Soluble mesothelin-related peptides in the diagnosis of malignant pleural mesothelioma
Soluble mesothelin-related peptides in the diagnosis of malignant pleural mesothelioma
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DOI：
10.1164/rccm.200511-1789oc
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发表时间：
2006-05-15
影响因子：
24.7
通讯作者：
Lassalle, Philippe
中科院分区：
文献类型：
--
作者：
Scherpereel, Arnaud;Grigoriu, Bogdan;Lassalle, Philippe
背景：恶性胸膜间皮瘤的诊断是一个具有挑战性的问题。间皮瘤诊断的潜在标志物包括可溶性间皮素相关肽（SMRPs）和骨桥蛋白，但尚未发表后续验证。我们前瞻性地评估了间皮瘤（n = 74）、癌胸膜转移（n = 35）或与石棉暴露相关的良性胸膜病变（n = 28）患者血清和胸腔积液中的SMRP，发现：间皮瘤患者的平均血清SMRP水平（2.05 +/- 2.57 nM/L [中位数+/-四分位数间距]）高于转移（1.02 +/- 1.79 nM/L）或良性病变（0.55 +/- 0.59 nM/L）患者。血清SMRP的受试者工作特征曲线下面积（AUC）为0.872，用于区分间皮瘤和良性病变，临界值= 0.93 nM/L（灵敏度= 80%，特异性= 82.6%）。血清SMRP区分转移和间皮瘤的AUC为0.693，临界值= 1.85 nM/L（灵敏度= 58.3%，特异性= 73.3%）。在所有组中，胸膜液中的SMRP值均高于血清中的SMRP值（间皮瘤：46.1 +/- 83.2 nM/L，良性病变：6.4 +/- 11.1 nM/L;转移瘤：6.36 +/- 21.73 nM/L）。胸膜SMRP分化良性病变和间皮瘤的AUC为0.831，临界值= 10.4 nM/L（灵敏度= 76.7%，特异性= 76.2%）。胸膜SMRP分化转移和间皮瘤的AUC为0.793。解释：我们表明SMRP可能是一个有前途的标志物间皮瘤诊断时，无论是在血清或胸膜液中测量。SMRP在两种类型的样本中的诊断价值相似，但胸膜液SMRP可以更好地区分间皮瘤和胸膜转移瘤。
Background: Diagnosis of malignant pleural mesothelioma is a challenging issue. Potential markers in mesothelioma diagnosis include soluble mesothelin-related peptides (SMRPs) and osteopontin, but no subsequent validation has been published yet.Methods: We prospectively evaluated SMRPs 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 patients with mesothelioma (2.05 +/- 2.57 nM/L [median +/- interquartile range]) than in patients with metastasis (1.02 +/- 1.79 nM/L) or benign lesions (0.55 +/- 0.59 nM/L). 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 SMRPs may be a promising marker for mesothelioma diagnosis when measured either in serum or pleural fluid. The diagnostic value of SMRPs was similar in both types of samples, but pleural fluid SMRPs may better discriminate mesothelioma from pleural metastasis.