CCL2, galectin-3, and SMRP combination improves the diagnosis of mesothelioma in pleural effusions.
BACKGROUND
Malignant pleural mesothelioma (MPM) is a highly aggressive tumor with poor prognosis. One major challenge for this disease is the development of new, early, and highly reliable diagnostic markers. The aim of this study was to compare the diagnostic value of the chemokine chemokine (C-C motif) ligand 2 (CCL2), galectin-3, and the secretory leukocyte peptidase inhibitor (SLPI) with soluble mesothelin-related peptides (SMRP), and to evaluate the diagnostic performance of marker combinations.


METHODS
The levels of the different markers were measured by enzyme-linked immunosorbent assay in pleural fluids from patients with MPM (n = 61), adenocarcinomas (ADCA, n = 25), or with benign pleural effusions (BPE, n = 15).


RESULTS
SMRP, SLPI, and CCL2 concentrations were significantly higher in pleural effusions from mesothelioma patients. Conversely, galectin-3 levels seemed to be elevated in patients with pulmonary ADCA. Receiver operating characteristic curve analysis revealed that SMRP (area under the curve [AUC] = 0.9059), CCL2 (AUC = 0.7912), galectin-3 (AUC = 0.7584), and SLPI (AUC = 0.7219) were potentially interesting biomarkers for the differentiation of MPM patients from those with BPE or ADCA. Of interest, we showed that the combination of SMRP/CCL2/galectin-3 greatly improved MPM diagnosis (AUC = 0.9680), when compared with SMRP alone.


CONCLUSIONS
The combination of SMRP/CCL2/galectin-3 seems to represent a promising panel of biomarkers for the reliable diagnosis of MPM in pleural fluids.
INSERM, U892, Institut de Recherche Thérapeutique Université de Nantes, Centre de Recherche en Cancérologie Nantes-Angers, Nantes, France.
Christophe
C
Blanquart
Fabien
F
Gueugnon
Jean-Michel
JM
Nguyen
David
D
Roulois
Laurent
L
Cellerin
Christine
C
Sagan
Christian
C
Perigaud
Arnaud
A
Scherpereel
Marc
M
Gregoire
D000230:Adenocarcinoma / Q000175:diagnosis* / Q000378:metabolism; D000368:Aged; D019540:Area Under Curve; D014408:Biomarkers, Tumor / Q000378:metabolism; D018932:Chemokine CCL2 / Q000378:metabolism*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D037502:Galectin 3 / Q000378:metabolism*; D006801:Humans; D008297:Male; D008565:Membrane Proteins / Q000378:metabolism*; D008654:Mesothelioma / Q000175:diagnosis* / Q000378:metabolism; D027425:ATP-Binding Cassette, Sub-Family C Proteins / Q000378:metabolism*; D009419:Nerve Tissue Proteins; D010996:Pleural Effusion / Q000175:diagnosis* / Q000378:metabolism; D011379:Prognosis; D012372:ROC Curve; D012680:Sensitivity and Specificity
D014408:Biomarkers, Tumor; D018932:Chemokine CCL2; D037502:Galectin 3; D008565:Membrane Proteins; D027425:ATP-Binding Cassette, Sub-Family C Proteins; D009419:Nerve Tissue Proteins; C120809:ABCC5 protein, human; C111835:CCL2 protein, human; C117201:STOML1 protein, human