RT Journal Article
SR Electronic
T1 Evaluating the utility of mesothelin in diagnosing mesothelioma
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP P2937
VO 42
IS Suppl 57
A1 Patrick Bradley
A1 Jurgen Herre
A1 Stefan Marciniak
A1 James Wason
A1 Pasupathy Sivasothy
YR 2013
UL http://erj.ersjournals.com/content/42/Suppl_57/P2937.abstract
AB BackgroundMalignant pleural mesothelioma (MPM) is difficult to diagnose at an early stage, when management options can be more beneficial. The biomarker, which is found both in serum and pleural fluid, has been proposed to improve early diagnosis in selected cases.AimsWe set out to evaluate in consecutive cases referred to a pleural investigation service the diagnostic utility of serum and pleural fluid mesothelin levels alone and in conjunction with history of asbestos exposure, radiological and cytological findings. We wished to assess whether mesothelin offers added diagnostic value to standard investigations, which may have the potential to reduce the number of invasive investigations.MethodsSerum and pleural fluid mesothelin concentrations were measured in samples from 18 patients with suspected malignant effusions. These patients were followed up until a definitive diagnosis was made. Sensitivities and specificities were calculated, alone or in relation to asbestos exposure, radiological findings and cytology.ResultsSix of the patients were eventually confirmed to have MPM. Pleural mesothelin had greater sensitivity and positive predictive value (PPV) than serum mesothelin (0.83 and 0.63 vs 0.67 and 0.50). Neither added diagnostic value to the current initial investigations.ConclusionsMesothelin measurements did not add diagnostic value to standard investigations in suspected cases of malignant effusion in this study. This type of interim analysis, incorporating current-practice investigations, may warrant further data collection in a larger study for adequately powered statistical analysis.