Comparison of multiple serum and pleural fluid biomarkers for the diagnosis of Malignant Pleural Mesothelioma

Abstract

Introduction: Malignant Pleural Mesothelioma (MPM) is an asbestos related malignancy that usually requires invasive procedures for diagnosis. Serum or pleural fluid biomarkers may reduce the need for such procedures. We aimed to determine the diagnostic accuracy of SMRP, Fibulin-3, Osteopontin and HMGB-1 in serum and pleural fluid, alone and in combination. Methods: Serum and pleural fluid samples were obtained from patients with pleural effusions of benign or malignant aetiology. Concentrations of SMRP, Fibulin-3, Osteopontin and HMGB-1 were determined using ELISA assays. ROC Curves and area under the ROC curve (AUC) were generated to assess the ability of each serum and pleural fluid biomarker to discriminate between MPM and those without MPM. Results: 20 patients with epithelioid MPM, 29 with non-MPM malignancies and 22 patients with benign effusions were recruited. Paired serum was analysed in 11 with MPM, 23 with other malignancy and 20 with benign effusions. SMRP levels were significantly higher in the pleural fluid of patients with MPM (p Conclusions: SMRP has a significant ability to predict epithelioid mesothelioma from benign and other causes of pleural effusion. There is no additional benefit in combining Fibulin-3, HMGB-1 or osteopontin.