title: Mesothelin is more useful in pleural effusion than in serum in the diagnosis of pleural mesothelioma.
abstract: OBJECTIVE
  Soluble mesothelin-related peptide (SMRP) is regarded as a biomarker of malignant pleural mesothelioma (MPM). Herein, we compared the diagnostic performances of SMRP in matched pleural effusion (PE-SMRP) and serum (S-SMRP).
  
  
  METHODS
  Diagnosis on pleural biopsies was performed for all patients including 43 with MPM, 23 with non-MPM pleural metastases (MTS) and 36 with benign (BNG) pleural diseases. SMRP was measured by a MesoMark ELISA (Cis-Bio International Gif/Yvette; France).
  
  
  RESULTS
  Using the receiver operating characteristic (ROC) analysis, 12.70 and 1.08 nM were detected as cut-off values to optimal discrimination for PE-SMRP and S-SMRP, respectively. PE-SMRP showed a better diagnostic accuracy than S-SMRP in MPM vs. MTS+BNG (area under the ROC curve=81.6 vs. 70.5; sensitivity=69.8% vs. 46.5%; specificity=88.1% vs. 84.7%; diagnostic odds ratio (DOR)=17.1 vs. 4.8). In S-SMRP-negative patients, PE-SMRP maintained an acceptable performance (Sensitivity=47.8%; DOR=8.3; p=0.001), whereas in PE-SMRP-negative patients, S-SMRP performed very poorly (Sensitivity=15.4%; DOR=1.2; p=0.858).
  
  
  CONCLUSIONS
  PE-SMRP detection has a superior diagnostic accuracy than S-SMRP detection in the diagnosis of MPM.
authors.affiliation: Division of Histopathology and Cytopathology, 2Division of Pneumology, 3Division of Clinical Pathology, Azienda Sanitaria Locale n˚ 5, La Spezia, Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: Ferro
authors.forename: Pier Aldo
authors.initials: PA
authors.lastname: Canessa
authors.forename: Enrico
authors.initials: E
authors.lastname: Battolla
authors.forename: Paolo
authors.initials: P
authors.lastname: Dessanti
authors.forename: Maria Cristiana
authors.initials: MC
authors.lastname: Franceschini
authors.forename: Luigi
authors.initials: L
authors.lastname: Chiaffi
authors.forename: Anna
authors.initials: A
authors.lastname: Morabito
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Fontana
authors.forename: Riccardo
authors.initials: R
authors.lastname: Pezzi
authors.forename: Franco
authors.initials: F
authors.lastname: Fedeli
authors.forename: Maria Pia
authors.initials: MP
authors.lastname: Pistillo
authors.forename: Silvio
authors.initials: S
authors.lastname: Roncella
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000032:analysis / Q000097:blood; D005260:Female; D058851:GPI-Linked Proteins / Q000032:analysis* / Q000097:blood*; D006801:Humans; D008175:Lung Neoplasms / Q000097:blood / Q000175:diagnosis*; D008297:Male; D000090204:Mesothelin; D008654:Mesothelioma / Q000097:blood / Q000175:diagnosis*; D000086002:Mesothelioma, Malignant; D008875:Middle Aged; D009362:Neoplasm Metastasis / Q000175:diagnosis; D016017:Odds Ratio; D010996:Pleural Effusion; D010997:Pleural Neoplasms / Q000097:blood / Q000175:diagnosis; D011379:Prognosis; D012372:ROC Curve; D013906:Thoracoscopy
chemical_list: D014408:Biomarkers, Tumor; D058851:GPI-Linked Proteins; D000090204:Mesothelin
keywords: Mesomark assay; Pleural mesothelioma; malignant pleural effusion; mesothelin