title: Diagnostic and prognostic value of soluble syndecan-1 in pleural malignancies.
abstract: BACKGROUND
  The distinction between malignant and benign pleural effusions is a diagnostic challenge today and measuring soluble biomarkers could add to the diagnostic accuracy. Syndecan-1 is a proteoglycan involved in various cellular functions and is cleaved from the cell surface in a regulated manner. The shed fragment, which can be recovered in effusion supernatant and in serum, retains its binding capacities, but often with different functions and signalling properties than the cell-bound form.
  
  
  OBJECTIVE
  This study aimed to investigate the diagnostic and prognostic value of soluble syndecan-1 in pleural effusions and sera from patients with pleural malignancies.
  
  
  METHODS
  Using two cohorts of patients, we assessed the diagnostic and prognostic value of soluble syndecan-1 in pleural effusions and sera, using enzyme-linked immunosorbent assays.
  
  
  RESULTS
  In pleural effusions, syndecan-1 distinguished malignant and benign diseases, with an odds ratio of 8.59 (95% CI 3.67 to 20.09). Furthermore, syndecan-1 in pleural effusions predicted a survival difference for patients with pleural metastatic disease and malignant mesothelioma of 11.2 and 9.2 months, respectively. However, no such effects were seen when syndecan-1 was measured in serum.
  
  
  CONCLUSIONS
  Soluble syndecan-1 is a promising candidate biomarker for the cytopathological diagnosis and prognostication of malignant pleural effusions.
authors.affiliation: Division of Pathology, Department of Laboratory Medicine, Karolinska Institutet, F46, Huddinge University Hospital, 141 86 Stockholm, Sweden.
authors.forename: Filip
authors.identifier: 0000-0003-2396-8658
authors.initials: F
authors.lastname: Mundt
authors.affiliation: Division of Pathology, Department of Laboratory Medicine, Karolinska Institutet, F46, Huddinge University Hospital, 141 86 Stockholm, Sweden.
authors.forename: Ghazal
authors.identifier: 0000-0002-1182-3219
authors.initials: G
authors.lastname: Heidari-Hamedani
authors.affiliation: Division of Cognitive Neurophysiology and Osher Center for Integrative Medicine, Department of Clinical Neuroscience, Karolinska Institutet, 171 77 Stockholm, Sweden ; Stress Research Center, Stockholm University, 106 91 Stockholm, Sweden.
authors.forename: Gustav
authors.identifier: 0000-0001-5273-0150
authors.initials: G
authors.lastname: Nilsonne
authors.affiliation: Department of Chest Diseases, Eskisehir Osmangazi University Medical Faculty, 260 40 Eskisehir, Turkey.
authors.forename: Muzaffer
authors.initials: M
authors.lastname: Metintas
authors.affiliation: Division of Pathology, Department of Laboratory Medicine, Karolinska Institutet, F46, Huddinge University Hospital, 141 86 Stockholm, Sweden.
authors.forename: Anders
authors.initials: A
authors.lastname: Hjerpe
authors.affiliation: Division of Pathology, Department of Laboratory Medicine, Karolinska Institutet, F46, Huddinge University Hospital, 141 86 Stockholm, Sweden.
authors.forename: Katalin
authors.initials: K
authors.lastname: Dobra
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000097:blood; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000097:blood / Q000175:diagnosis / Q000473:pathology; D008297:Male; D008654:Mesothelioma / Q000097:blood / Q000175:diagnosis / Q000473:pathology; D000086002:Mesothelioma, Malignant; D008875:Middle Aged; D016066:Pleural Effusion, Malignant / Q000097:blood* / Q000175:diagnosis* / Q000473:pathology; D011379:Prognosis; D053668:Syndecan-1 / Q000097:blood*
chemical_list: D014408:Biomarkers, Tumor; D053668:Syndecan-1