Abstract
BackgroundCD157/Bst1 glycoprotein is expressed in >85% of malignant pleural mesotheliomas and is a marker of enhanced tumor aggressiveness.ResultsIn vitro, mesothelial cells (malignant and non-malignant) released CD157 in soluble form or as an exosomal protein. In vivo, sCD157 is released and can be measured in pleural effusions by ELISA. Significantly higher levels of effusion sCD157 were detected in patients with malignant pleural mesothelioma than in patients with non-mesothelioma tumors or with non-malignant conditions. In our patient cohort, the area under the receiver-operating characteristic curve for sCD157 that discriminated malignant pleural mesothelioma from all other causes of pleural effusion was 0.685, cut-off (determined by the Youden Index) = 23.66 ng/ml (62.3% sensitivity; 73.93% specificity). Using a cut-off that yielded 95.58% specificity, measurement of sCD157 in cytology-negative effusions increased sensitivity of malignant pleural mesothelioma diagnosis from 34.42% to 49.18%.ConclusionsEvaluation of soluble CD157 in pleural effusions provides a diagnostic aid in malignant mesothelioma.MethodsSoluble CD157 (sCD157) was detected biochemically in culture supernatants of malignant and non-malignant mesothelial cells, and in pleural effusions from various pathological conditions. An ELISA system was established to measure the concentration of sCD157 in fluids, and extended to analyze sCD157 in pleural effusions from a cohort of 295 patients.
Highlights
Malignant pleural mesothelioma (MPM) is an incurable tumor that originates from mesothelial cells lining the pleural cavity
Higher levels of effusion Soluble CD157 (sCD157) were detected in patients with malignant pleural mesothelioma than in patients with non-mesothelioma tumors or with non-malignant conditions
Evaluation of soluble CD157 in pleural effusions provides a diagnostic aid in malignant mesothelioma
Summary
Malignant pleural mesothelioma (MPM) is an incurable tumor that originates from mesothelial cells lining the pleural cavity. MPM is associated with asbestos exposure and because of its long latency, tumor incidence is predicted to increase significantly in the decade, especially in countries where asbestos has not been banned [1]. Over 80% of MPM patients present dyspnea with malignant pleural effusion [4], caused in part by increased vascular permeability and tissue leakage. Pleural fluid obtained by thoracentesis often contains malignant cells, www.oncotarget.com and effusion cytology constitutes the most common method for establishing a diagnosis. In MPM, the sensitivity of cytological evaluation is low histological examination of biopsy specimens obtained by thoracoscopy is considered the gold standard diagnostic procedure [5, 6]. CD157/Bst glycoprotein is expressed in >85% of malignant pleural mesotheliomas and is a marker of enhanced tumor aggressiveness
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