title: Comparison of mesothelin and fibulin-3 in pleural fluid and serum as markers in malignant mesothelioma.
abstract: OBJECTIVE
  Malignant mesothelioma is an asbestos-induced, aggressive tumour, which frequently presents with pleural effusion. There are over 60 reported causes that can result in the development of a pleural effusion. Currently, there are no tumour biomarkers in widespread clinical use for the differential diagnosis of mesothelioma from other diseases. With the incidence of mesothelioma expected to continue to increase, it is timely to review the current status of effusion-based biomarkers for mesothelioma diagnosis.
  
  
  RESULTS
  The majority of recent studies have evaluated soluble mesothelin in effusions in a diagnostic setting for mesothelioma. However, at high specificity, the sensitivity of the assay is limited to approximately 60% at the time of diagnosis. There is considerable research effort directed toward the identification of new markers for mesothelioma through a variety of genomic, proteomic and immunomic based platforms. One of the few new biomarkers to be identified through a biomarker discovery pipeline and evaluated in pleural effusions is fibulin-3. Preliminary results on the diagnostic accuracy of fibulin-3 have been inconsistent.
  
  
  CONCLUSIONS
  To date, soluble mesothelin remains the best available biomarker for mesothelioma and a positive result is clinically useful in patients with pleural effusions in whom the diagnosis is uncertain.
authors.affiliation: aSchool of Medicine and Pharmacology bNational Centre for Asbestos Related Diseases, University of Western Australia, Perth cDepartment of Respiratory Medicine, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia.
authors.forename: Jenette
authors.initials: J
authors.lastname: Creaney
authors.forename: Ian M
authors.initials: IM
authors.lastname: Dick
authors.forename: Bruce W
authors.initials: BW
authors.lastname: Robinson
mesh_terms: D014408:Biomarkers, Tumor; D003937:Diagnosis, Differential; D016326:Extracellular Matrix Proteins; D058851:GPI-Linked Proteins; D006801:Humans; D008175:Lung Neoplasms; D000090204:Mesothelin; D008654:Mesothelioma; D000086002:Mesothelioma, Malignant; D010996:Pleural Effusion / Q000175:diagnosis
chemical_list: D014408:Biomarkers, Tumor; C119630:EFEMP1 protein, human; D016326:Extracellular Matrix Proteins; D058851:GPI-Linked Proteins; D000090204:Mesothelin