title: Individual predictors of increased serum mesothelin in asbestos-exposed workers.
abstract: The soluble mesothelin-related peptide (SMRP), a candidate marker for screening of subjects with asbestos exposure, is influenced by some individual and clinical factors. The aim of this study was to quantify the role of age, smoking, weight, presence of diseases and exposure to asbestos on serum SMRP levels in a large series of subjects exposed to asbestos, possible candidates for mesothelioma screening. One thousand seven hundred and four participants underwent clinical examination and were interviewed on medical anamnesis, occupation, smoking and weight. SMRP was measured by an ELISA assay. Overall, median SMRP was 0.4 (IQR 25-75: 0.3-0.7) nmol/l. It was higher in current smokers and in subjects with a cumulative asbestos exposure >50 ff/cc/years than in all the other subjects (p < 0.001 and p = 0.002, respectively). SMRP was positively correlated with age (ρ = 0.11, p < 0.001) and, inversely, with BMI (ρ = -0.15, p < 0.001). SMRP was lower in healthy subjects (n = 1,217: median 0.4 nmol/l) than in subjects with malignant tumors (n = 118: 0.5 nmol/l; p = 0.01), asbestos-related pleural lesions (plaques or thickenings, n = 152: 0.6 nmol/l; p < 0.001) and other benign diseases (n = 182: 0.5 nmol/l; p = 0.04). Multivariate analysis revealed significant predictors of increased SMRP: age >57 years, current smoking, a positive anamnesis for cancer and for asbestos-related pleural lesions, and BMI < 25. Some clinical and demographic variables are associated with serum SMRP levels. The degree of these associations is low, nevertheless they should be accounted for in the interpretation of SMPR as a candidate marker predictive of mesothelioma. The potential predictive value of serum SMRP in screening/surveillance programs must be validated in prospective studies.
authors.affiliation: Epidemiology, Biostatistics and Clinical Trials, IRCCS AOU San Martino-IST - Istituto Nazionale per la Ricerca sul Cancro, Largo Rosanna Benzi, 10, 16132 Genoa, Italy. rosangela.filiberti@istge.it
authors.forename: Rosa
authors.initials: R
authors.lastname: Filiberti
authors.forename: Paola
authors.initials: P
authors.lastname: Marroni
authors.forename: Manlio
authors.initials: M
authors.lastname: Mencoboni
authors.forename: Virginia
authors.initials: V
authors.lastname: Mortara
authors.forename: Pietro
authors.initials: P
authors.lastname: Caruso
authors.forename: Alex
authors.initials: A
authors.lastname: Cioè
authors.forename: Luigi
authors.initials: L
authors.lastname: Michelazzi
authors.forename: Domenico F
authors.initials: DF
authors.lastname: Merlo
authors.forename: Andrea
authors.initials: A
authors.lastname: Bruzzone
authors.forename: Barbara
authors.initials: B
authors.lastname: Bobbio
authors.forename: Lisette
authors.initials: L
authors.lastname: Del Corso
authors.forename: Roberto
authors.initials: R
authors.lastname: Galli
authors.forename: Paola
authors.initials: P
authors.lastname: Taveggia
authors.forename: Guglielmo
authors.initials: G
authors.lastname: Dini
authors.forename: Fabio
authors.initials: F
authors.lastname: Spigno
mesh_terms: D000368:Aged; D001194:Asbestos / Q000009:adverse effects; D014408:Biomarkers, Tumor / Q000097:blood*; D055088:Early Detection of Cancer / Q000379:methods*; D004797:Enzyme-Linked Immunosorbent Assay; D058851:GPI-Linked Proteins / Q000097:blood*; D006801:Humans; D008297:Male; D000090204:Mesothelin; D008654:Mesothelioma / Q000097:blood / Q000175:diagnosis*; D008875:Middle Aged; D016273:Occupational Exposure / Q000009:adverse effects; D012907:Smoking
chemical_list: D014408:Biomarkers, Tumor; D058851:GPI-Linked Proteins; D001194:Asbestos; D000090204:Mesothelin