title: Markers for the non-invasive diagnosis of mesothelioma: a systematic review.
abstract: BACKGROUND
  Numerous markers have been evaluated to facilitate the non-invasive diagnostic work-up of mesothelioma. The purpose of this study was to conduct a structured review of the diagnostic performance of non-invasive marker tests for the detection of mesothelioma in patients with suspected mesothelioma.
  
  
  METHODS
  Studies on the diagnostic accuracy of serum and cytological markers published till 31 December 2009, available in either PUBMED or Embase, to detect or exclude the presence of mesothelioma were extracted. Study quality was assessed with use of the Quadas criteria.
  
  
  RESULTS
  In total, 82 articles were included in this systemic review. Overall, quality of the incorporated studies to address our objective was poor. The most frequently studied immunohistochemical markers for cytological analysis were EMA, Ber-Ep4, CEA, and calretinin. The most frequently investigated serum marker was soluble mesothelin-related protein (SMRP). The markers CEA, Ber-EP4, and calretinin were most valuable in discriminating mesothelioma from other malignant diseases. Markers EMA and SMRP were most valuable in discriminating mesothelioma from non-malignant diseases. No marker performed well in discriminating between mesothelioma and all other diseases.
  
  
  CONCLUSIONS
  Currently, there is only limited evidence to properly assess the value of non-invasive marker tests in the diagnosis of mesothelioma. Studies were of limited value to address our objective and results showed considerable unexplained study heterogeneity.
authors: Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Stratenum 6.131, PO Box 85500, 3508 GA Utrecht, The Netherlands. s.vanderbij@umcutrecht.nl
authors: S
authors: S
authors: van der Bij
authors: E
authors: E
authors: Schaake
authors: H
authors: H
authors: Koffijberg
authors: J A
authors: JA
authors: Burgers
authors: B A J M
authors: BA
authors: de Mol
authors: K G M
authors: KG
authors: Moons
mesh_terms: D000465:Algorithms; D014408:Biomarkers, Tumor / Q000032:analysis* / Q000097:blood / Q000378:metabolism; D006801:Humans; D008654:Mesothelioma / Q000097:blood / Q000175:diagnosis* / Q000378:metabolism / Q000473:pathology; D010996:Pleural Effusion / Q000175:diagnosis / Q000473:pathology; D010997:Pleural Neoplasms / Q000097:blood / Q000175:diagnosis* / Q000378:metabolism / Q000473:pathology; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity
chemical_list: D014408:Biomarkers, Tumor