title: Changes of mesothelin and osteopontin levels over time in formerly asbestos-exposed power industry workers.
abstract: OBJECTIVE
  In patients developing malignant pleural mesothelioma (MPM) or lung cancer, using effective tumour markers is the quickest way to ensure early diagnosis and improve survival time. The aim of our study was to assess the influence of age and asbestos exposure on the blood levels of the proposed tumour markers, mesothelin and osteopontin, and to determine the change of these markers over time.
  
  
  METHODS
  We analysed 3,329 blood samples of 2,262 participants including 1,894 formerly asbestos-exposed power industry workers, a mixed group of 266 participants with an unknown history of asbestos exposure and a group of 102 non-asbestos-exposed controls. Marker concentrations were determined using commercial ELISA kits.
  
  
  RESULTS
  While age had a strong influence on marker levels, there was no association between exposure duration or benign asbestos-related disease and marker levels. In order to assess the maximum increase that can be expected to occur in asbestos-exposed workers those with an at least 10 % increase were selected (n = 290 for mesothelin and n = 81 for osteopontin). The 95th percentile of the annual change was 0.402 nmol/l for mesothelin and 334 ng/ml for osteopontin. In two patients with MPM and five with lung cancer, we could obtain more than one marker result before the diagnosis was made. Both MPM patients showed a steep increase of mesothelin levels.
  
  
  CONCLUSIONS
  Fixed cut-off values for deciding between intensive clinical work-up and continued surveillance appeared inadequate for the evaluated markers. While general conclusions cannot be drawn, we can say that the results of the two patients would be consistent with a mesothelin increase between 6 and 18 months before clinical symptoms developed.
authors: Medical Faculty, Institute of Occupational and Social Medicine, RWTH Aachen University, Pauwelsstr. 30, 52074, Aachen, Germany, mfelten@ukaachen.de.
authors: Michael K
authors: MK
authors: Felten
authors: Khaled
authors: K
authors: Khatab
authors: Lars
authors: L
authors: Knoll
authors: Thomas
authors: T
authors: Schettgen
authors: Hendrik
authors: H
authors: Müller-Berndorff
authors: Thomas
authors: T
authors: Kraus
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000097:blood*; D001194:Asbestos / Q000009:adverse effects*; D014408:Biomarkers, Tumor / Q000097:blood*; D016022:Case-Control Studies; D055088:Early Detection of Cancer; D005260:Female; D058851:GPI-Linked Proteins / Q000097:blood*; D006801:Humans; D008137:Longitudinal Studies; D008175:Lung Neoplasms / Q000097:blood* / Q000175:diagnosis / Q000209:etiology; D008297:Male; D000090204:Mesothelin; D008654:Mesothelioma / Q000097:blood* / Q000175:diagnosis / Q000209:etiology; D008875:Middle Aged; D016273:Occupational Exposure / Q000009:adverse effects*; D053495:Osteopontin / Q000097:blood*; D010997:Pleural Neoplasms / Q000097:blood* / Q000175:diagnosis / Q000209:etiology; D011210:Power Plants; D013997:Time Factors
chemical_list: D014408:Biomarkers, Tumor; D058851:GPI-Linked Proteins; D053495:Osteopontin; D001194:Asbestos; D000090204:Mesothelin