Abstract
The PRIMATE study is an Italian translational research project, which aims to identify personalized biomarkers associated with clinical characteristics of malignant pleural mesothelioma (MPM). For this purpose, characteristics of MPM patients with different degrees of asbestos exposure will be compared to identify somatic mutations, germline polymorphism, and blood inflammatory biomarkers. In this framework, we assessed exposure to asbestos for 562 cases of MPM extracted from the Lombardy region Mesothelioma Registry (RML), for which a complete interview based on a standardized national questionnaire and histopathological specimens were available. Exposure assessment was performed: (1) through experts' evaluation (considered as the gold standard for the purpose of this study), according to the guidelines of the Italian National Mesothelioma Registry (ReNaM) and (2) using a job-exposure matrix (SYN-JEM) to obtain qualitative (ever/never) and quantitative estimates of occupational asbestos exposure (cumulative exposure expressed in fibers per mL (f/mL)). The performance of SYN-JEM was evaluated against the experts' evaluation. According to experts' evaluation, occupational asbestos exposure was recognized in 73.6% of men and 23.6% of women; furthermore, 29 men (7.8%) and 70 women (36.9%) had non-occupational exposure to asbestos. When applying SYN-JEM, 225 men (60.5%) and 25 women (13.2%) were classified as occupationally exposed, with a median cumulative exposure higher for men (1.7 f/mL-years) than for women (1.2 f/mL-years). The concordance between the two methods (Cohen’s kappa) for occupational exposure assessment was 0.46 overall (0.41 in men, and 0.07 in women). Sensitivity was higher in men (0.73) than in women (0.18), while specificity was higher in women (0.88) than in men (0.74). Overall, both methods can be used to reconstruct past occupational exposure to asbestos, each with its own advantages and limitations.
Highlights
The term “Asbestos” refers to a group of silicate minerals classified into two mineralogical groups: serpentine mineral and amphiboles [1]
This study aims to conduct a retrospective exposure assessment for a group of residents in Lombardy who were diagnosed with malignant pleural mesothelioma (MPM) and enrolled in the "PRIMATE" project (“An integrated precision medicine approach to malignant mesothelioma: from mutation load to epidemiology and therapy”), within which this study was conducted
Sensitivity was higher with expert-based assessment (RML) based on the national mesothelioma registry (ReNaM) guidein men (0.73) than in women (0.18), while specificity was higher in women (0.88) than line, PRIMATE study, Lombardy, Italy, 2000–2019
Summary
This study aims to conduct a retrospective exposure assessment for a group of residents in
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