title: Clinical significance of serum mesothelin in patients with mesothelioma and lung cancer.
abstract: OBJECTIVE
  High levels of serum-soluble mesothelin family proteins (SMRP) have been found to be associated with malignant mesothelioma (MM), but not lung cancer (LC). To verify the clinical role of this marker for both these tumors, we tested serum SMRP in the largest population of thoracic cancers ever assembled.
  
  
  METHODS
  SMRP blood concentrations were measured in 107 patients with MM, 215 patients with LC, 130 patients with benign respiratory diseases (BRD), and 262 controls. Statistical comparison between mean serum SMRP levels in all groups was done and receiver operating characteristic curves were constructed to evaluate the performance of this marker.
  
  
  RESULTS
  SMRP levels were significantly higher in patients with MM and LC than in patients with benign respiratory diseases and controls (P < 0.001). The area under the receiver operating characteristic curve for serum SMRP discriminating MM and controls was 0.77 (95% confidence interval, 0.71-0.83), with a best cutoff of 1.00 nmol/L (sensitivity, 68.2%; specificity, 80.5%). In both MM and LC, serum SMRP levels did not differ significantly between early and late stages. High SMRP levels proved to be an independent negative prognostic factor in patients with MM.
  
  
  CONCLUSIONS
  Our data confirm that serum SMRP is a promising marker for the diagnosis, prognosis, and clinical monitoring of MM. We found that serum SMRP dosage may prove helpful in LC diagnosis as well. These data may also have positive repercussions on secondary preventive medical strategies for workers previously exposed to asbestos.
authors.affiliation: Department of Endocrinology and Metabolism, University of Pisa, Pisa, Italy. a.cristaudo@med.unipi.it
authors.forename: Alfonso
authors.initials: A
authors.lastname: Cristaudo
authors.forename: Rudy
authors.initials: R
authors.lastname: Foddis
authors.forename: Agnese
authors.initials: A
authors.lastname: Vivaldi
authors.forename: Giovanni
authors.initials: G
authors.lastname: Guglielmi
authors.forename: Nicola
authors.initials: N
authors.lastname: Dipalma
authors.forename: Rosangela
authors.initials: R
authors.lastname: Filiberti
authors.forename: Monica
authors.initials: M
authors.lastname: Neri
authors.forename: Marcello
authors.initials: M
authors.lastname: Ceppi
authors.forename: Michela
authors.initials: M
authors.lastname: Paganuzzi
authors.forename: Gian Paolo
authors.initials: GP
authors.lastname: Ivaldi
authors.forename: Manlio
authors.initials: M
authors.lastname: Mencoboni
authors.forename: Pier Aldo
authors.initials: PA
authors.lastname: Canessa
authors.forename: Nicolino
authors.initials: N
authors.lastname: Ambrosino
authors.forename: Antonio
authors.initials: A
authors.lastname: Chella
authors.forename: Luciano
authors.initials: L
authors.lastname: Mutti
authors.forename: Riccardo
authors.initials: R
authors.lastname: Puntoni
mesh_terms: D000368:Aged; D005260:Female; D058851:GPI-Linked Proteins; D006801:Humans; D008175:Lung Neoplasms / Q000097:blood* / Q000401:mortality; D008297:Male; D008562:Membrane Glycoproteins / Q000097:blood*; D000090204:Mesothelin; D008654:Mesothelioma / Q000097:blood* / Q000401:mortality; D008875:Middle Aged; D011379:Prognosis; D012140:Respiratory Tract Diseases / Q000097:blood