Soluble mesothelin-related peptide level elevation in mesothelioma serum and pleural effusions

Ann Thorac Surg. 2008 Jan;85(1):265-72; discussion 272. doi: 10.1016/j.athoracsur.2007.07.042.

Abstract

Background: Soluble mesothelin-related peptide (SMRP) is a potential marker for malignant pleural mesothelioma (MPM), which may be useful for screening high-risk asbestos-exposed individuals.

Methods: We evaluated SMRP in serum from MPM patients (n = 90), lung cancer patients (n = 170), age and tobacco-matched asbestos-exposed individuals (n = 66), and in MPM pleural effusions (n = 45), benign effusions (n = 30), and non-MPM effusions (n = 20) using the MesoMark enzyme-linked immunosorbent assay kit (Fujirebio Diagnostics, Malvern, PA). Receiver operating characteristic (ROC) curves were used to define true and false positive rates at various cutoffs.

Results: Mean serum SMRP levels were higher in MPM compared with lung cancer (5.67 +/- 0.82 nM [mean +/- standard error of the mean vs 1.99 +/- 0.43 nM, p < 0.001), and stage I MPM SMRP levels (n = 12; 2.09 +/- 0.41 nM) were significantly higher than those in asbestos-exposed individuals (0.99 +/- 0.09 nM, p = 0.02, respectively). Stage 2 to 4 SMRP serum levels were significantly higher than those for stage 1 MPM. The area under the ROC curve for serum SMRP was 0.81 for differentiating MPM and asbestos-exposed individuals; cutoff = 1.9 nM (sensitivity = 60%, specificity = 89%). The MPM pleural effusion SMRP was significantly higher than benign or other non-MPM pleural effusions (65.57 +/- 11.33 nM vs 27.46 +/- 11.25 nM [p = 0.003] and 18.99 +/- 7.48 nM [p = 0.044], respectively).

Conclusions: These data support SMRP as a promising marker for MPM in both serum and pleural effusion fluid, and justify prospective screening studies of SMRP in combination with other markers for screening of asbestos-exposed cohorts.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Analysis of Variance
  • Area Under Curve
  • Asbestosis / blood
  • Asbestosis / complications
  • Asbestosis / mortality
  • Asbestosis / pathology
  • Biomarkers, Tumor / blood*
  • Case-Control Studies
  • Female
  • GPI-Linked Proteins
  • Humans
  • Immunohistochemistry
  • Male
  • Membrane Glycoproteins / blood*
  • Mesothelioma / blood*
  • Mesothelioma / complications
  • Mesothelioma / mortality
  • Mesothelioma / pathology
  • Middle Aged
  • Neoplasm Staging
  • Pleural Effusion, Malignant / blood*
  • Pleural Effusion, Malignant / etiology
  • Pleural Neoplasms / blood*
  • Pleural Neoplasms / complications
  • Pleural Neoplasms / mortality
  • Pleural Neoplasms / pathology
  • Prognosis
  • ROC Curve
  • Retrospective Studies
  • Risk Assessment
  • Sensitivity and Specificity
  • Survival Analysis

Substances

  • Biomarkers, Tumor
  • GPI-Linked Proteins
  • Membrane Glycoproteins
  • mesothelin