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Original Articles: General Thoracic

Soluble Mesothelin-Related Peptide Level Elevation in Mesothelioma Serum and Pleural Effusions

^a Department of Cardiothoracic Surgery, Division of Thoracic Surgery, New York University School of Medicine, New York, New York
^b Karmanos Cancer Institute, Detroit, Michigan
^c Cancer Research Center of Hawaii, Honolulu, Hawaii
^d Fujirebio Diagnostics Inc, Malvern, Pennsylvania

Accepted for publication July 16, 2007.

^_* Address correspondence to Dr Pass, Department of Cardiothoracic Surgery, Division of Thoracic Surgery, NYU School of Medicine, 530 First Avenue, 9V, New York, NY 10016 (Email: harvey.pass{at}med.nyu.edu).

Presented at the Forty-third Annual Meeting of The Society of Thoracic Surgeons, San Diego, CA, Jan 29–31, 2007.

Background: Soluble mesothelin-related peptide (SMRP) is a potential marker for malignant pleural mesothelioma (MPM), which may be useful for screening high-risk asbestos-exposed individuals.

Methods: We evaluated SMRP in serum from MPM patients (n = 90), lung cancer patients (n = 170), age and tobacco-matched asbestos-exposed individuals (n = 66), and in MPM pleural effusions (n = 45), benign effusions (n = 30), and non-MPM effusions (n = 20) using the MesoMark enzyme-linked immunosorbent assay kit (Fujirebio Diagnostics, Malvern, PA). Receiver operating characteristic (ROC) curves were used to define true and false positive rates at various cutoffs.

Results: Mean serum SMRP levels were higher in MPM compared with lung cancer (5.67 ± 0.82 nM [mean ± standard error of the mean vs 1.99 ± 0.43 nM, p < 0.001), and stage I MPM SMRP levels (n = 12; 2.09 ± 0.41 nM) were significantly higher than those in asbestos-exposed individuals (0.99 ± 0.09 nM, p = 0.02, respectively). Stage 2 to 4 SMRP serum levels were significantly higher than those for stage 1 MPM. The area under the ROC curve for serum SMRP was 0.81 for differentiating MPM and asbestos-exposed individuals; cutoff = 1.9 nM (sensitivity = 60%, specificity = 89%). The MPM pleural effusion SMRP was significantly higher than benign or other non-MPM pleural effusions (65.57 ± 11.33 nM vs 27.46 ± 11.25 nM [p = 0.003] and 18.99 ± 7.48 nM [p = 0.044], respectively).

Conclusions: These data support SMRP as a promising marker for MPM in both serum and pleural effusion fluid, and justify prospective screening studies of SMRP in combination with other markers for screening of asbestos-exposed cohorts.

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