title: Mesothelin in serum and pleural effusion in the diagnosis of malignant pleural mesothelioma with non-positive cytology.
abstract: OBJECTIVE
  Mesothelin (SMRP) is regarded as a biomarker of malignant pleural mesothelioma (MPM). Herein, we analyzed the contribution of SMRP detection in pleural effusion and in serum to the diagnosis of MPM with non-positive cytology.
  
  
  METHODS
  The present study included 52 cases of MPM, 43 of pleural benign lesions and 25 of non-MPM pleural metastases. SMRP was measured by MesoMark ELISA (Cis-Bio International Gif/Yvette; France).
  
  
  RESULTS
  In non-positive cytology, effusion-SMRP showed higher diagnostic performance than serum-SMRP. We found 38 out of 52 (73.1%) cases of non-positive cytology MPM, out of which 27 (71.0%) were positive for effusion-SMRP (cut-off=12.70 nM) and 18 (47.4%) for serum-SMRP (cut-off=1.08 nM). When cytology, effusion- and serum-SMRP were used in combination, an overall sensitivity in detection of MPM of 78.9% was achieved. The same sensitivity was obtained by combining cytology with effusion-SMRP alone, whereas the combination of serum-SMRP with cytology led to a sensitivity of 61.5%.
  
  
  CONCLUSIONS
  Detection of both effusion- and serum-SMRP can contribute to improve the diagnosis of MPM with non-positive cytology. However, the analysis of SMRP in effusion makes it unnecessary to test SMRP in the serum.
authors.affiliation: Division of Histopathology and Cytopathology, Azienda Sanitaria Locale n° 5, La Spezia, Italy.
authors.forename: Maria Cristiana
authors.initials: MC
authors.lastname: Franceschini
authors.affiliation: Division of Histopathology and Cytopathology, Azienda Sanitaria Locale n° 5, La Spezia, Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: Ferro
authors.affiliation: Division of Pneumology, Azienda Sanitaria Locale n° 5, La Spezia, Italy.
authors.forename: Pier Aldo
authors.initials: PA
authors.lastname: Canessa
authors.affiliation: Division of Clinical Pathology, Azienda Sanitaria Locale n° 5, La Spezia, Italy.
authors.forename: Enrico
authors.initials: E
authors.lastname: Battolla
authors.affiliation: Division of Histopathology and Cytopathology, Azienda Sanitaria Locale n° 5, La Spezia, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Dessanti
authors.affiliation: Division of Histopathology and Cytopathology, Azienda Sanitaria Locale n° 5, La Spezia, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Valentino
authors.affiliation: Division of Histopathology and Cytopathology, Azienda Sanitaria Locale n° 5, La Spezia, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Casolari
authors.affiliation: Unit of Epidemiology and Biostatistics, IRCCS Azienda Ospedaliera Universitaria San Martino-Istituto Nazionale per la Ricerca sul Cancro, Genova, Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Fontana
authors.affiliation: Unit of Epidemiology and Biostatistics, IRCCS Azienda Ospedaliera Universitaria San Martino-Istituto Nazionale per la Ricerca sul Cancro, Genova, Italy.
authors.forename: Riccardo
authors.initials: R
authors.lastname: Pezzi
authors.affiliation: Division of Histopathology and Cytopathology, Azienda Sanitaria Locale n° 5, La Spezia, Italy.
authors.forename: Franco
authors.initials: F
authors.lastname: Fedeli
authors.affiliation: Tumor Epigenetics, IRCCS Azienda Ospedaliera Universitaria San Martino-Istituto Nazionale per la Ricerca sul Cancro, Genova, Italy.
authors.forename: Maria Pia
authors.initials: MP
authors.lastname: Pistillo
authors.affiliation: Division of Histopathology and Cytopathology, Azienda Sanitaria Locale n° 5, La Spezia, Italy silvio.roncella@asl5.liguria.it.
authors.forename: Silvio
authors.initials: S
authors.lastname: Roncella
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001195:Asbestosis / Q000097:blood; D014408:Biomarkers, Tumor / Q000097:blood*; D003581:Cytodiagnosis; D005260:Female; D058851:GPI-Linked Proteins / Q000097:blood*; D006801:Humans; D008175:Lung Neoplasms / Q000097:blood / Q000175:diagnosis* / Q000473:pathology; D008297:Male; D000090204:Mesothelin; D008654:Mesothelioma / Q000097:blood / Q000175:diagnosis* / Q000473:pathology; D000086002:Mesothelioma, Malignant; D008875:Middle Aged; D009362:Neoplasm Metastasis; D010996:Pleural Effusion / Q000473:pathology*; D010997:Pleural Neoplasms / Q000097:blood / Q000175:diagnosis* / Q000473:pathology
chemical_list: D014408:Biomarkers, Tumor; D058851:GPI-Linked Proteins; D000090204:Mesothelin
keywords: Mesomark assay; Mesothelioma; cytology; malignant pleural effusion; mesothelin