Comparison of serum biochemical markers in patients with mesothelioma and pleural plaques versus healthy individuals exposed to environmental asbestos

Our plain-English summary of Comparison of serum biochemical markers in patients with mesothelioma and pleural plaques versus healthy individuals exposed to environmental asbestos, by İ. Döngel, A. Akbaş, İ. Benli, et al (Türk Göğüs Kalp Damar Cerrahisi Dergisi, 2019).

The study

• Authors: İ. Döngel, A. Akbaş, İ. Benli, M. Bayram
• Journal: Türk Göğüs Kalp Damar Cerrahisi Dergisi
• Published: 2019;27(3):374-380
• Cited by: 4 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Background: In this study, we aimed to compare serum biochemical markers in patients with malignant pleural mesothelioma and pleural plaques versus healthy individuals exposed to environmental asbestos.

Methods: Between September 01, 2010 and March 31, 2011, a total of 540 participants (354 males, 186 females; mean age 61.4 years; range, 35 to 89 years) were included in the study. The participants were divided into four groups as follows: (1) patients with pleural plaques (n=277); (2) healthy individuals with normal chest X-rays who were exposed to environmental asbestos (n=121); (3) healthy individuals with normal chest X-rays who were not exposed to environmental asbestos (n=118); and (4) patients with malignant pleural mesothelioma (n=24). Serum levels of carcinoembryonic antigen, cancer antigen 125, 15-3, 19-9, free T3, free T4, thyroidstimulating hormone, vitamin B12, folate, and ferritin were measured.

Results: Serum cancer antigen 125, 15-3, folic acid, vitamin B12, and ferritin levels were higher with lower free T3 levels in Group 4 than the other groups. The areas under the curve for cancer antigen 125 and 15-3 were 0.78 and 0.67, respectively in the differential diagnosis of mesothelioma from other pathologies (p<0.001 for both). Optimal limits of these biomarkers were 13.63 and 18.43 ng/mL, respectively with 83% and 75% sensitivity and 69% and 48% specificity, respectively.

Conclusion: The combination or individual use of serum cancer antigen 125, 15-3, folic acid, vitamin B12, and ferritin levels may be helpful for early diagnosis and treatment of malignant pleural mesothelioma.

Copyright © 2019, Turkish Society of Cardiovascular Surgery.

In plain English

This study, carried out in Sivas province in central Turkey between September 2010 and March 2011, compared blood test results among 540 people aged 35 or older. There were four groups: 277 people with pleural plaques; 121 healthy people with normal chest X-rays exposed to environmental asbestos near ophiolite rock; 118 unexposed healthy controls from more distant villages; and 24 patients with malignant pleural mesothelioma. Ten blood markers were measured. Median levels of CA125, CA15-3, folic acid, vitamin B12 and ferritin were higher in the mesothelioma group than in the other groups, and free T3 was lower. Ferritin was 371 ng/mL in the mesothelioma patients and 71 to 89 ng/mL in the other groups. CEA, CA19-9, free T4 and TSH did not differ significantly between groups. In separating mesothelioma from the other groups, CA125 had an area under the curve of 0.78, with 83.3% sensitivity and 69.6% specificity at the chosen cut-off. The authors concluded that CA125, CA15-3, folic acid, vitamin B12 and ferritin, used alone or in combination, may be helpful for early diagnosis and treatment of malignant pleural mesothelioma.

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: Cross-sectional comparison of blood markers across four groups. Three groups were drawn from an earlier field-based cross-sectional study. The mesothelioma patients were identified from a cancer registry.
• Who was studied: 540 participants (354 males, 186 females; mean age 61.4 years; range 35 to 89) in Sivas province, Turkey, September 2010 to March 2011. They were 277 people with pleural plaques, 121 healthy people exposed to environmental asbestos with normal chest X-rays, 118 unexposed healthy controls with normal chest X-rays, and 24 surviving patients with malignant pleural mesothelioma diagnosed in 2009 to 2010.
• Exposure: Environmental (non-occupational) asbestos exposure from living in villages within 10 km of ophiolite rock units. Participants had to have lived in the same village for 20 years. Controls came from villages more than 25 km from ophiolitic areas. No fiber type is named.
• Main results:
  • Median CA125, CA15-3, folic acid, vitamin B12 and ferritin were significantly higher in the mesothelioma group than in the pleural plaque, exposed healthy and unexposed control groups. In Table 2, CA125 was 40.2 U/mL in the mesothelioma group against 14.23, 11.74 and 12.6, and CA15-3 was 31.1 U/mL against 20.6, 17.5 and 21.5.
  • Ferritin was 371 ng/mL in mesothelioma patients, 89 ng/mL in the control and pleural plaque groups, and 71 ng/mL in healthy asbestos-exposed individuals.
  • Vitamin B12 was 587 pg/mL in the mesothelioma group, significantly higher than in the other groups (Table 2: 276, 264 and 296 pg/mL).
  • Free T3 was lower in the mesothelioma group than in the other groups (Table 2: 1.89 pg/mL against 3.25 to 3.27 pg/mL).
  • CEA, CA19-9, free T4 and TSH did not differ significantly between the groups.
  • In distinguishing mesothelioma from the other groups, the area under the ROC curve was 0.78 for CA125 and 0.68 for CA15-3 (p less than 0.001 for both).
  • At the optimal cut-off of 13.63, CA125 had 83.3% sensitivity and 69.6% specificity for mesothelioma.
  • At the optimal cut-off of 18.43, CA15-3 had 75% sensitivity and 48.4% specificity for mesothelioma.
  • Mesothelioma patients had a lower body mass index than the other groups (Table 1: mean 24.9 against 26.5 to 27.3 kg/m2).
• The authors' conclusion: The authors concluded that serum CA125, CA15-3, folic acid, vitamin B12 and ferritin, used alone or in combination, may be helpful for early diagnosis and treatment of malignant pleural mesothelioma.

Topics

Medical terms in this study, explained in our Lexicon: Mesothelioma, Pleural Plaques, Pleural Mesothelioma, Chest X-Ray, Carcinoembryonic Antigen (CEA), Ferritin, Differential Diagnosis, Biomarker.

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