Molecular tumor markers for asbestos-related mesothelioma: serum diagnostic markers

Our plain-English summary of Molecular tumor markers for asbestos-related mesothelioma: serum diagnostic markers, by M. Maeda, O. Hino (Pathology International, 2006).

The study

• Authors: M. Maeda, O. Hino
• Journal: Pathology International
• Published: 2006;56(11):649-54
• Type of article: Review
• Cited by: 41 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. In addition to immunohistochemical markers, recently, serum markers for the diagnosis of mesothelioma have been reported as candidates. In contrast, the expression in renal carcinoma (ERC) gene has been discovered in the Eker rat model (Tsc2 gene mutant), which is a homolog of the human mesothelin/megakaryocyte potentiating factor gene, and a novel ELISA system (N-ERC/mesothelin) has been developed. It has also been found that N-ERC/mesothelin is very stable and plentiful in the blood. In the present paper the potential utility of molecular diagnostic markers is reviewed, including ELISA systems for asbestos-related mesothelioma.

In plain English

This review article concerned tumor markers for mesothelioma, a cancer the authors describe as usually associated with asbestos exposure. It covered tissue-staining (immunohistochemical) markers and blood (serum) tests. Among cited studies, Yaziji et al. described a three-antibody panel (calretinin, BG8 and MOC-31) with high sensitivity and specificity for distinguishing epithelioid mesothelioma from adenocarcinoma. For blood tests, Robinson et al. reported 83% sensitivity and 95% specificity for a protein called SMRP in their first 48 mesothelioma patients. Hassan et al. reported raised serum mesothelin in 40 of 56 (71%) mesothelioma patients. Onda et al. reported raised MPF in 51 of 56 (91%). The authors also described their own group's earlier blood test for a fragment they call N-ERC/mesothelin. In seven mesothelioma patients, all epithelial type, the median level was 25.12 ng/mL, compared with 1.4 ng/mL in 13 healthy volunteers, 1.31 ng/mL in four patients with lung cancer spread to the pleura, and 1.10 ng/mL in three patients with benign asbestos pleuritis. The authors concluded that N-ERC/mesothelin may represent a promising tumor marker and called for prospective studies.

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: Review article of published research on immunohistochemical and serum (blood) markers for mesothelioma, including the authors' own group's earlier ELISA work
• Who was studied: Published studies on mesothelioma markers. In the authors' own group's ELISA work, serum was tested from 7 patients with mesothelioma (all epithelial type), 4 with pleural metastasis from lung cancer, 3 with benign asbestos pleuritis, and 13 healthy volunteers
• Exposure: Not an exposure study. The review concerns diagnostic markers for mesothelioma, which the authors describe as usually associated with asbestos exposure. No fiber types or doses were analyzed.
• Main results:
  • In the authors' group's N-ERC/mesothelin ELISA, the median serum concentration was 25.12 ng/mL (range 10.32 to 53.13) in the 7 mesothelioma patients, whose diagnosis was confirmed immunohistochemically as all epithelial type. It was 1.4 ng/mL (range 0.67 to 7.60) in the 13 healthy controls, 1.31 ng/mL in the 4 pleural metastasis (lung cancer) patients, and 1.10 ng/mL in the 3 benign asbestos pleuritis patients.
  • Cited study (Robinson et al.): serum SMRP had a sensitivity of 83% and specificity of 95% for diagnosing mesothelioma in the first 48 mesothelioma patients examined
  • Cited study (Hassan et al.): serum mesothelin was elevated in 40 of 56 (71%) mesothelioma patients and 14 of 21 (67%) ovarian cancer patients
  • Cited study (Onda et al.): MPF (N-ERC/mesothelin) levels were elevated in 91% (51 of 56) of mesothelioma patients compared with healthy controls
  • Cited study (Yaziji et al.): a panel of calretinin, BG8 and MOC-31 was reported to give high sensitivity and specificity for distinguishing epithelioid mesothelioma from adenocarcinoma. The text prints the figure as 96%, but a comparison symbol before it (likely meaning 'at least') appears to have been lost in scanning, so the exact value cannot be confirmed from this text.
• The authors' conclusion: The authors concluded that N-ERC/mesothelin may represent a promising tumor marker for mesothelioma, and that retrospective and prospective studies of molecular markers should be conducted together with imaging diagnosis
• Limitations the authors state:
  • The clinical usefulness, cut-off values and sensitivity/specificity of the authors' ELISA had not yet been established. The authors proposed a prospective study to do so.
  • The SMRP variant measured by one ELISA had not yet been shown to exist in the serum of mesothelioma patients
  • Results differ among immunohistochemical markers, and standardization of protocols may be needed

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, Mesothelioma, Mesothelium, Prognosis, Carcinoma, Mesothelin.

Related studies

• 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)
• Diagnostic biomarker of asbestos-related mesothelioma: example of translational research — H. Okio, S. Kazu, et al. (2007)
• Soluble mesothelin-related peptides (SMRP) - high stability of a potential tumor marker for mesothelioma — D.G. Weber, D. Taeger, et al. (2007)
• Megakaryocyte potentiating factor as a tumor marker of malignant pleural mesothelioma: evaluation in comparison with mesothelin — K. Iwahori, T. Osaki, et al. (2008)
• Comparison of osteopontin, megakaryocyte potentiating factor, and mesothelin proteins as markers in the serum of patients with malignant mesothelioma — J. Creaney, D. Yeoman, et al. (2008)
• Serum levels of soluble mesothelin-related peptides in malignant and nonmalignant asbestos-related pleural disease: relation with past asbestos exposure — J.A. Rodríguez Portal, E. Rodríguez Becerra, et al. (2009)

Browse more research in Pathology International, or return to medical research.