Soluble mesothelin-related peptides in the diagnosis of malignant pleural mesothelioma.
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.
Scherpereel
Arnaud
A
INSERM Unit 774, Institut Pasteur de Lille, 59037 Lille Cedex, France. a-scherpereel@chru-lille.fr
Grigoriu
Bogdan
B
Conti
Massimo
M
Gey
Thomas
T
Grégoire
Marc
M
Copin
Marie-Christine
MC
Devos
Patrick
P
Chahine
Bachar
B
Porte
Henri
H
Lassalle
Philippe
P
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
D014408:Biomarkers, Tumor; D058851:GPI-Linked Proteins; D008562:Membrane Glycoproteins; C506895:SPP1 protein, human; D012795:Sialoglycoproteins; D053495:Osteopontin; D000090204:Mesothelin