Abstract / Summary
Pleural mesothelioma is an aggressive malignancy that presents significant diagnostic challenges, particularly in its differentiation from reactive mesothelial proliferations. Given the controversial reliability of traditional immunohistochemical (IHC) markers, there is a critical need for high-specificity markers. This study aims to evaluate the diagnostic availability of BAP1, MTAP, and 5-hmC, as individual markers and in combination. The study cohort comprised 65 cases of pleural mesothelioma and 28 pleural benign control cases. IHC staining was performed for BAP1, MTAP, and 5-hmC. BAP1 loss demonstrated a sensitivity of 67.7%; this rate was 61,5% for MTAP and %52,3 for 5-hmC. When all three markers are used together, the sensitivity reached 95.4%. All three markers exhibited 100% specificity, as no loss of expression was observed in the control group. This study is the first in the English-language literature to evaluate these three markers together in pleural mesothelioma. The findings confirm that although no single marker is sufficient to identify all cases, algorithmic application of these markers to use BAP1 in the first line in a mesothelial lesion will enable the diagnosis of the majority of mesothelioma cases.