Scherpereel en collega’s onderzochten de niveaus van het eiwit soluble mesothelin-related protein (SMRP) in het bloedplasma (serum) en in het pleuraal vocht (vocht uit het longvlies) van 74 mensen met (maligne) mesothelioom (longvlies-/buikvlieskanker), 35 mensen met uitzaaiingen van andere tumoren in het longvlies en 28 mensen met goedaardige afwijkingen door asbestblootstelling. Het gemiddelde SMRP-niveau was bij de mesothelioompatiënten hoger dan bij de andere groepen, zowel in het bloedplasma als in het pleuraal vocht. De onderzoekers concluderen dat SMRP een veelbelovende merker voor de diagnose van mesothelioom zou kunnen worden. Het SMRP-niveau in het pleuraal vocht liet de grootste verschillen zien tussen de groep mesothelioompatiënten en de groep met uitzaaiingen van andere tumoren. Bron: Scherpereel, A. et al. (2006). Soluble mesothelin-related protein in the diagnosis of malignant pleural mesothelioma. Amercan Thoracic Society: Am J Respir Crit Care Medicine, Feb 2.
Scherpereel A, Grigoriu BD, Conti M, Gey T, Gregoire M, Copin MC, Devos P, Chahine B, Porte H, Lassalle P. (2006). Soluble Mesothelin-related Protein in the Diagnosis of Malignant Pleural Mesothelioma. American Thoracic Society. Am J Respir Crit Care Medicine, Feb 2
Background: Diagnosis of malignant pleural mesothelioma is a challenging issue. Potential markers in mesothelioma diagnosis include soluble mesothelin-related peptides (SMRP) and osteopontin but no subsequent validation have been published yet.
Methods: We prospectively evaluated SMRP in serum and pleural effusion from patients with mesothelioma (n=74), pleural metastasis of carcinomas (n=35), or benign pleural lesions associated with asbestos exposure (n=28), recruited when first suspected for mesothelioma.
Findings: Mean serum SMRP level was higher in mesothelioma (2.05 +/- 2.57 nM/l – median +/- interquartile range) than in metastasis (1.02 +/- 1.79 nM/l) or benign lesions (0.55 +/- 0.59 nM/l) patients. The area under the receiver operating characteristic curve (AUC) for serum SMRP was 0.872 for differentiating mesothelioma and benign lesions. cut-off= 0.93 nM/l (Sensitivity= 80%, Specificity= 82.6%). The AUC for serum SMRP differentiating metastasis and mesothelioma was 0.693. cut-off= 1.85 nM/l (Sensitivity = 58.3%. Specificity = 73.3%). SMRP values in pleural fluid were higher than in serum in all groups (mesothelioma: 46.1 +/- 83.2 nM/l. benign lesions: 6.4 +/- 11.1 nM/l. metastasis: 6.36 +/- 21.73 nM/l). The AUC for pleural SMRP differentiating benign lesions and mesothelioma was 0.831. cut-off= 10.4 nM/l (Sensitivity = 76.7%, Specificity = 76.2%). The AUC for pleural SMRP differentiating metastasis and mesothelioma was 0.793.
Interpretation: We show that SMRP may be a promising marker for mesothelioma diagnosis when measured either in serum or pleural fluid. The diagnostic value of SMRP was similar in both types of samples, but pleural fluid SMRP may better discriminate mesothelioma from pleural metastasis.