Pleural fluid mesothelin for the differential diagnosis of exudative pleural effusions.
BACKGROUND
Malignant mesothelioma (MM) is a highly aggressive tumor that can be difficult to diagnose, resulting in a delayed diagnosis in some cases. Recent studies have reported that determination of soluble mesothelin-related peptides (SMRP) in pleural fluid may be a promising marker for use in the diagnosis of MM.


METHODS
Pleural fluid SMRP concentration was measured in 68 patients: 47 had malignant pleural effusions (18 MM and 29 metastatic effusion) and 21 had benign pleural effusion (8 infectious disease and 13 idiopathic effusion). Mann-Whitney analysis was used to compare SMRP values according to the etiology of the effusion.


RESULTS
Pleural fluid SMRP concentration was significantly higher in patients with malignant pleural effusion than in those with benign effusion (P=0.02). When malignant pleural effusions were analyzed separately, MM patients had the highest median pleural fluid SMRP concentration, with significant differences as compared to patients with idiopathic pleural effusion.


CONCLUSIONS
Soluble mesothelin-related peptide measurement in pleural fluid may aid in the diagnosis of patients presenting with pleural effusion.
Department of Internal Medicine, Vall d'Hebron University Hospital, Barcelona, Spain. 29261cal@comb.es
Carmen
C
Alemán
José
J
Manuel Porcel
Rosa
R
Ma Segura
José
J
Alegre
Aureli
A
Esquerda
Eva
E
Ruiz
Silvia
S
Bielsa
Tomás Fernández
TF
de Sevilla
D000230:Adenocarcinoma / Q000175:diagnosis*; D015415:Biomarkers; D001943:Breast Neoplasms / Q000175:diagnosis*; D018288:Carcinoma, Small Cell / Q000175:diagnosis*; D003937:Diagnosis, Differential; D005260:Female; D058851:GPI-Linked Proteins; D019337:Hematologic Neoplasms / Q000175:diagnosis*; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis*; D008297:Male; D008562:Membrane Glycoproteins / Q000032:analysis* / Q000378:metabolism; D000090204:Mesothelin; D008654:Mesothelioma / Q000175:diagnosis*; D010051:Ovarian Neoplasms / Q000175:diagnosis*; D010190:Pancreatic Neoplasms / Q000175:diagnosis*; D010996:Pleural Effusion / Q000175:diagnosis* / Q000378:metabolism; D016066:Pleural Effusion, Malignant / Q000175:diagnosis* / Q000378:metabolism; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D018709:Statistics, Nonparametric
D015415:Biomarkers; D058851:GPI-Linked Proteins; D008562:Membrane Glycoproteins; D000090204:Mesothelin