The sensitivity of hyaluronan analysis of pleural fluid from patients with malignant mesothelioma and a comparison of different methods.
BACKGROUND
Hyaluronan may be used as a marker for malignant mesothelioma, thus indicating its mesodermal origin.


METHODS
The sensitivity as a diagnostic test of three different methods for hyaluronan analyses of pleural fluid was examined in patients with biopsy-verified malignant pleural mesothelioma.


RESULTS
A quantitative high-performance liquid-chromatography (HPLC) method was performed on fluids from 43 patients. Using a cutoff level of 100 mg/l, higher levels were noted in 30 (70%) patients, with a median value of 220 mg/l (mean, 560 mg/l; range, 20-6600 mg/l). An identical median value (220 mg/l) was obtained with a radioassay method when simultaneously performed on paired samples from 21 patients (correlation coefficient, 0.91). A qualitative precipitation test using 0.5% cetylpyridinium chloride combined with a quantitative viscosimetric method was significantly less sensitive (P < 0.01).


CONCLUSIONS
Hyaluronan analyses is beneficial in distinguishing malignant mesothelioma if methods such as the evaluated HPLC or radioassay with a sensitivity of 70% toward mesothelioma are used and other known causes of elevated content are considered.
Martensson
G
G
Department of Pulmonary Medicine, Renströmska Hospital, University of Göteborg, Sweden.
Thylen
A
A
Lindquist
U
U
Hjerpe
A
A
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001667:Binding, Competitive; D002851:Chromatography, High Pressure Liquid; D005260:Female; D006801:Humans; D006820:Hyaluronic Acid / Q000032:analysis*; D008297:Male; D008654:Mesothelioma / Q000175:diagnosis*; D008875:Middle Aged; D016066:Pleural Effusion, Malignant / Q000737:chemistry*; D010997:Pleural Neoplasms / Q000175:diagnosis*; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D014783:Viscosity
D006820:Hyaluronic Acid