The Correlation of Serum Mesothelin Level With Pleural Thickness in Malignant Pleural Mesothelioma Makes it a Valuable Tool for Monitoring Tumor Progression

Our plain-English summary of The Correlation of Serum Mesothelin Level With Pleural Thickness in Malignant Pleural Mesothelioma Makes it a Valuable Tool for Monitoring Tumor Progression, by V. Fontana, A. Vigani, M.P. Pistillo, et al (Journal of Thoracic Oncology, 2019).

The study

• Authors: V. Fontana, A. Vigani, M.P. Pistillo, U. Giannoni, I. Rosemberg, P.A. Canessa, G. Berisso, P. Ferro, M.C. Franceschini, M. Tonarelli, S. Roncella
• Journal: Journal of Thoracic Oncology
• Published: 2019;14(5):e92-e94
• Type of article: Letter
• Cited by: 4 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Summary of the article

In this letter, the authors extended an earlier single-case report and examined whether serum soluble mesothelin-related peptide (Se-SMRP) levels tracked pleural thickness measured by computed tomography (CT) in malignant pleural mesothelioma (MPM). They analyzed 10 MPM patients (6 epithelioid, 3 sarcomatoid, 1 biphasic; 9 male; median age 67.5 years) recruited at the Oncology Division, ASL5 La Spezia, Italy, between March 2011 and May 2017. Pleural effusion was present at diagnosis in eight patients and appeared later in two. Se-SMRP was measured in duplicate with an enzyme-linked immunosorbent assay on blood taken at diagnosis, before therapy and during follow-up. Costal pleural thickness was measured on repeated CT scans by the same two thoracic radiologists. The association was analyzed with mixed-effects regression on log-transformed values, adjusted for age and disease stage at diagnosis. Se-SMRP and pleural thickness showed very similar trends, most closely in seven patients. In three patients, the trends diverged at time points when pleural effusion strongly increased or newly appeared. Pleural thickness showed a statistically significant geometric mean increase of 110% (95% CI 16%–280%, p = 0.014) per unit increase in log-SMRP. The authors concluded that the study confirmed a strong positive association. They noted that Se-SMRP levels could be influenced by new or changing pleural effusion, and suggested that Se-SMRP testing could be performed routinely and integrated with CT to monitor MPM progression.

PubMed has no abstract for this study, and the article doesn't print one. We wrote this summary from the full article with the help of AI. It is not the authors' wording.

In plain English

This was a short letter to the editor reporting a small follow-up study of 10 patients with malignant pleural mesothelioma (6 epithelioid, 3 sarcomatoid, 1 biphasic; 9 male; median age 67.5 years). The patients were recruited at the Oncology Division of ASL5 La Spezia, Italy, between March 2011 and May 2017. The article does not describe the patients' asbestos exposure. Over each patient's follow-up, the authors repeatedly measured a blood marker, serum soluble mesothelin-related peptides (Se-SMRP), and the thickness of the pleura on CT scans. The two measures followed very similar trends, most closely in seven patients. In three patients the trends diverged at times when fluid around the lung (pleural effusion) strongly increased or newly appeared. In an analysis adjusted for age and disease stage at diagnosis, pleural thickness rose on average by 110% (95% confidence interval 16% to 280%, p = 0.014) per unit increase in log-transformed Se-SMRP. The authors concluded that Se-SMRP testing could be performed routinely alongside CT to monitor progression. They noted that new or changing pleural effusion could influence Se-SMRP levels.

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: Letter to the editor reporting a small longitudinal patient series with repeated blood and CT measurements, extending the authors' earlier single-case report
• Who was studied: 10 malignant pleural mesothelioma patients (6 epithelioid, 3 sarcomatoid, 1 biphasic; 9 male; median age 67.5 years), recruited at the Oncology Division, ASL5 La Spezia, Italy, between March 2011 and May 2017
• Exposure: Asbestos exposure is not described. The factor studied was serum soluble mesothelin-related peptide (Se-SMRP) levels, measured with the MesoMark enzyme-linked immunosorbent assay and compared with pleural thickness on repeated CT scans
• Main results:
  • Se-SMRP levels and pleural thickness showed very similar trends during follow-up, with the overlap particularly marked in seven of the 10 cases
  • In three cases the trends diverged at certain time points: when pleural effusion strongly increased (case 8) or when a pleural effusion not present at diagnosis appeared (cases 9 and 10)
  • After adjusting for age and disease stage at diagnosis, there was a statistically significant (geometric) mean increase in pleural thickness of 110% (95% confidence interval 16% to 280%, p = 0.014) per unit increase in log-SMRP, across the 10 patients
• The authors' conclusion: The authors concluded that they were strongly led to believe that Se-SMRP levels can be measured routinely and integrated with CT for monitoring the progression of malignant pleural mesothelioma
• Limitations the authors state:
  • Se-SMRP levels could be influenced by the development of a new pleural effusion or by changes in its volume

Topics

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

Medical terms in this study, explained in our Lexicon: Mesothelin, Pleural Thickness, Pleural Mesothelioma, Soluble Mesothelin-Related Peptides (SMRP), Epithelioid, Sarcomatoid, Biphasic Mesothelioma, Pleural Effusion.

Related studies

• Use of Serum Mesothelin as an Indicator of Tumor Progression in Routine Clinical Practice of Malignant Pleural Mesothelioma Treatment — A. Vigani, M.P. Pistillo, et al. (2018)
• Plasma versus serum levels of osteopontin and mesothelin in patients with malignant mesothelioma--which is best? — J. Creaney, D. Yeoman, et al. (2011)
• Evaluation of soluble mesothelin-related peptide as a diagnostic marker of malignant pleural mesothelioma effusions: its contribution to cytology — P.A. Canessa, M.C. Franceschini, et al. (2013)
• The relationship between tumor MSLN methylation and serum mesothelin (SMRP) in mesothelioma — H.H. Nelson, L.M. Almquist, et al. (2011)
• Soluble mesothelin-related peptides levels in patients with malignant mesothelioma — A. Franko, V. Dolzan, et al. (2012)
• Serum soluble mesothelin-related protein (SMRP) and fibulin-3 levels correlate with baseline malignant pleural mesothelioma (MPM) tumor volumes but are not useful as biomarkers of response in an immunotherapy trial — S.I. Katz, L. Roshkovan, et al. (2021)

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