Soluble mesothelin in effusions: a useful tool for the diagnosis of malignant mesothelioma
Soluble mesothelin in effusions: a useful tool for the diagnosis of malignant mesothelioma
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DOI：
10.1136/thx.2006.068114
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发表时间：
2007-07-01
期刊：
影响因子：
10
通讯作者：
Robinson, Bruce W. S.
中科院分区：
文献类型：
--
作者：
Creaney, Jenette;Yeoman, Deborah;Robinson, Bruce W. S.
背景：恶性间皮瘤的诊断通常是困难的，最常见的鉴别诊断是反应性胸膜疾病和转移性腺癌。血清中可溶性间皮素水平最近被证明对间皮瘤具有高度特异性和中度敏感性。由于大多数间皮瘤患者存在胸膜或腹膜渗出液，因此进行了一项研究，以确定这些液体中间皮素水平是否升高，以及升高的水平是否有助于将间皮瘤与其他原因的渗出液区分开来。方法：收集192例呼吸内科患者的胸膜液，其中52例为恶性间皮瘤，56例为非间皮瘤性恶性肿瘤，84例为非肿瘤性积液。收集42例患者的腹膜液（7例间皮瘤，14例非间皮瘤恶性肿瘤，21例良性积液）。采用ELISA法测定积液和血清中间皮素水平。结果：间皮瘤患者积液中间皮素含量明显增高；特异性为98%，比较间皮瘤患者和非肿瘤源性积液患者，该检测的敏感性为67%。10例患者中有7例在诊断为间皮瘤前3周至10个月收集的积液中间皮素水平升高；8例中有4例，积液中间皮素水平升高，而血清中没有。结论：测量患者胸膜和/或腹膜积液中的间皮素浓度可能有助于以积液为表现的间皮瘤患者的鉴别诊断。
Background: The diagnosis of malignant mesothelioma is frequently difficult, the most common differential diagnosis being reactive pleural conditions and metastatic adenocarcinoma. Soluble mesothelin levels in serum have recently been shown to be highly specific and moderately sensitive for mesothelioma. As most patients with mesothelioma present with exudative effusions of either the pleura or the peritoneum, a study was undertaken to determine if levels of mesothelin were raised in these fluids and if the increased levels could help to distinguish mesothelioma from other causes of exudative effusion.Methods: Pleural fluid was collected from 192 patients who presented to respiratory clinics (52 with malignant mesothelioma, 56 with non-mesotheliomatous malignancies and 84 with effusions of nonneoplastic origin). Peritoneal fluid was collected from 42 patients (7 with mesothelioma, 14 with nonmesotheliomatous malignancies and 21 with benign effusions). Mesothelin levels were determined in effusion and serum samples by ELISA.Results: Significantly higher levels of mesothelin were found in effusions of patients with mesothelioma; with a specificity of 98%, the assay had a sensitivity of 67% comparing patients with mesothelioma and those with effusions of non-neoplastic origin. In 7 out of 10 cases mesothelin levels were raised in the effusion collected 3 weeks to 10 months before the diagnosis of mesothelioma was made; in 4 out of 8 of these, mesothelin levels were increased in the effusion but not in the serum.Conclusions: Measurement of mesothelin concentrations in the pleural and/or peritoneal effusion of patients may aid in the differential diagnosis of mesothelioma in patients presenting with effusions.