Combined CA125 and mesothelin levels for the diagnosis of malignant mesothelioma
Combined CA125 and mesothelin levels for the diagnosis of malignant mesothelioma
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DOI：
10.1378/chest.07-0013
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发表时间：
2007-10-01
期刊：
影响因子：
9.6
通讯作者：
Robinson, Bruce W. S.
中科院分区：
文献类型：
--
作者：
Creaney, Jenette;van Bruggen, Ivonne;Robinson, Bruce W. S.
背景：恶性间皮瘤是一种侵袭性、致命性一致的肿瘤。血清标志物有助于该病的诊断。一个潜在的标记物是间甲肾上腺素。本研究的目的是在一个大的患者队列中研究间皮素生物标记物，并确定另一个生物标记物CA125是否提高了间皮瘤诊断间皮瘤的敏感性。方法：采用商品化的分析方法检测117例胸膜恶性间皮瘤患者、33名健康石棉暴露者、53名石棉相关性肺或胸膜疾病患者以及30名良性胸腔积液患者的血清中间皮素和CA125水平。结果：CA125对间皮瘤诊断的敏感度为27%，特异度为95%，与良性胸腔积液的特异度为50%。间皮脂对间皮瘤的交叉验证敏感性为52%。与良性肺部或胸膜疾病患者相比，敏感性为95%。在50%的间皮瘤患者中，CA125和间皮质素水平不一致。使用Logistic回归模型结合两个生物标志物的数据并不能提高检测间皮瘤的敏感性。结论：联合使用间皮素和CA125数据并不能提高间皮瘤的敏感性。单独使用间甲硫磷进行诊断。这两个标志物的使用可能会增加可以监测的患者数量。
Background: Malignant mesothelioma is an aggressive, uniformly fatal tumor. Serum markers would be useful for the diagnosis of this disease. One potential marker is mesothelin. The purpose of this study was to study the mesothelin biomarker in a large patient cohort and to determine if another biomarker, CA125, improves on the sensitivity of mesothelin in the diagnosis of mesothelioma.Methods: Serum levels of mesothelin and CA125 were determined by commercially available assays in 117 samples obtained at diagnosis from patients with pleural malignant mesothelioma, 33 healthy, asbestos-exposed individuals, 53 patients with asbestos-related lung or pleural disease, and 30 patients presenting with benign pleural effusions. Cross-validated sensitivities were determined, and receiver operator characteristic curves were generated to compare the diagnostic accuracy of the biomarkers.Results: CA125 had a cross-validated sensitivity of 27% for mesothelioma patients at a specificity of 95% relative to asbestos-exposed individuals, or 50% relative to individuals with benign pleural effusions. Mesothelin had a cross-validated sensitivity of 52% for mesothelioma. patients, at a sensitivity of 95% relative to individuals with benign lung or pleural disease. CA125 and mesothelin levels were discordant in > 50% of mesothelioma patients. Combining the data from the two biomarkers using a logistic regression model did not improve sensitivity for detecting mesothelioma above that of the mesothelin marker alone.Conclusion: Combining mesothelin and CA125 data does not improve the sensitivity of mesothelioma. diagnosis over mesothelin alone. The use of both markers potentially increases the number of patients who can be monitored.