Combined CA125 and Mesothelin Levels for the Diagnosis of Malignant Mesothelioma

Creaney, Jenette; Bruggen, Ivonne van; Hof, Michelle; Segal, Amanda; Musk, Arthur W.; Klerk, Nicholas de; Horick, Nora; Skates, Steven J.; Robinson, B. W.

doi:10.1378/chest.07-0013

Cited by 77 publications

(80 citation statements)

References 24 publications

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“…The same results were obtained in a 2012 Italian study, with mean SMRP levels of 0.51 nmol/L in benign disease and 0.43 nmol/L in healthy exposed population 62 . Similar findings were documented in numerous other studies 6,52,57,[63][64][65][66] . The presented study also showed statistically significantly higher mesothelin levels in a group of persons with just benign findings than in a group with no abnormalities detected by X-ray (0.755 ± 0.543 vs. 0.50 ± 0.35, P<0.001).…”

Section: Discussionsupporting

confidence: 92%

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

Jakubec¹,

Pelclová²,

Smolková³

et al. 2015

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub

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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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Section: Discussionsupporting

confidence: 92%

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

Jakubec¹,

Pelclová²,

Smolková³

et al. 2015

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub

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“…The present study supports the growing evidence that serum SMRP levels are elevated in patients with MPM (14,15), thereby confirming the potential usefulness of this biomarker in the clinical practice. Notably, we have also shown that serum SMRP concentrations are higher in patients with MPM than in people exposed to asbestos with benign pleural disease.…”

Section: Discussionsupporting

confidence: 88%

Serum Levels of Soluble Mesothelin-Related Peptides in Malignant and Nonmalignant Asbestos-Related Pleural Disease: Relation with Past Asbestos Exposure

Portal

Becerra

Rodríguez

et al. 2009

Cancer Epidemiology, Biomarkers &Amp; Prevention

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Background: Malignant pleural mesothelioma (MPM) results from malignant transformation of mesothelial cells. Past asbestos exposure represents a major risk factor for MPM and other benign pleural disease. Soluble mesothelin-related peptides (SMRP) have been regarded as a promising serum biomarker for MPM. The aim of this study was to investigate serum levels of SMRP in malignant and nonmalignant asbestos-related pleural disease. Patients: Four groups of patients were investigated: group 1 composed of 48 healthy subjects, group 2 composed of 177 patients with previous asbestos exposure and no pleural disease, group 3 composed of 36 patients with MPM, and group 4 composed of 101 patients with previous asbestos exposure and benign pleural disease. Serum SMRP levels were determined by ELISA.

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“…CA 125 was proposed as an alternative diagnostic marker for MPM but its sensitivity (below 30%) is insufficient. Moreover the combination of CA 125 with other more specific/sensitive markers (as for example soluble mesothelin) does not significantly improve the diagnostic capabilities over the markers used alone [30].…”

Section: "Old" Candidate Markersmentioning

confidence: 97%

“…A few publications have tried to combine soluble mesothelin with other markers. To date no combination has been proved superior to soluble mesothelin alone either if combined with CA 125 [30], with hyaluronic acid or with MPF and/or osteopontin [73]. Some authors have suggested that the association of Cyfra 21.1 to soluble mesothelin may be useful [24] but the perceived utility may depend on how the data is analysed (i.e.…”

Section: Mesothelinmentioning

confidence: 99%

Clinical utility of diagnostic markers for malignant pleural mesothelioma

Grigoriu

Grigoriu²,

Chahine

et al. 2016

Monaldi Arch Chest Dis

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Malignant mesothelioma has a very dismal prognosis with very few patients surviving one year after diagnosis. Early multimodal treatment, however, is expected to improve the outcome. Today, there is a strong need to have disease markers which could be used for screening, diagnosing, and/or monitoring tumour response to treatment. Old markers such as hyaluronic acid, various cytokeratin fragments (CYFRA 21.1, TPA) and other cancer antigens (CA 15.3, CA 125 or CA 19.9 or CEA) are not sensitive or specific enough and cannot be used in practice. More recently new molecules, such as soluble mesothelin and osteopontin, have been proposed for diagnostic purposes. Soluble mesothelin has a good specificity but has a suboptimal sensitivity being negative in all sarcomatoid and in up to one half of epithelioid mesothelioma. On the contrary osteopontin has an inadequate specificity. Combining different markers together does not lead to an improvement in diagnostic accuracy. Neither marker can be used for screening purposes, the main limitation being the very low incidence of the disease in the at-risk, asbestos exposed population. Mesothelin is also a promising marker for monitoring response to treatment but published data is still insufficient to make recommendations. There is still a strong need for research is this area both in order to discover new markers as well as to correct the positioning of each existing molecule (alone or in combination) is the evaluation of the patients with a mesothelioma.

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Combined CA125 and Mesothelin Levels for the Diagnosis of Malignant Mesothelioma

Cited by 77 publications

References 24 publications

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

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

Serum Levels of Soluble Mesothelin-Related Peptides in Malignant and Nonmalignant Asbestos-Related Pleural Disease: Relation with Past Asbestos Exposure

Clinical utility of diagnostic markers for malignant pleural mesothelioma

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