Blood tests for asbestos-related mesothelioma

Our plain-English summary of Blood tests for asbestos-related mesothelioma, by M. Maeda, O. Hino (Oncology, 2006).

The study

• Authors: M. Maeda, O. Hino
• Journal: Oncology
• Published: 2006;71(1-2):26-31
• Type of article: Review
• Cited by: 13 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Mesothelioma is an aggressive tumor arising from the mesothelium, and is usually associated with previous exposure to asbestos. The incubation period of the tumor may be described as 30-40 years, and the prognosis is dismal. Recently, serum markers for the diagnosis of mesothelioma have been reported as candidates. In this paper, we mini-reviewed the potential utility of ELISA systems as serum diagnostic markers for asbestos-related mesothelioma.

In plain English

This article was a review ("mini-review") of blood tests under development to help diagnose mesothelioma, a cancer the authors described as usually associated with past asbestos exposure. It summarized studies of tests measuring forms of a protein the authors called ERC/mesothelin. Other researchers reported raised blood levels of one form (SMRP) in 84% of 44 mesothelioma patients, compared with 2% of 160 patients with other lung or pleural diseases. Another study found that when the test was set to detect more than 90 to 95% of cases, its specificity (how often people without mesothelioma tested negative) fell to between 30 and 50%. The authors also described their own group's test for a different fragment, N-ERC/mesothelin. The median blood level was 25.12 ng/ml in 7 mesothelioma patients, against 1.4 ng/ml in 13 healthy volunteers, 1.31 in 4 patients with lung cancer spread to the pleura, and 1.10 ng/ml in 3 patients with benign asbestos pleuritis. The authors concluded that N-ERC/mesothelin may be a promising tumor marker. They proposed a prospective study to establish its clinical usefulness, cut-off values and accuracy.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: narrative mini-review of blood (serum ELISA) tests for mesothelioma, including a description of the authors' group's own small series
• Who was studied: Published studies of serum tests for mesothelioma by several research groups. Also the authors' group's own series: serum from 7 patients with mesothelioma, 4 with pleural metastasis from lung cancer, 3 with benign asbestos pleuritis and 13 healthy volunteers. No place or dates are given for this series.
• Exposure: Asbestos exposure itself was not studied. The article concerns blood markers for mesothelioma, which it describes as usually associated with previous asbestos exposure.
• Main results:
  • In a study by Robinson et al. (not the authors' own), raised serum SMRP was found in 84% of 44 mesothelioma patients, compared with 2% of 160 patients with other lung or pleural diseases.
  • In the same Robinson et al. study, 7 of 40 asbestos-exposed individuals had raised SMRP. Of these 7, 3 developed mesothelioma and 1 developed lung carcinoma within 1 to 5 years.
  • In a second Robinson et al. paper, the SMRP test had a sensitivity of 83% and a specificity of 95% in the first 48 mesothelioma patients examined.
  • In a study by Scherpereel et al. using the commercial MESOMARK test, mean serum SMRP was higher in patients with mesothelioma than in those with pleural metastasis or benign pleural lesions.
  • In the Scherpereel et al. study, when the cut-off was changed to give a sensitivity of more than 90 to 95%, the specificity fell to between 30 and 50%.
  • In a study by Hassan et al., serum mesothelin was raised in 40 of 56 (71%) mesothelioma patients and in 14 of 21 (67%) ovarian cancer patients.
  • With the authors' group's N-ERC/mesothelin test, median serum levels were: 25.12 ng/ml (range 10.32 to 53.13) in 7 mesothelioma patients; 1.4 ng/ml (range 0.67 to 7.60) in 13 healthy controls; 1.31 (range 0.68 to 4.33 ng/ml) in 4 pleural metastasis (lung cancer) patients; and 1.10 ng/ml (range 0.3 to 1.19) in 3 benign asbestos pleuritis patients.
  • In a study by Onda et al., MPF (N-ERC/mesothelin) levels were raised in 91% (51 of 56) of mesothelioma patients compared with healthy controls.
• The authors' conclusion: The authors concluded that N-ERC/mesothelin may represent a promising tumor marker for mesothelioma.
• Limitations the authors state:
  • The authors stated that the clinical usefulness of their own test, its cut-off values and its sensitivity and specificity still needed to be established in a prospective study.
  • The authors noted that it is not clear which part of the SMRP molecule the antibodies in the commercial MESOMARK kit recognize, so what that test actually detects is uncertain.
  • The authors noted that the Onda et al. test gave only relative values, so its results cannot be compared with those of other studies.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Mesothelioma.

Medical terms in this study, explained in our Lexicon: Mesothelioma, Mesothelium, Prognosis.

Related studies

• Diagnostic biomarker of asbestos-related mesothelioma: example of translational research — H. Okio, S. Kazu, et al. (2007)
• Soluble mesothelin-related protein--a blood test for mesothelioma — B.W. Robinson, J. Creaney, et al. (2005)
• Molecular tumor markers for asbestos-related mesothelioma: serum diagnostic markers — M. Maeda, O. Hino (2006)
• Sensitive and specific new enzyme-linked immunosorbent assay for N-ERC/mesothelin increases its potential as a useful serum tumor marker for mesothelioma — K. Shiomi, Y. Hagiwara, et al. (2008)
• Establishment of a novel specific ELISA system for rat N- and C-ERC/mesothelin. Rat ERC/mesothelin in the body fluids of mice bearing mesothelioma — Y. Hagiwara, Y. Hamada, et al. (2008)
• Antitumor activity of anti-C-ERC/mesothelin monoclonal antibody in vivo — K. Inami, M. Abe, et al. (2010)

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