Soluble mesothelin-related protein in pleural effusion from patients with malignant pleural mesothelioma
Soluble mesothelin-related protein in pleural effusion from patients with malignant pleural mesothelioma
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DOI：
10.3892/etm_00000048
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发表时间：
2010-03-01
影响因子：
2.7
通讯作者：
Kishimoto, Takumi
中科院分区：
文献类型：
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作者：
Fujimoto, Nobukazu;Gemba, Kenichi;Kishimoto, Takumi
恶性胸膜间皮瘤（MPM）是一种高度侵袭性的肿瘤，主要来自胸膜表面的浆膜细胞，与石棉暴露密切相关。MPM患者通常以胸腔积液为首发症状。然而，使用胸水的细胞学诊断通常是困难的，并且具有有限的实用性。因此，迫切需要一种有效的分子标记物用于肺癌的鉴别诊断。本研究旨在探讨胸水可溶性间皮素相关蛋白（SMRP）的诊断价值。对23例MPM、38例LC、26例良性石棉胸膜炎（BAP）、5例结核性胸膜炎（TP）和4例慢性心力衰竭（CHF）患者的胸水进行SMRP浓度测定。所有数据均采用非参数双侧统计检验进行分析。MPM、LC、BAP、TP和CHF中SMRP的中位浓度分别为11.5（范围0.90-82.80）、5.20（0.05-36.40）、6.65（1.45-11.25）、3.20（1.65-6.50）和2.03（1.35-2.80）nmol/l。MPM组SMRP浓度显著高于其他疾病组（P=0.001）。MPM诊断的ROC曲线下面积（AUC）值为0.75，用于与其他组的鉴别诊断。以8 nmol/l为界值，诊断MPM的敏感性和特异性分别为70.0%和68.4%。提示胸水SMRP浓度是诊断MPM的一个有用指标。
Malignant pleural mesothelioma (MPM) is a highly aggressive neoplasm primarily arising from surface serosal cells of the pleura and is strongly associated with asbestos exposure. Patients with MPM often develop pleural fluid as initial presentation. However, cytological diagnosis using pleural fluid is usually difficult and has limited utility. A useful molecular marker for differential diagnosis particularly with lung cancer (LC) is urgently needed. The aim of the present study was to investigate the diagnostic value of soluble mesothelin-related protein (SMRP) in pleural fluid. Pleural fluids were collected from 23 patients with MPM, 38 with LC, 26 with benign asbestos pleurisy (BAP), 5 with tuberculosis pleurisy (TP) and 4 with chronic heart failure (CHF), and the SMRP concentration was determined. All data were analyzed by using non-parametric two-sided statistical tests. The median concentration of SMRP in MPM, LC, BAP, TP and CHF were 11.5 (range 0.90-82.80), 5.20 (0.05-36.40), 6.65 (1.45-11.25), 3.20 (1.65-6.50) and 2.03 (1.35-2.80) nmol/l, respectively. The SMRP concentration was significantly higher in MPM than in the other diseases (P=0.001). The area under the ROC curve (AUC) values of the MPM diagnosis was 0.75 for the differential diagnosis from the other groups. Based on the cut-off value of 8 nmol/l, the sensitivity and specificity for diagnosis of MPM were 70.0 and 68.4%, respectively. These results indicate that the SMRP concentration in pleural fluid is a useful marker for the diagnosis of MPM.