Moving Beyond Morphology: Toward a Morpho‑Molecular Classification of Pleural Mesothelioma
This review summarizes recent major molecular findings relating not only to histology but also ploidy, tumor microenvironment, and methylation— which together offer a more comprehensive understanding of inter‑patient heterogeneity.
The article reviews advances in the molecular characterization of pleural mesothelioma, highlighting how genomics, epigenomics, transcriptomics, and tumor‑microenvironment analyses reveal a four‑axis model that surpasses traditional morphology‑based classification. It discusses key somatic alterations (BAP1, CDKN2A‑MTAP, NF2), copy‑number changes, whole‑genome duplication, and epigenetic signatures such as CIMP, as well as immune–microenvironment states that collectively inform prognosis and therapeutic strategy.
Improved morpho‑molecular classification could enhance diagnostic accuracy, refine prognostication, and guide targeted and immunotherapeutic approaches, thereby addressing the heterogeneity that limits current pleural mesothelioma management.
Evidence level: Korai humán adat. Kis vagy feltáró emberi adat.
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