Circulating activin A is a novel prognostic biomarker in malignant pleural mesothelioma - A multi-institutional study
Circulating activin A is a novel prognostic biomarker in malignant pleural mesothelioma - A multi-institutional study
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DOI：
10.1016/j.ejca.2016.04.018
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发表时间：
2016-08-01
影响因子：
8.4
通讯作者：
Hegedus, Balazs
中科院分区：
文献类型：
--
作者：
Hoda, Mir Alireza;Dong, Yawen;Hegedus, Balazs
前言：激活素的表达异常常见于多种恶性肿瘤。以往的研究表明，激活素A在恶性胸膜间皮瘤(MPM)中起促癌作用。本研究的目的是评价循环激活素A水平作为MPM生物标志物的作用。方法：采集4个机构的129例MPM患者在诊断时或手术切除前的血浆样本。对照组为45例健康人和16例非恶性胸膜疾病患者。结果：MPM患者血浆激活素A水平(862+/-83pg/ml)显著高于健康对照组(391+/-21pg/ml，P<0.0001)。有胸膜炎或纤维化的患者仅有轻微增加(与对照组相比；625+/-95pg/ml；P=0.0067)。肉瘤样(n=10,1629+/-202pg/ml，P=0.0019)和双相(n=23,1164+/-233pg/ml，P=0.0188)形态与激活素A的高水平相关，而上皮样组织(n=94,712+/-75pg/ml)的激活素A水平较高。肿瘤体积与循环激活素A水平升高呈正相关。与激活素A水平高的患者相比，激活素A水平低于中位数的多发性骨髓瘤患者的总生存期显著延长(中位生存期735d比365d，P<；0.0001)。结论：循环激活素A的检测可支持MPM的组织学分型，同时有助于鉴别预后不良的上皮样MPM患者。(C)2016爱思唯尔有限公司。保留所有权利。
Introduction: The deregulation of activin expression is often observed in various malignancies. Previous studies indicate that activin A plays a protumourigenic role in malignant pleural mesothelioma (MPM). The aim of the study was to evaluate circulating activin A level as a biomarker in MPM.Methods: Plasma samples were collected from 129 MPM patients in four institutions at the time of diagnosis or before surgical resection. Samples from 45 healthy individuals and from 16 patients with non-malignant pleural diseases served as controls. Circulating activin A was measured by enzyme-linked immunosorbent assay and correlated to clinicopathological variables.Results: Plasma activin A level was significantly elevated in MPM patients (862 +/- 83 pg/ml) when compared to healthy controls (391 +/- 21 pg/ml; P < 0.0001). Patients with pleuritis or fibrosis only showed a modest increase (versus controls; 625 +/- 95 pg/ml; P = 0.0067). Sarcomatoid (n = 10, 1629 +/- 202 pg/ml, P = 0.0019) and biphasic (n = 23, 1164 +/- 233 pg/ml, P = 0.0188) morphology were associated with high activin A levels when compared to epithelioid histology (n = 94, 712 +/- 75 pg/ml). The tumour volume showed a positive correlation with increased circulating activin A levels. MPM patients with below median activin A levels had a significantly longer overall survival when compared to those with high activin A levels (median survival 735 versus 365 d, P < 0.0001). Importantly, circulating activin A levels were exclusively prognostic in epithelioid MPM.Conclusions: Our findings suggest that the measurement of circulating activin A may support the histological classification of MPM and at the same time help to identify epithelioid MPM patients with poor prognosis. (C) 2016 Elsevier Ltd. All rights reserved.