Soluble mesothelin-related peptides in the diagnosis of malignant pleural mesothelioma

Am J Respir Crit Care Med. 2006 May 15;173(10):1155-60. doi: 10.1164/rccm.200511-1789OC. Epub 2006 Feb 2.

Abstract

Background: Diagnosis of malignant pleural mesothelioma is a challenging issue. Potential markers in mesothelioma diagnosis include soluble mesothelin-related peptides (SMRPs) and osteopontin, but no subsequent validation has been published yet.

Methods: We prospectively evaluated SMRPs in serum and pleural effusion from patients with mesothelioma (n = 74), pleural metastasis of carcinomas (n = 35), or benign pleural lesions associated with asbestos exposure (n = 28), recruited when first suspected for mesothelioma.

Findings: Mean serum SMRP level was higher in patients with mesothelioma (2.05 +/- 2.57 nM/L [median +/- interquartile range]) than in patients with metastasis (1.02 +/- 1.79 nM/L) or benign lesions (0.55 +/- 0.59 nM/L). The area under the receiver operating characteristic curve (AUC) for serum SMRP was 0.872 for differentiating mesothelioma and benign lesions, cut-off = 0.93 nM/L (sensitivity = 80%, specificity = 82.6%). The AUC for serum SMRP differentiating metastasis and mesothelioma was 0.693, cut-off = 1.85 nM/L (sensitivity = 58.3%, specificity = 73.3%). SMRP values in pleural fluid were higher than in serum in all groups (mesothelioma: 46.1 +/- 83.2 nM/L; benign lesions: 6.4 +/- 11.1 nM/L; metastasis: 6.36 +/- 21.73 nM/L). The AUC for pleural SMRP-differentiating benign lesions and mesothelioma was 0.831, cut-off = 10.4 nM/L (sensitivity = 76.7%, specificity = 76.2%). The AUC for pleural SMRP-differentiating metastasis and mesothelioma was 0.793.

Interpretation: We show that SMRPs may be a promising marker for mesothelioma diagnosis when measured either in serum or pleural fluid. The diagnostic value of SMRPs was similar in both types of samples, but pleural fluid SMRPs may better discriminate mesothelioma from pleural metastasis.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Analysis of Variance
  • Area Under Curve
  • Asbestosis / metabolism
  • Asbestosis / mortality
  • Asbestosis / pathology*
  • Biomarkers, Tumor / analysis
  • Diagnosis, Differential
  • Disease Progression
  • Female
  • GPI-Linked Proteins
  • Humans
  • Male
  • Membrane Glycoproteins / analysis
  • Membrane Glycoproteins / metabolism*
  • Mesothelioma / blood
  • Mesothelioma / mortality
  • Mesothelioma / pathology*
  • Middle Aged
  • Neoplasm Staging
  • Osteopontin
  • Pleural Effusion, Malignant / diagnosis*
  • Pleural Effusion, Malignant / metabolism
  • Pleural Effusion, Malignant / mortality
  • Pleural Neoplasms / blood
  • Pleural Neoplasms / mortality
  • Pleural Neoplasms / pathology*
  • Prognosis
  • Prospective Studies
  • Sensitivity and Specificity
  • Sialoglycoproteins / metabolism*
  • Solubility
  • Survival Analysis

Substances

  • Biomarkers, Tumor
  • GPI-Linked Proteins
  • Membrane Glycoproteins
  • SPP1 protein, human
  • Sialoglycoproteins
  • Osteopontin
  • mesothelin