Sensitive and specific new enzyme-linked immunosorbent assay for N-ERC/mesothelin increases its potential as a useful serum tumor marker for mesothelioma.
BACKGROUND
Because mesothelioma initially progresses on the surface of the pleura and peritoneum without forming masses, it has been difficult to diagnose at an early stage. It would be very useful to identify a tumor marker that could be used for screening to enable more diagnoses to be made at an early, treatable stage.


METHODS
We had previously identified N-ERC/mesothelin as a potential biomarker for mesothelioma. In the current work, we used a newly developed ELISA system to gain data on N-ERC/mesothelin levels in various clinical settings. A total of 102 healthy volunteers were recruited. In addition, 39 patients were diagnosed with mesothelioma, 53 patients were diagnosed with diseases that should be distinguished from mesothelioma, and 201 subjects were diagnosed with asbestos-related nonmalignant diseases (including simple exposure to asbestosis) who were treated at any of the cooperating hospitals were enrolled.


RESULTS
Serum N-ERC/mesothelin levels measured by a new ELISA system showed that the median values from patients with mesothelioma were extremely high compared with levels obtained from other patients. Analysis in terms of histologic type showed that serum levels of N-ERC/mesothelin were elevated in epithelioid type mesothelioma, especially. In four important models of clinical settings, the sensitivity and specificity of N-ERC/mesothelin were about 71% to 90% and 88% to 93%, respectively.


CONCLUSIONS
N-ERC/mesothelin is a very promising tumor marker for mesothelioma, especially epithelioid mesothelioma.
Shiomi
Kazu
K
Department of General Thoracic Surgery, Respiratory Medicine, Human Pathology, Juntendo University, School of Medicine, Tokyo, Japan.
Hagiwara
Yoshiaki
Y
Sonoue
Kouji
K
Segawa
Tatsuya
T
Miyashita
Kazuya
K
Maeda
Masahiro
M
Izumi
Hiroshi
H
Masuda
Kimihiko
K
Hirabayashi
Masataka
M
Moroboshi
Takao
T
Yoshiyama
Takashi
T
Ishida
Atsuko
A
Natori
Yuji
Y
Inoue
Akira
A
Kobayashi
Masashi
M
Sakao
Yukinori
Y
Miyamoto
Hideaki
H
Takahashi
Kazuhisa
K
Hino
Okio
O
D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D000911:Antibodies, Monoclonal / Q000276:immunology; D001194:Asbestos; D001195:Asbestosis / Q000097:blood / Q000175:diagnosis; D014408:Biomarkers, Tumor / Q000097:blood*; D015153:Blotting, Western; D016466:CHO Cells; D016022:Case-Control Studies; D002478:Cells, Cultured; D006224:Cricetinae; D003412:Cricetulus; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D058851:GPI-Linked Proteins; D006801:Humans; D008175:Lung Neoplasms / Q000097:blood / Q000175:diagnosis; D008297:Male; D008562:Membrane Glycoproteins / Q000097:blood*; D000090204:Mesothelin; D008654:Mesothelioma / Q000097:blood* / Q000175:diagnosis; D051379:Mice; D008875:Middle Aged; D010997:Pleural Neoplasms / Q000097:blood / Q000175:diagnosis; D012680:Sensitivity and Specificity
D000911:Antibodies, Monoclonal; D014408:Biomarkers, Tumor; D058851:GPI-Linked Proteins; D008562:Membrane Glycoproteins; C000715528:Msln protein, mouse; D001194:Asbestos; D000090204:Mesothelin