Biphasic Mesothelioma Diagnosis, Cell Types, Treatment & Prognosis
Biphasic mesothelioma is a cancer type caused due to asbestos exposure. This kind of mesothelioma is also sometimes called mixed mesothelioma as the symptoms include pleural effusion, shortness of breath and dry cough.
Before going through the diagnosis, cell types and prognosis, you need to first understand the meaning of biphasic mesothelioma. Simply go through the entire article to know more about this kind of mesothelioma which spreads due to the exposure of asbestos.
What Is Biphasic Mesothelioma?
It's another type of mesothelioma. The name is given 'biphasic' which means tumor has the presence of both epithelial and sarcomatoid cell types. Like all other type of mesothelioma, the disease is caused due to the asbestos exposure for over a period of time.
As far as life expectancy of patients with biphasic mesothelioma is concerned, it varies depending on the ratio of epithelial and sarcomatoid cells.
Larger the percentage of sarcomatoid cells, the poorer the prognosis. The above cell type has most commonly seen among pleural patients as compared to peritonial patients.
Please note that biphasic happens to be the 2nd most common mesothelioma cell type. Take a look at some other type of mesothelioma below:
Epithelial mesothelioma: It's also known as epithelioid which happens to be the most common type and also the easiest one to treat.
Sarcomatoid mesothelioma generally amounts up to 20% of mesothelioma cases and is found to be more resistant to the treatment given.
Biphasic mesothelioma prognosis and life expectancy mainly depends on the ratio of epithelial and sarcomatoid cells.
It's better for you to understand the diagnosis and characteristics of this mesothelioma type to get the better understanding of the disease. This will also help you well informed about different line of treatment adopted by the doctor. The study of all the above cell types is called mesothelioma histology.
Characteristics of Biphasic Mesothelioma
The very basic fact about biphasic mesothelioma is that here both epithelioid and sarcomatoid cells can be seen existing close together. Not only that they also sometimes appear within separate areas of the tumor.
For example, areas of epithelial cells are generally composed of solid and tubopapillary cells (epithelial subtypes). They can be seen lying scattered among sarcomatoid cells. Another fact to note down is that in biphasic mesothelioma, both epithelial and sarcomatoid cells ratio can vary greatly.
Cell Behavior and Prevalence
If you go by the incidence rate, it can show up to 30% of pleural mesothelioma tumors and up to 25% of peritoneal tumors are known as biphasic types.
There are pathologists who always advocate of sampling more mesothelioma tumors as it will give them precise information regarding the cell prevalence of biphasic mesothelioma. They also believe that prevalence of such type of tumors would be higher if more samples are tested.
Pathologists are known to be the experts in pathology where a diseased tissue is studied so as to know the diagnosis of various conditions including cancer.
In addition to this, the cell behavior of biphasic mesothelioma also depends on the more prevalent cell types out of the two.
Diagnosing the Biphasic Cell Type
In simple words, the biphasic cell type is quite difficult to diagnose and detect.
As per a clinical research conducted in the year 2021, it was highlighted that membranous HEG1 staining had specificity up to 92.3% to separate biphasic mesothelioma from all other carcinomas.
In detecting mesothelioma, cell types play a vital role. Detection of cell type at the time of diagnosing mesothelioma becomes crucial in most circumstances. It’s mainly because there are some treatments and clinical trials available that target specific cell types.
Please note that the characteristics of a particular cell type don't affect symptoms. But in any case, they may largely affect life expectancy. It came to light as per a study conducted in the year 2017 which was published in Lung Cancer International.
s far as survival rate is concerned, epithelial mesothelioma patients can survive up to 200 days longer as compared to other cell types.
In detecting any type of tumor, doctors have to undergo biopsy where a small sample of tissue is taken to test it in the lab.
While taking such a sample from one particular location offers a limited view of the amount and type of mesothelioma cells involved.
This is why it becomes easier for physicians to make more accurate mesothelioma diagnosis by taking tissue sample from several parts of a tumor. And so, cell type determination plays a crucial role as can directly affect prognosis and treatment options.
How to Prevent a Misdiagnosis?
Out of the various tests, doctors recommend immunohistochemistry to mainly distinguish biphasic mesothelioma from other conditions that are generally confused with this type of cancer.
Using immunohistochemistry can detect certain proteins that help to reveal certain types of abnormal cells.
As per a fact, the diagnosis becomes harder in cases of biphasic mesothelioma as both epithelioid and sarcomatoid cells must be detected.
With all the above options, doctors can simply rule out the probability of common misdiagnosis that sometimes include the presence of carcinosarcoma anbd synovial sarcoma.
Biphasic Mesothelioma Treatment
Biphasic mesothelioma patients are not recommended to be considered for an aggressive treatment plan as compared to patients with epithelioid type.
It’s due to the fact that biphasic cell type generally carries a poorer prognosis as compared to epithelioid. However, treatment doesn't completely rely on cell type.
There are patients who undergo these therapies:
The line of treatment generally depends on the stage and location of the tumor as compared to the cell type involved.
Today, loads of clinical trials are being done to test new drugs and therapies mainly for mesothelioma patients having biphasic or sarcomatoid tumors.
Biphasic Prognosis and Life Expectancy
Please note that the prognosis for biphasic mesothelioma varies mainly depending on the ratio of epithelial and sarcomatoid cells.
As per facts, the more epithelial cells a patient has in the biphasic mix, the better will be the prognosis.
As per the results by various researchers in this regard, biphasic patients have slightly better survival rates as compared to epithelial cell types. The third cell type involves sarcomatoid cell type which has the lowest survival rates.
It has been observed that sarcomatoid cells are less responsive to the line of treatment as compared to epithelial cells.
Another factor that contributes poor prognosis of biphasic mesothelioma is that sarcomatoid cells are observed to move faster than epithelial cells.
Biphasic tumors having a high amount of sarcomatoid cells generally spreads faster and therefore results in lesser life expectancy.