac). La muerte cardíaca súbita fue la principal causa de fallecimiento en la población del estudio, y la embolia pulmonar fue otro hallazgo crítico encontrado en el estudio forense. No se pudo determinar la relación entre las causas de muerte y la vacunación contra el SARS-CoV-2. Conclusiones: La autopsia clínica es una herramienta vital en las instituciones de salud para brindar un diagnóstico post mortem. Consideramos que el estudio de la causalidad de la vacunación contra el SARS-CoV-2 y las muertes es fundamental para futuros estudios, con la intención de proporcionar información basada en evidencia a la población para apoyar el concepto de vacunación segura contra la COVID-19.(AU)

Familial Adenomatous Polyposis: Case Report and Literature Review.

Familial adenomatous polyposis (FAP) is an autosomal inheritance disease characterized by 100 or more adenomatous polyps in the colon and rectum with a high risk of developing colorectal carcinoma (CRC). The management of this disease is based on early screening and timely follow up, with subsequent planning of risk-reducing or therapeutic surgeries. We present a case of a patient with a strong family history of FAP with a "de novo" diagnosis of CRC. Furthermore, a literature discussion of current and future perspectives of treatment is performed.