Clinical Impact and Reliability of Pleural Fluid Mesothelin in Undiagnosed Pleural Effusions

Davies, Helen; Sadler, Ross S.; Bielsa, Silvia; Maskell, Nick A; Rahman, Najib M.; Davies, Robert J. O.; Ferry, Berne; Lee, Gary

doi:10.1164/rccm.200811-1729oc

Cited by 92 publications

(75 citation statements)

References 38 publications

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“…Similar diagnostic power of serum mesothelin was also exhibited [22,24,29,33,46]. However, pleural levels of mesothelin were much higher than the respective serum values.…”

Section: Table 1 Continuedsupporting

confidence: 63%

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Effectiveness of mesothelin family proteins and osteopontin for malignant mesothelioma: Table 1–

et al. 2012

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Malignant mesothelioma (MM) is an aggressive tumour with poor prognosis whose early diagnosis is difficult. Mesothelin, megakaryocyte potentiating factor (MPF) and osteopontin have attracted attention as biomarkers. The aim of the present review is to provide an overview regarding these candidate biomarkers for MM, and discuss their potential role in today's clinical practice.Mesothelin and MPF have good specificity but sub-optimal sensitivity for detection of MM, being negative both in the sarcomatoid histological sub-type and in almost half of epithelioid mesothelioma, especially in the early stages. Osteopontin is a marker of the duration of asbestos exposure, but lacks specificity for mesothelioma. Several patient characteristics influence the diagnostic accuracy of biomarkers and make the establishment of the ''optimal'' diagnostic threshold difficult. Mesothelin and MPF have proved useful in assessing response to treatment. Combining different markers together may lead to an improvement in diagnostic accuracy, but there is still need for research in this area. Extensive validation and further research is required to improve the use of serum markers in mesothelioma management. In the near future, their application in clinical practice is probably in monitoring response to therapy, rather than in guiding diagnostic decisions and risk assessment of asbestos-exposed populations.

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“…Similar diagnostic power of serum mesothelin was also exhibited [22,24,29,33,46]. However, pleural levels of mesothelin were much higher than the respective serum values.…”

Section: Table 1 Continuedsupporting

confidence: 63%

“…However, pleural levels of mesothelin were much higher than the respective serum values. Pleural levels of mesothelin were also significantly higher in epithelioid MM compared with sarcomatoid and mixed MM sub-types [24,29,33].…”

Section: Table 1 Continuedmentioning

confidence: 87%

Effectiveness of mesothelin family proteins and osteopontin for malignant mesothelioma: Table 1–

et al. 2012

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“…Higher cut-offs mostly lead to higher sensitivity and lower specificity. There have been studies measuring pleural SMRP, the absolute values of which tend to be higher than those of serum SMRP, showing similar sensitivity and specificity 6,37,58,75 . Most studies have shown higher SMRP levels in epithelioid mesothelioma than in other mesothelioma types, with an SMRP sensitivity of only 10% in sarcomatoid mesothelioma and 40% in the mixed type 30,36,37,53,[69][70][71]76,77 .…”

Section: Discussionmentioning

confidence: 99%

Significance of serum mesothelin in an asbestos-exposed population in the Czech Republic

Jakubec¹,

Pelclová²,

Smolková³

et al. 2015

BIOMED PAP

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Aims. Pleural mesothelioma is a highly aggressive and difficult-to-treat form of cancer induced by asbestos in 80-90% of cases. The population group most at risk of the condition are asbestos-exposed workers. Mesothelin or soluble mesothelin-related protein (SMRP) is studied as a potential marker of mesothelioma in the at-risk population. Methods. The study comprised 239 subjects with a mean duration of occupational exposure to asbestos of 19.9 years. In all of them, a complete medical history was taken, focused on exposure duration and a physical examination, a chest X-ray or other imaging investigations and a lung function test were performed. Their serum SMRP levels were measured and biopsy samples were taken to diagnose pleural disease. Based on the above examinations, the subjects were classified into subgroups and serum SMRP concentrations were statistically analyzed with respect to individual parameters. Results. In asbestos-exposed individuals, mesothelin levels were significantly higher in those with pathological X-ray findings than in those with normal X-ray results (0.78 ± 0.63 vs. 0.50 ± 0.35, P<0.0001). The group of patients with benign disease had statistically significantly higher mesothelin levels than those with normal X-ray findings (0.755 ± 0.543 vs. 0.50 ± 0.35, P<0.001). In the group with present malignant processes, mesothelin levels were higher than in individuals with benign disease (1.19 ± 0.89 vs. 0.76 ± 0.54, P=0.015). Only a weak correlation was found between mesothelin levels and asbestos exposure duration. There were relatively high sensitivity and high specificity (75% and 90.6%, respectively) of serum mesothelin for pleural mesothelioma. However, given the small number of mesothelioma cases in the group, the results cannot be considered as statistically significant. Conclusions. In persons followed up for asbestos exposure, increased mesothelin levels signalize pathological processes in the chest and correlate with severity of the disease. The study suggests that mesothelin cannot be considered a reliable marker for the early stage of malignant degeneration of pleural disease but only an additional criterion for examination of the followed-up individuals.

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“…26 of these patients had PF collected as part of a separate study on the use of PF mesothelin [3]. Additional samples were collected from seven patients (malignant, n55; benign, n52) to assess the effects of storage and freeze-thaw cycles.…”

Section: Reproducibility and Reliability Of Pleural Fluid Cytokine Mementioning

confidence: 99%

Reproducibility and reliability of pleural fluid cytokine measurements

Bielsa¹,

Davies²,

Rjo.³

et al. 2009

European Respiratory Journal

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Clinical Impact and Reliability of Pleural Fluid Mesothelin in Undiagnosed Pleural Effusions

Abstract: Pleural fluid mesothelin provides additional diagnostic value relative to cytological examination. Mesothelin measurements are reproducible and not affected by inflammatory pleural processes.

Cited by 92 publications

References 38 publications

Effectiveness of mesothelin family proteins and osteopontin for malignant mesothelioma: Table 1–

Effectiveness of mesothelin family proteins and osteopontin for malignant mesothelioma: Table 1–

Significance of serum mesothelin in an asbestos-exposed population in the Czech Republic

Reproducibility and reliability of pleural fluid cytokine measurements

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