Comparison between mesothelin and fibulin-3 detection in pleural malignant mesothelioma (MPM) patients

Abstract

Background: MPM is an asbestos-related tumour with a poor prognosis. Pleural effusion (PE) is often the primary manifestation and can be found in about 95% of MPM at diagnosis. PE is obtained by thoracentesis and it may be important for initial diagnosis. A reliable diagnostic biomarker for MPM is an area of intense research. Among the biomarkers, soluble mesothelin-related peptide (SMRP) and fibulin-3 (FBL-3) have received considerable attention. In the present study, we compared the diagnostic performances of SMRP and FBL-3 detection in the same effusions taken at the time of diagnosis. Methods: the study was performed in 33 patients with MPM, 64 with pleural benign lesions (BNG) and 23 with non-MPM pleural metastases (MTS). All patients had developed a PE and underwent thoracentesis. PE were processed by centrifugation and stored at -20°C until SMRP and FBL-3 analysis was performed. All pleural effusion samples were tested in duplicate. Results: patients with MPM were found to have higher SMRP-median levels in effusion than patients with PE form other pathologies (MPM-median = 22.5 nM; Mts+Bng-median = 4.8 nM; P-value P-value = 0.174).Next, we assessed the diagnostic accuracy of SMRP and FBL-3 biomarkers by using the ROC analysis. The results showed that SMRP outperformed FBL-3. Conclusion: the present study confirms that SMRP is a good diagnostic marker for MPM effusion as opposed to FBL-3 which proved not to be a valuable marker. In addition, FBL-3 does not add any information to the determination of the SMRP in effusion.