Plasma Fibulin-3 as a Potential Biomarker for Patients with Asbestos-Related Diseases in the Han Population

Our plain-English summary of Plasma Fibulin-3 as a Potential Biomarker for Patients with Asbestos-Related Diseases in the Han Population, by Z. Jiang, S. Ying, W. Shen, et al (Disease Markers, 2017).

The study

• Authors: Z. Jiang, S. Ying, W. Shen, X. He, J. Chen, H. Xia, M. Yu, Y. Xiao, L. Feng, L. Zhu, L. Ju, X. Guo, Y. Zhang, J.W. Shen, Y. Tong, X. Zhang, J. Lou
• Journal: Disease Markers
• Published: 2017;2017:1725354
• Cited by: 17 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Fibulin-3 has been reported as a potential biomarker for mesothelioma. However, little is known about the diagnostic efficacies of fibulin-3 for asbestos-related diseases (ARDs) in China. This study was to investigate the utility of fibulin-3 for asbestos exposure and ARDs. A total of 430 subjects were recruited from Southeast China, including healthy individuals, asbestos-exposed (AE) individuals, and patients with pleural plaques (PP), asbestosis, and malignant pleural mesothelioma (MPM). Plasma fibulin-3 was measured using the enzyme-linked immunosorbent assay. Linear regression analyses were applied to explore the influencing factors of fibulin-3. Receiver operating characteristic curves were used to determine the cutoff values. The median fibulin-3 level of subjects in the mesothelioma group was higher than that in other groups. Subjects in the asbestosis group had higher median fibulin-3 level than those in the control group. A higher fibulin-3 level was found in the group with ≥10 years of asbestos exposure as compared with control groups. The AUCs of fibulin-3 for distinguishing MPM subjects from control, AE, PP, and asbestosis subjects were 0.92, 0.88, 0.90, and 0.81, respectively. Our study provided evidence that fibulin-3 could be a potential biomarker for the early screening of MPM, but not of other nonmalignant ARDs in Chinese populations.

In plain English

The authors measured blood fibulin-3 in 430 people from a historical asbestos processing area in Southeast China. The groups were 94 unexposed controls, 218 exposed people without imaging changes, 74 with pleural plaques alone, 29 with asbestosis and 15 with epithelial-type malignant pleural mesothelioma. Median levels were highest with mesothelioma (19.8 ng/ml), against 12.0 for asbestosis, 11.5 for pleural plaques, 11.0 for exposed people and 10.5 for controls. The asbestosis group was also higher than controls. Other group differences were not statistically significant. Exposed people with 10 or more years of exposure had higher levels than controls. Separating mesothelioma patients from controls, fibulin-3 had an area under the curve of 0.92 (95% confidence interval 0.81 to 1.00; 1.0 means perfect discrimination). A cutoff of 15.30 ng/ml gave 86.67% sensitivity and 97.87% specificity. Separating other groups from controls gave lower areas: 0.57 (0.50 to 0.64) for pleural plaques, 0.61 (0.53 to 0.70) for exposed people and 0.67 (0.55 to 0.79) for asbestosis. The authors concluded fibulin-3 could be a potential biomarker for early mesothelioma screening, but not for non-malignant asbestos-related diseases. They noted the small number of mesothelioma patients.

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 plasma fibulin-3 levels (measured by ELISA) across five groups, with regression analysis and receiver operating characteristic (ROC) analysis of diagnostic accuracy
• Who was studied: 430 Han Chinese subjects from a historical asbestos processing area in Southeast China. Groups: 94 healthy controls not exposed to asbestos with normal chest X-rays; 218 occupationally asbestos-exposed individuals without imaging changes; 74 with pleural plaques alone; 29 with asbestosis; 15 with malignant pleural mesothelioma of epithelial type. Mesothelioma blood samples were collected at two local hospitals from 2014 to 2016.
• Exposure: Occupational asbestos exposure in asbestos processing work; the fiber type is not specified. Exposure duration came from job histories. Potential exposure level (mg/m3 × years) was estimated from median total dust concentrations of 0.7 mg/m3 in small household workshops and 5.9 mg/m3 in large manufactories. Not all disease-group members reported exposure: Table 1 gives yes/no counts of 48/26 for pleural plaques, 23/6 for asbestosis and 8/7 for mesothelioma.
• Main results:
  • Median plasma fibulin-3 (interquartile range) by group: mesothelioma 19.8 (7.1) ng/ml, higher than asbestosis 12.0 (5.5), pleural plaques 11.5 (3.6), asbestos-exposed 11.0 (3.6) and controls 10.5 (3.5) ng/ml
  • The asbestosis group had higher fibulin-3 than controls; differences between the other groups were not statistically significant
  • Within the asbestos-exposed group, those with 10 or more years of exposure had higher fibulin-3 (median 11.4 ng/ml) than controls (median 10.5 ng/ml). No significant difference was found across levels of estimated potential exposure compared with controls.
  • Mesothelioma patients versus controls: area under the curve 0.92 (95% CI: 0.81–1.00)
  • Mesothelioma patients versus controls: the best cutoff of 15.30 ng/ml gave 86.67% sensitivity and 97.87% specificity
  • Mesothelioma patients versus asbestos-exposed, pleural plaque and asbestosis subjects: areas under the curve 0.88 (95% CI: 0.75–1.00), 0.90 (95% CI: 0.78–1.00) and 0.81 (95% CI: 0.67–0.96)
  • Asbestos-exposed, pleural plaque and asbestosis subjects versus controls: areas under the curve 0.61 (95% CI: 0.53–0.70), 0.57 (95% CI: 0.50–0.64) and 0.67 (95% CI: 0.55–0.79)
• The authors' conclusion: The authors concluded that fibulin-3 could be used as a potential biomarker for early screening for malignant pleural mesothelioma in high-risk asbestos-exposed and healthy Chinese populations, but not for other nonmalignant asbestos-related diseases.
• Limitations the authors state:
  • Fibulin-3 was measured in only a limited number of mesothelioma patients.
  • A follow-up study is needed to validate fibulin-3 for early diagnosis and screening of mesothelioma.
  • The relatively low area under the curve of 0.67 may limit the usefulness of fibulin-3 for identifying asbestosis patients in large cohorts.
  • Blood sample storage time and experimental conditions could affect measured levels. The authors raise this when explaining differences from other studies.

Topics

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

Medical terms in this study, explained in our Lexicon: Fibulin-3, Biomarker, Mesothelioma, Asbestos Exposure, Pleural Plaques, Pleural Mesothelioma.

Related studies

• Overexpression of fibulin-3 in tumor tissue predicts poor survival of malignant mesothelioma patients from hand-spinning asbestos exposed area in eastern China — Z. Jiang, W. Shen, et al. (2020)
• Serum HMGB1 as a Potential Biomarker for Patients with Asbestos-Related Diseases — S. Ying, Z. Jiang, et al. (2017)
• Fibulin-3 as a blood and effusion biomarker for pleural mesothelioma — H.I. Pass, S.M. Levin, et al. (2012)
• Fibulin-3 as biomarker of malignant mesothelioma — C. Ledda, R. Caltabiano, et al. (2019)
• Serum Proteomics and Plasma Fibulin-3 in Differentiation of Mesothelioma From Asbestos-Exposed Controls and Patients With Other Pleural Diseases — S. Tsim, L. Alexander, et al. (2021)
• Exploration of identifying novel serum biomarkers for malignant mesothelioma using iTRAQ combined with 2D-LC-MS/MS — H. Xia, L. Feng, et al. (2021)

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