Functions of mesothelioma panels

Our plain-English summary of Functions of mesothelioma panels, by M. Kannerstein, J. Churg, W.T. McCaughey (Annals of the New York Academy of Sciences, 1979).

The study

• Authors: M. Kannerstein, J. Churg, W.T. McCaughey
• Journal: Annals of the New York Academy of Sciences
• Published: 1979;330:433-9
• Cited by: 8 articles, as counted by NIH iCite
• Read it: PubMed · Publisher
• In J-M's library: Johns-Manville's company medical library held a copy (J-M no. 003995).

Summary of the article

The authors described the history and functions of mesothelioma pathology reference panels, which were proposed at the 1964 New York Academy of Sciences conference on the biological effects of asbestos. They reported on the United States Mesothelioma Reference Panel registry at Barnert Memorial Hospital Center in Paterson, New Jersey. Over a 10-year period it received about 800 cases. Of these, 517 were graded for certainty of diagnosis, and 419 were considered highly possible to definitely mesothelioma: 253 (60%) pleural, 146 (35%) peritoneal, 15 involving both cavities, 2 pericardial and 3 of the tunica vaginalis. In 168 cases from a 1972 national survey, panel members graded diagnostic certainty on a 0-4 scale, and the panel median was used. Seventy percent were accepted as probable or definite mesothelioma, 13% were rejected and 16% were considered possible. Agreement among members was strong in the probable/definite and rejected categories but poor in the possible group. Majority opinion favored epithelial type in 64% and mixed type in 13%, with no majority in 14%. The Canadian panel, founded in 1968, had reviewed almost 300 cases. The authors concluded that panels have performed a useful function. They suggested that panels could do more with better organization and support, including stimulating case detection, educating pathologists, holding periodic meetings and developing lung asbestos analysis.

PubMed has no abstract for this study, and the article doesn't print one. We wrote this summary from the full article with the help of AI. It is not the authors' wording.

In plain English

This paper described how mesothelioma reference panels had worked, mainly in the United States and Canada. These panels are groups of pathologists experienced in diagnosing mesothelioma who review cases. It was not a study of asbestos exposure. Over a 10-year period, the United States panel's registry in Paterson, New Jersey, received approximately 800 cases. Of 517 graded for diagnostic certainty, 419 were considered highly possible to definitely mesothelioma. Of these, 253 (60%) were in the pleura and 146 (35%) in the peritoneum. As an example of panel work, the authors reported 168 cases from a 1972 national survey. Using the median of members' grades, 70% were accepted as probable or definite mesothelioma, 13% were rejected and 16% were considered possible. Members agreed strongly on probable and definite cases and well on rejected ones, but not on "possible" cases. The authors noted that missing information or tissue often limited the grading of the other registry cases. The authors concluded that panels had performed a useful function, but that their potential would be greater with more extensive organization and substantial support.

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: Descriptive report and commentary on the work of mesothelioma pathology reference panels. It includes a registry case series and a review of agreement among panel members on 168 survey cases.
• Who was studied: Cases sent to the United States Mesothelioma Reference Panel registry at the Barnert Memorial Hospital Center, Paterson, New Jersey, over a 10-year period: approximately 800 cases. The agreement review covered 168 cases submitted in a 1972 United States national survey and graded by a panel of about 10 pathologists. The paper also briefly describes the five-member Canadian panel, which had reviewed almost 300 cases since 1968.
• Exposure: No specific asbestos exposure or fiber type was studied. The registry received material on asbestos-associated disease traced occupationally, and about one third of cases came through Dr. I. J. Selikoff, mostly from occupational studies. The authors state that no correlations with asbestos exposure had yet been made in the 168-case series.
• Main results:
  • Of the 517 registry cases graded for certainty of diagnosis, 419 were considered highly possible to definitely mesothelioma.
  • Of these 419 mesothelioma cases, 253 (60%) were pleural and 146 (35%) peritoneal. In 15, one or both pleural cavities and the peritoneal cavity were involved equally. Two were pericardial and 3 involved the tunica vaginalis.
  • Among the 168 cases from the 1972 national survey, the panel median accepted 70% as probable or definite mesotheliomas, rejected 13%, and considered 16% possible.
  • Panel members showed strong agreement for cases graded 3 and 4 (probable and definite) and good agreement for grades 0 and 1 (not a mesothelioma and unlikely). Agreement was not good in the possible grades (2-, 2, 2+).
  • Even where the median grade was 2+ (leaning toward mesothelioma), panel members disagreed in more than half of cases. The possible group made up less than 10% of the series.
  • For cell type, the majority opinion favored epithelial type in 64% of the 168 cases and mixed type in 13%. No majority was reached in 14%.
• The authors' conclusion: The authors concluded that panels had performed a useful function. They considered that panel potential would be greater with more extensive organization, possibly more members, wider geographic distribution and substantial support. They suggested further panel roles in case detection and education, and said periodic meetings were needed.
• Limitations the authors state:
  • For the two thirds of registry cases from individual consultations and from Dr. Selikoff, grading was often decisively affected by deficient information or tissue.
  • The case-by-case review needed to analyze those cases statistically had not been completed, so they were presented only by site.
  • Most of those cases were seen by only two of the authors rather than the full panel.
  • Circulating material to panel members by mail limited what the panel could do, including reducing observer variation.

Topics

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

Medical terms in this study, explained in our Lexicon: Mesothelioma, Pathology, Pericardial, Tunica Vaginalis.

Related studies

• The progression of panels — M. Greenberg (1991)
• How to assess the best immunohistochemical panel in the diagnosis of malignant pleural mesothelioma in a pathology lab — M. Mlika, O. Lamzibri, et al. (2018)
• Peritoneal tumours in asbestosis — J.B. Enticknap, W.J. Smither (1964)
• The pathology of mesotheliomata and an analysis of their association with asbestos exposure — D.O. Hourihane (1964)
• Diffuse mesothelioma and exposure to asbestos dust in the Merseyside area — W.G. Owen (1964)
• Exposure to asbestos and mesothelioma of the pleura — P.B. Fowler, J.C. Sloper, et al. (1964)

Browse more research in Annals of the New York Academy of Sciences, or return to medical research.