Soluble mesothelin-related protein in an asbestos-exposed population: the dust diseases board cohort study

Am J Respir Crit Care Med. 2008 Oct 15;178(8):832-7. doi: 10.1164/rccm.200802-258OC. Epub 2008 Jun 26.


Rationale: Soluble mesothelin-related protein (SMRP) is raised in epithelial-type malignant mesothelioma (MM), but the utility of SMRP in screening for MM is unknown.

Objectives: We aimed to evaluate SMRP in an asbestos-exposed cohort.

Methods: A total of 538 subjects were studied. Those with elevated SMRP (> or =2.5 nM) underwent further investigation including positron emission tomography/computed tomography.

Measurements and main results: Mean (+/-SD) SMRP in healthy subjects exposed to asbestos (n = 223) was 0.79 (+/-0.45) nM. Fifteen subjects had elevated SMRP, of whom one had lung cancer, which was successfully resected. Another with lung cancer was undetected by SMRP. No subjects were diagnosed with MM. Mean SMRP in healthy subjects was significantly lower than in subjects with pleural plaques alone (P < 0.01).

Conclusions: This is the first large-scale prospective study of SMRP for screening for malignancy in asbestos-exposed individuals. A high false-positive rate was observed. SMRP seems unlikely to prove useful in screening for MM.

Publication types

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

MeSH terms

  • Aged
  • Asbestos / adverse effects*
  • Biomarkers, Tumor / blood
  • Blood Proteins
  • Diagnosis, Differential
  • Enzyme-Linked Immunosorbent Assay
  • Female
  • Follow-Up Studies
  • GPI-Linked Proteins
  • Humans
  • Male
  • Mass Screening / methods
  • Membrane Glycoproteins / biosynthesis*
  • Membrane Glycoproteins / blood
  • Mesothelin
  • Mesothelioma / blood
  • Mesothelioma / diagnosis*
  • Mesothelioma / etiology
  • Middle Aged
  • Occupational Diseases / blood
  • Occupational Diseases / complications
  • Occupational Diseases / diagnosis*
  • Occupational Exposure / adverse effects*
  • Pleural Neoplasms / blood
  • Pleural Neoplasms / diagnosis*
  • Pleural Neoplasms / etiology
  • Positron-Emission Tomography
  • Prospective Studies
  • Tomography, X-Ray Computed


  • Biomarkers, Tumor
  • Blood Proteins
  • GPI-Linked Proteins
  • Membrane Glycoproteins
  • Asbestos
  • Mesothelin