title: Soluble mesothelin-related peptides in the diagnosis of malignant pleural mesothelioma.
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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: INSERM Unit 774, Institut Pasteur de Lille, 59037 Lille Cedex, France. a-scherpereel@chru-lille.fr
authors.forename: Arnaud
authors.initials: A
authors.lastname: Scherpereel
authors.forename: Bogdan
authors.initials: B
authors.lastname: Grigoriu
authors.forename: Massimo
authors.initials: M
authors.lastname: Conti
authors.forename: Thomas
authors.initials: T
authors.lastname: Gey
authors.forename: Marc
authors.initials: M
authors.lastname: Grégoire
authors.forename: Marie-Christine
authors.initials: MC
authors.lastname: Copin
authors.forename: Patrick
authors.initials: P
authors.lastname: Devos
authors.forename: Bachar
authors.initials: B
authors.lastname: Chahine
authors.forename: Henri
authors.initials: H
authors.lastname: Porte
authors.forename: Philippe
authors.initials: P
authors.lastname: Lassalle
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D019540:Area Under Curve; D001195:Asbestosis / Q000378:metabolism / Q000401:mortality / Q000473:pathology*; D014408:Biomarkers, Tumor / Q000032:analysis; D003937:Diagnosis, Differential; D018450:Disease Progression; D005260:Female; D058851:GPI-Linked Proteins; D006801:Humans; D008297:Male; D008562:Membrane Glycoproteins / Q000032:analysis / Q000378:metabolism*; D000090204:Mesothelin; D008654:Mesothelioma / Q000097:blood / Q000401:mortality / Q000473:pathology*; D008875:Middle Aged; D009367:Neoplasm Staging; D053495:Osteopontin; D016066:Pleural Effusion, Malignant / Q000175:diagnosis* / Q000378:metabolism / Q000401:mortality; D010997:Pleural Neoplasms / Q000097:blood / Q000401:mortality / Q000473:pathology*; D011379:Prognosis; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D012795:Sialoglycoproteins / Q000378:metabolism*; D012995:Solubility; D016019:Survival Analysis
chemical_list: D014408:Biomarkers, Tumor; D058851:GPI-Linked Proteins; D008562:Membrane Glycoproteins; C506895:SPP1 protein, human; D012795:Sialoglycoproteins; D053495:Osteopontin; D000090204:Mesothelin