title: Serum biomarkers in patients with mesothelioma and pleural plaques and healthy subjects exposed to naturally occurring asbestos.
abstract: OBJECTIVE
  This study investigated the diagnostic accuracy of the serum biomarkers osteopontin and mesothelin in discriminating mesothelioma patients from those with other, benign conditions and whether levels of the biomarkers differed in subjects who had inhaled naturally occurring asbestos compared with a non-exposed control group.
  
  
  METHODS
  This cross-sectional study studied 24 subjects with mesothelioma, 279 subjects with pleural plaques, 123 "healthy exposed," and 120 control subjects. The Kruskal-Wallis test was performed to compare mesothelin and osteopontin levels of the groups, and receiver operating characteristics curves were generated to determine diagnostic yields of both biomarkers. Multiple linear regression analyses were used to identify associated covariates with osteopontin and mesothelin levels.
  
  
  RESULTS
  Serum osteopontin and mesothelin levels were higher in mesothelioma than in benign asbestos-related diseases and healthy exposed subjects. Both biomarker levels were independently associated with mesothelioma, age and smoking pack years. Mesothelin levels were also associated with body mass index. The sensitivity and specificity of osteopontin in distinguishing mesothelioma from the three other groups were 75 and 86 %, respectively; those of mesothelin were 58 and 83 %, respectively. The sensitivity and specificity to discriminate mesothelioma from pleural plaques and healthy subjects were 93 and 73 %, respectively, if osteopontin and mesothelin levels were higher than their optimal cut off levels.
  
  
  CONCLUSIONS
  The combination of serum osteopontin and mesothelin levels can help to distinguish mesothelioma from benign asbestos-related diseases and asbestos-exposed subjects.
authors.affiliation: Department of Pulmonology, Bezmialem Vakif University, Istanbul, Turkey, drmehmetbayram@yahoo.com.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Bayram
authors.forename: Isa
authors.initials: I
authors.lastname: Dongel
authors.forename: Ali
authors.initials: A
authors.lastname: Akbaş
authors.forename: Ismail
authors.initials: I
authors.lastname: Benli
authors.forename: Muhammed Emin
authors.initials: ME
authors.lastname: Akkoyunlu
authors.forename: Nur Dilek
authors.initials: ND
authors.lastname: Bakan
mesh_terms: D000368:Aged; D019540:Area Under Curve; D001194:Asbestos / Q000009:adverse effects*; D014408:Biomarkers, Tumor / Q000097:blood*; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D003937:Diagnosis, Differential; D058851:GPI-Linked Proteins / Q000097:blood*; D006801:Humans; D019570:Inhalation Exposure / Q000009:adverse effects; D016014:Linear Models; D000090204:Mesothelin; D008654:Mesothelioma / Q000097:blood* / Q000175:diagnosis / Q000209:etiology; D008875:Middle Aged; D053495:Osteopontin / Q000097:blood*; D010994:Pleura / Q000473:pathology*; D010997:Pleural Neoplasms / Q000097:blood* / Q000175:diagnosis / Q000209:etiology; D011237:Predictive Value of Tests; D012372:ROC Curve; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D014421:Turkey
chemical_list: D014408:Biomarkers, Tumor; D058851:GPI-Linked Proteins; C506895:SPP1 protein, human; D053495:Osteopontin; D001194:Asbestos; D000090204:Mesothelin