title: The N-ERC index is a novel monitoring and prognostic marker for advanced malignant pleural mesothelioma.
abstract: BACKGROUND
  Although N-ERC/mesothelin (N-ERC) is an attractive diagnostic and treatment monitoring biomarker for malignant pleural mesothelioma (MPM), its clinical utility for predicting the prognosis has not yet been clarified. The aim of this study is to investigate whether the serum N-ERC level can accurately predict the outcome in patients with MPM.
  
  
  METHODS
  Twenty-six patients with MPM were enrolled. Serum N-ERC level was measured before and after chemotherapy. The N-ERC index was determined by the logarithm of the division of the N-ERC level after two courses of chemotherapy by the prior level.
  
  
  RESULTS
  The median N-ERC index in the partial response (PR) group was significantly lower than that in patients with the stable disease (SD) plus the progressive disease (PD) group. The overall survival in the group whose median N-ERC index was lower than its median value was significantly longer than the group whose median N-ERC index was higher than its median value.
  
  
  CONCLUSIONS
  The N-ERC index is therefore considered to be a useful biomarker for predicting not only the chemotherapeutic response, but also the prognosis in patients with advanced MPM.
authors.affiliation: Departments of Respiratory Medicine, Juntendo University, Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-Ku, Tokyo 113-8421, Japan;
authors.forename: Takanori
authors.initials: T
authors.lastname: Mori
authors.forename: Ken
authors.initials: K
authors.lastname: Tajima
authors.forename: Michihiro
authors.initials: M
authors.lastname: Hirama
authors.forename: Tadashi
authors.initials: T
authors.lastname: Sato
authors.forename: Kenji
authors.initials: K
authors.lastname: Kido
authors.forename: Shin-Ichiro
authors.initials: S
authors.lastname: Iwakami
authors.forename: Shinichi
authors.initials: S
authors.lastname: Sasaki
authors.forename: Akihiko
authors.initials: A
authors.lastname: Iwase
authors.forename: Kazu
authors.initials: K
authors.lastname: Shiomi
authors.forename: Masahiro
authors.initials: M
authors.lastname: Maeda
authors.forename: Okio
authors.initials: O
authors.lastname: Hino
authors.forename: Kazuhisa
authors.initials: K
authors.lastname: Takahashi
keywords: Mesothelioma; N-ERC index; biomarker; prognosis; response