Comment on 'Validation of the diagnosis of mesothelioma and BAP1 protein expression in a cohort of asbestos textile workers from Northern Italy'

Our plain-English summary of Comment on 'Validation of the diagnosis of mesothelioma and BAP1 protein expression in a cohort of asbestos textile workers from Northern Italy', by C. Brentisci, M. Gangemi, E. Migliore, et al (Annals of Oncology, 2018).

The study

• Authors: C. Brentisci, M. Gangemi, E. Migliore, D. Mirabelli, A. Stura
• Journal: Annals of Oncology
• Published: 2018;29(12):2395-2396
• Type of article: Letter, Comment
• Cited by: 2 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

In plain English

This is a letter to the editor, not an original study. The authors, from the Turin unit running the Piedmont Registry of Malignant Mesotheliomas (RMM), responded to a paper by Boffetta and colleagues on 127 deceased members of a cohort of Italian asbestos-textile workers. That paper could re-examine the pathology of only 35 cases and confirmed mesothelioma in all. It estimated 83% sensitivity and 34% specificity for the registry's classification of 'certain confirmed mesothelioma' versus other cases. At Boffetta's request, the authors had linked their registry with that group, finding 76 of the 127. They stated that neither the published figures nor the shared data allowed these estimates to be checked. Of the 51 not in the registry, 21 lived outside Piedmont, 16 died before 1990, when the registry began, and 6 died of unrelated causes. The other 8 were still under investigation. The authors argued that the specificity estimate was not justified: no reviewed diagnosis had been rejected, and nothing from a gold standard ruled out the unreviewed cases. They also stated that the registry actively searches pathology laboratory records.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Letter to the editor commenting on another published study (Boffetta et al., Ann Oncol 2018)
• Who was studied: The 127 deceased members of a cohort of Italian asbestos-textile workers in the Boffetta et al. paper, compared against the Registry of Malignant Mesotheliomas of Piedmont
• Exposure: Work in the asbestos textile industry. The letter does not name fiber types or doses.
• Main results:
  • The authors' record-linkage between the Piedmont registry and the Boffetta case series found 76 of the decedents in the registry files
  • The individual data given to the registry did not include the results of the diagnosis review, so the authors could not repeat the sensitivity and specificity calculations
  • According to the letter, Boffetta et al. could revise 35 cases and confirmed mesothelioma in all of them
  • The letter's authors argued that if all 35 confirmed cases were linked to registry records, registry sensitivity would be 100% rather than 83%
  • The authors argued that Boffetta et al. were wrong to count only 'certain' cases and to exclude 'probable/possible' cases, because those categories describe only the basis of diagnosis
  • Of the 51 individuals not registered by the RMM, 21 lived outside Piedmont, so the registry had no reason to record them
  • Of those 51 unregistered individuals, 16 died before 1990 (the year the registry started) and 6 died of causes unrelated to mesothelioma. The remaining 8 were under investigation.
  • The authors stated that the registry identifies cases by searching the records of all pathology laboratories serving Piedmont hospitals
• The authors' conclusion: The authors concluded that the 34% specificity estimate was not justified. They gave two reasons. First, no mesothelioma diagnosis among the reviewed cases had been rejected. Second, for the unreviewed cases, Boffetta et al. had no gold-standard evidence that ruled out the original diagnoses.
• Limitations the authors state:
  • The authors stated that 8 of the 51 unregistered cases were still under investigation

Topics

The National Library of Medicine indexes this study under subjects our site covers: Lung cancer, Mesothelioma.

Medical terms in this study, explained in our Lexicon: Mesothelioma, BAP1.

Related studies

• Comment on the paper 'Boffetta et al. Validation of the diagnosis of mesothelioma and BAP1 protein expression in a cohort of asbestos textile workers from Northern Italy. Ann Oncol 2018; 29(2): 484-489' — D. Consonni, C. Mensi (2019)
• Validation of the diagnosis of mesothelioma and BAP1 protein expression in a cohort of asbestos textile workers from Northern Italy — P. Boffetta, L. Righi, et al. (2018)
• Is Mesothelioma Unrelated to the Lung Asbestos Burden? Comment on Visonà et al. Inorganic Fiber Lung Burden in Subjects with Occupational and/or Anthropogenic Environmental Asbestos Exposure in Broni (Pavia, Northern Italy): An SEM-EDS Study on Autoptic Samples. Int. J. Environ. Res. Public Health 2021, 18, 2053 — D. Mirabelli, A. Angelini, et al. (2021)
• Differential Diagnosis of Malignant Pleural Mesothelioma on Cytology: A Gene Expression Panel versus BRCA1-Associated Protein 1 and p16 Tests — R. Bruno, G. Alì, et al. (2020)
• Reply to Mirabelli et al. Is Mesothelioma Unrelated to the Lung Asbestos Burden? Comment on "Visonà et al. Inorganic Fiber Lung Burden in Subjects with Occupational and/or Anthropogenic Environmental Asbestos Exposure in Broni (Pavia, Northern Italy): An SEM-EDS Study on Autoptic Samples. Int. J. Environ. Res. Public Health 2021, 18, 2053" — S.D. Visonà, S. Capella, et al. (2021)
• Mortality of Talc Miners and Millers From Val Chisone, Northern Italy: An Updated Cohort Study — E. Pira, M. Coggiola, et al. (2017)

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