Clinical significance of serum mesothelin in patients with mesothelioma and lung cancer
Clinical significance of serum mesothelin in patients with mesothelioma and lung cancer
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DOI：
10.1158/1078-0432.ccr-07-0629
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发表时间：
2007-09-01
影响因子：
11.5
通讯作者：
Puntoni, Riccardo
中科院分区：
文献类型：
--
作者：
Cristaudo, Alfonso;Foddis, Rudy;Puntoni, Riccardo
目的：已发现高水平的血清可溶性间皮素家族蛋白（SMRP）与恶性间皮瘤（MM）相关，但与肺癌（LC）无关。为了验证该标志物对这两种肿瘤的临床作用，我们在有史以来最大的胸部癌症人群中测试了血清SMRP。在107例MM患者、215例LC患者、130例良性呼吸道疾病（BIRD）患者和262例对照者中测量SMRP血液浓度。结果：MM和LC患者血清SMRP水平显著高于良性呼吸道疾病患者和正常对照组（P < 0.001）;血清SMRP区分MM和对照的受试者工作特征曲线下面积为0.77（95%置信区间，0.71-0.83），最佳临界值为1.00 nmol/L（灵敏度，68.2%;特异性，80.5%）。在MM和LC中，血清SIVIRP水平在早期和晚期之间没有显著差异。高SMRP水平被证明是一个独立的负面预后因素MM患者。结论：我们的数据证实，血清SMRP是一个很有前途的标志物MM的诊断，预后和临床监测。我们发现，血清SMRP剂量可能证明有助于LC诊断以及。这些数据也可能对以前接触石棉的工人的二级预防性医疗战略产生积极影响。
Purpose: High levels of serum-soluble mesothelin family proteins (SMRP) have been found to be associated with malignant mesothelioma (MM), but not lung cancer (LC).To verify the clinical role of this marker for both these tumors, we tested serum SMRP in the largest population of thoracic cancers ever assembled.Experimental Design: SMRP blood concentrations were measured in 107 patients with MM, 215 patients with LC, 130 patients with benign respiratory diseases (BIRD), and 262 controls. Statistical comparison between mean serum SMRP levels in all groups was done and receiver operating characteristic curves were constructed to evaluate the performance of this marker.Results: SMRP levels were significantly higher in patients with MM and LC than in patients with benign respiratory diseases and controls (P < 0.001). The area under the receiver operating characteristic curve for serum SMRP discriminating MM and controls was 0.77 (95% confidence interval, 0.71-0.83), with a best cutoff of 1.00 nmol/L (sensitivity, 68.2%; specificity, 80.5%). In both MM and LC, serum SIVIRP levels did not differ significantly between early and late stages. High SMRP levels proved to be an independent negative prognostic factor in patients with MM.Conclusions: Our data confirm that serum SMRP is a promising marker for the diagnosis, prognosis, and clinical monitoring of MM. We found that serum SMRP dosage may prove helpful in LC diagnosis as well. These data may also have positive repercussions on secondary preventive medical strategies for workers previously exposed to asbestos.