Megakaryocyte potentiating factor as a tumor marker of malignant pleural mesothelioma: evaluation in comparison with mesothelin

Our plain-English summary of Megakaryocyte potentiating factor as a tumor marker of malignant pleural mesothelioma: evaluation in comparison with mesothelin, by K. Iwahori, T. Osaki, S. Serada, et al (Lung Cancer, 2008).

The study

• Authors: K. Iwahori, T. Osaki, S. Serada, M. Fujimoto, H. Suzuki, Y. Kishi, A. Yokoyama, H. Hamada, Y. Fujii, K. Yamaguchi, T. Hirashima, K. Matsui, I. Tachibana, Y. Nakamura, I. Kawase, T. Naka
• Journal: Lung Cancer
• Published: 2008;62(1):45-54
• Cited by: 43 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Purpose: An early and reliable blood test is one deficiency in diagnosis of malignant pleural mesothelioma (MPM). Megakaryocyte potentiating factor (MPF) and mesothelin variants (MSLN), members of the mesothelin gene family, have been studied as candidate serum markers for MPM. We developed a novel enzyme-linked immunosorbent assay (ELISA) system to compare the diagnostic efficacy of MPF and MSLN in MPM and control groups.

Experimental Design: MPF and MSLN were assayed with ELISA in 27 consecutive MPM patients and 129 controls including patients with lung cancer and asymptomatic asbestos-exposed subjects.

Results: Statistically significant elevation of serum MPF and MSLN levels was noted in MPM patients in comparison with every control group. The area under the receiver operating characteristic curve (AUC) was calculated for differentiation of MPM and lung cancer, healthy asbestos-exposed subjects, and healthy adults. While the AUC for serum MPF was 0.879, cut-off=19.1ng/ml (sensitivity=74.1%, specificity=90.4%), the AUC for serum MSLN was 0.713, cut-off=93.5ng/ml (sensitivity=59.3%, specificity=86.2%). Comparison between AUC for MPF and MSLN values shows that MPF is significantly superior to MSLN (p=0.025). Finally, there was a significant correlation between MPF and MSLN values for MPM (Pearson's correlation coefficient=0.77; p<0.001).

Conclusions: These findings suggest that diagnostic value of MPF for MPM was better than that of MSLN although both markers showed almost equal specificity for MPM.

In plain English

This study tested two blood proteins, megakaryocyte potentiating factor (MPF) and mesothelin variants (MSLN), as markers of malignant pleural mesothelioma (MPM). The authors used blood tests (ELISA) they developed themselves. They tested serum from 27 consecutive patients with non-resectable MPM and from 129 controls: 47 with lung cancer, 35 with ovarian, stomach or colon cancer, 9 asbestos-exposed people without symptoms, and 38 healthy adults with no history of asbestos exposure. Median levels of both proteins were significantly higher in MPM patients than in each control group. The authors then compared MPM patients with the lung cancer, asbestos-exposed and healthy groups combined. MPF had an area under the curve of 0.879 (cut-off 19.1 ng/ml; sensitivity 74.1%, specificity 90.4%). MSLN had 0.713 (cut-off 93.5 ng/ml; sensitivity 59.3%, specificity 86.2%). The difference was significant (p = 0.025). Each marker was above its cut-off in 1 of the 9 asbestos-exposed people. In MPM patients the two markers were correlated (coefficient 0.77). Among MPM patients, neither marker differed significantly between histological subtypes. The authors concluded that MPF had better diagnostic value for MPM than MSLN, although both had almost equal specificity.

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: Diagnostic marker study comparing serum levels of two proteins, measured with newly developed ELISA tests, between mesothelioma patients and control groups
• Who was studied: 27 consecutive patients with non-resectable malignant pleural mesothelioma (13 epithelial, 3 sarcomatoid, 5 mixed, 6 unclassified type) and 129 controls: 47 lung cancer patients, 35 patients with other cancers (18 ovarian, 8 stomach, 9 colon), 9 asbestos-exposed asymptomatic subjects, and 38 healthy adults without a history of asbestos exposure. The text does not state where or when the samples were collected.
• Exposure: Not an exposure study. The study measured serum MPF and MSLN levels. Asbestos exposure appears only as the defining feature of one control group of 9 asymptomatic people. Fiber types, jobs and doses are not reported.
• Main results:
  • Mean serum MPF was 68.7 ng/ml (SD 101.1) in MPM patients. In the control groups it was 16.6 in lung cancer, 15.1 in other cancers, 9.7 in healthy asbestos-exposed subjects and 9.0 in healthy adults. Median MPF differed significantly between MPM and every control group (p less than 0.001).
  • Mean serum MSLN was 130.0 ng/ml in MPM patients. In the control groups it was 83.4 in lung cancer, 74.4 in other cancers, 59.5 in asbestos-exposed subjects and 61.4 in healthy adults. Median MSLN was significantly higher in MPM than in each control group: p = 0.028 against lung cancer, p = 0.005 against other cancers, p = 0.010 against asbestos-exposed subjects, and p less than 0.001 against healthy adults.
  • The authors compared MPM patients with controls made up of the lung cancer, asbestos-exposed and healthy adult groups. MPF had an AUC of 0.879 at a cut-off of 19.1 ng/ml (sensitivity 74.1%, specificity 90.4%). MSLN had an AUC of 0.713 at a cut-off of 93.5 ng/ml (sensitivity 59.3%, specificity 86.2%). The difference between the two markers was significant (p = 0.025).
  • MPF was above its cut-off in 20 of 27 MPM patients (74.1%), 8 lung cancer patients (17.0%), 5 patients with other cancers (14.3%), 1 asbestos-exposed adult (11.1%) and none of the healthy donors. MSLN was above its cut-off in 59.3% of MPM patients, 21.3% of lung cancer patients, 20.0% of other cancer patients, 1 asbestos-exposed adult (11.1%) and 2 healthy donors (5.3%). Both markers were elevated in 4 ovarian cancer patients (22.2%).
  • The authors repeated the comparison with the other-cancer group added to the controls. AUC was 0.865 for MPF and 0.712 for MSLN (p = 0.04). MSLN sensitivity fell to 40.7%, while MPF sensitivity did not change.
  • In the 27 MPM patients, MPF and MSLN values were significantly correlated (Pearson's correlation coefficient 0.77; p less than 0.001). Six patients were above the MPF cut-off but below the MSLN cut-off, and only one showed the opposite.
  • Among MPM patients, neither MPF nor MSLN levels differed significantly between histological subtypes (epithelial, sarcomatoid, mixed, unclassified).
• The authors' conclusion: The authors concluded that the diagnostic value of MPF for MPM was better than that of MSLN, although both markers showed almost equal specificity. Their final Conclusion section words this differently, stating it is 'suggested that MPF has superior specificity for MPM compared to MSLN'.

Topics

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

Medical terms in this study, explained in our Lexicon: Tumor Marker, Pleural Mesothelioma, Mesothelin, Lung Cancer.

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