title: Diagnostic performance of soluble mesothelin and megakaryocyte potentiating factor in mesothelioma.
abstract: BACKGROUND
  Soluble mesothelin (SM) is currently the reference serum biomarker of malignant pleural mesothelioma (MPM). Megakaryocyte potentiating factor (MPF), which originates from the same precursor protein, is potentially more sensitive, yet lacks validation.
  
  
  OBJECTIVE
  To analyze the diagnostic performance of MPF as an MPM biomarker and compare this performance with SM.
  
  
  METHODS
  A total of 507 participants were enrolled in six cohorts: healthy control subjects (n = 101), healthy asbestos-exposed individuals (n = 89), and patients with benign asbestos-related disease (n = 123), benign respiratory disease (n = 46), lung cancer (n = 63), and MPM (n = 85). Sera were analyzed for SM and MPF levels using the Mesomark and Human MPF ELISA kit, respectively.
  
  
  RESULTS
  SM and MPF levels differed significantly between patients with MPM and participants from each other cohort (P < 0.001). Receiver operating characteristics curve analysis did not reveal a significant difference between both markers in area under curve (AUC) for distinguishing MPM from all cohorts jointly (SM = 0.871, MPF = 0.849; P = 0.28). At 95% specificity, SM and MPF had a sensitivity of 64% (cutoff = 2.00 nmol/L) and 68% (cutoff = 12.38 ng/ml), respectively. Combining both markers did not improve the diagnostic performance.
  
  
  CONCLUSIONS
  In this prospective multicenter study, MPF is validated as a highly performant MPM biomarker. The similar AUC values of SM and MPF, together with the limited difference in sensitivity, show that both serum biomarkers have an equivalent diagnostic performance.
authors.affiliation: Ghent University Hospital, Department of Respiratory Medicine, Belgium. kevin.hollevoet@ugent.be
authors.forename: Kevin
authors.initials: K
authors.lastname: Hollevoet
authors.forename: Kristiaan
authors.initials: K
authors.lastname: Nackaerts
authors.forename: Joël
authors.initials: J
authors.lastname: Thimpont
authors.forename: Paul
authors.initials: P
authors.lastname: Germonpré
authors.forename: Lionel
authors.initials: L
authors.lastname: Bosquée
authors.forename: Paul
authors.initials: P
authors.lastname: De Vuyst
authors.forename: Catherine
authors.initials: C
authors.lastname: Legrand
authors.forename: Eliane
authors.initials: E
authors.lastname: Kellen
authors.forename: Yoshiro
authors.initials: Y
authors.lastname: Kishi
authors.forename: Joris R
authors.initials: JR
authors.lastname: Delanghe
authors.forename: Jan P
authors.initials: JP
authors.lastname: van Meerbeeck
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019540:Area Under Curve; D014408:Biomarkers, Tumor / Q000097:blood*; D015331:Cohort Studies; D004797:Enzyme-Linked Immunosorbent Assay / Q000379:methods; D005260:Female; D058851:GPI-Linked Proteins; D006801:Humans; D008297:Male; D008562:Membrane Glycoproteins / Q000097:blood*; D000090204:Mesothelin; D008654:Mesothelioma / Q000097:blood* / Q000175:diagnosis*; D008875:Middle Aged; D010997:Pleural Neoplasms / Q000097:blood*; D011446:Prospective Studies; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D055815:Young Adult
chemical_list: D014408:Biomarkers, Tumor; D058851:GPI-Linked Proteins; C000715527:MSLN protein, human; D008562:Membrane Glycoproteins; D000090204:Mesothelin