1
|
Systematic Review, Meta-Analysis and Bioinformatic Analysis of Biomarkers for Prognosis of Malignant Pleural Mesothelioma. Diagnostics (Basel) 2022; 12:diagnostics12092210. [PMID: 36140611 PMCID: PMC9497920 DOI: 10.3390/diagnostics12092210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 08/29/2022] [Accepted: 09/09/2022] [Indexed: 11/17/2022] Open
Abstract
In previous studies, non-invasive diagnostic biomarkers showed great benefit in the early-stage diagnosis of malignant pleural mesothelioma (MPM). However, the accuracy of different biomarkers was controversial. In this study, meta-analysis and bioinformatics analysis were conducted to compare the accuracy of the following three biomarkers and explore the relationship between the gene expression levels and MPM. A systematic search of meta-analysis was conducted using PubMed, EMBASE and Cochrane Library to identify relevant studies from the inception to March 2021. QUADAS-2 for Quality Assessment of Diagnostic Accuracy Studies was used to evaluate the quality of eligible studies. The meta-analysis was performed utilizing Stata 15.0 and Review Manager 5.4 software. The meta-analysis results showed that 31 studies that involved 8750 participants were included. The pooled sensitivity and specificity (SPE) were 0.90 (95% CI: 0.74, 0.97) and 0.91 (95% CI: 0.84, 0.95) for Fibulin-3, 0.66 (95% CI, 0.51–0.78) and 0.91 (95% CI, 0.82–0.96) for mesothelin (MSLN), 0.68 (95% CI: 0.63,0.73) and 0.86 (95% CI: 0.82,0.90) for soluble mesothelin-related peptides (SMRP), and 0.74 (95% CI, 0.66-0.80) and 0.89 (95% CI, 0.85–0.91) for MSLN + SMRP + Fibulin-3. Compared with the other two biomarkers, Fibulin-3 may be more appropriate to be one of the indicators for combined diagnosis. Bioinformatics analysis showed that the low expression level of the MSLN gene was significantly related to longer survival time and better prognosis of MPM patients. However, considering the limitation in the quality and sample size of the included research, further studies are required.
Collapse
|
2
|
Schillebeeckx E, van Meerbeeck JP, Lamote K. Clinical utility of diagnostic biomarkers in malignant pleural mesothelioma: a systematic review and meta-analysis. Eur Respir Rev 2021; 30:30/162/210057. [PMID: 34789461 PMCID: PMC9489015 DOI: 10.1183/16000617.0057-2021] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 06/08/2021] [Indexed: 02/06/2023] Open
Abstract
Malignant pleural mesothelioma (MPM) is characterised by late-stage diagnosis and poor prognosis. Currently, no screening tool is advocated and diagnosis is based on invasive techniques, which are not well tolerated. Non-invasive diagnostic biomarkers have shown potential and could have a huge clinical benefit. However, despite extensive research, there is no consensus yet on their clinical use, with many articles reporting contradicting results, limiting their clinical implementation. The aim of this systematic review is therefore to explore the different semi- and non-invasive diagnostic markers in several human matrices and identify those that might clinically be relevant. A total of 100 articles were selected through Web of Science and PubMed, with 56 articles included in the quantitative analysis. Although many studies have reported on the diagnostic accuracy of MPM biomarkers such as serum mesothelin and high-mobility group box protein 1 and plasma fibulin-3, none have resulted in a validated test for early detection. Future research should focus on external validation, combinations into biomarker panels, the inclusion of early stage MPM patients and a combination of different biomarker matrices, as well as new markers. Diagnostic biomarkers for malignant pleural mesothelioma seem promising; however, further research is necessary to prove their clinical value. This review provides a thorough overview of the different markers and compares them in several matrices.https://bit.ly/35ni6UO
Collapse
Affiliation(s)
- Eline Schillebeeckx
- Laboratory of Experimental Medicine and Pediatrics, University of Antwerp, Wilrijk, Belgium .,Infla-Med Centre of Excellence, University of Antwerp, Wilrijk, Belgium
| | - Jan P van Meerbeeck
- Laboratory of Experimental Medicine and Pediatrics, University of Antwerp, Wilrijk, Belgium.,Infla-Med Centre of Excellence, University of Antwerp, Wilrijk, Belgium.,Dept of Internal Medicine, Ghent University, Ghent, Belgium.,Pulmonology and Thoracic Oncology, Antwerp University Hospital, Edegem, Belgium.,European Reference Network for rare respiratory diseases (ERN-LUNG), Frankfurt Am Main, Germany
| | - Kevin Lamote
- Laboratory of Experimental Medicine and Pediatrics, University of Antwerp, Wilrijk, Belgium.,Infla-Med Centre of Excellence, University of Antwerp, Wilrijk, Belgium.,Dept of Internal Medicine, Ghent University, Ghent, Belgium
| |
Collapse
|
3
|
Ledda C, Caltabiano R, Vella F, Matera S, Marconi A, Loreto C, Rapisarda V. Fibulin-3 as biomarker of malignant mesothelioma. Biomark Med 2019; 13:875-886. [DOI: 10.2217/bmm-2018-0285] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Many malignant diseases are associated with past asbestos exposure; the most lethal and strictly related to previous fiber exposure being malignant mesothelioma (MM). Effective preventive protocols may include sensitive and specific biomarkers. The role of Fb-3 has been recently investigated for MM early detection, but its role is still under debate. After an independent search for scientific literature, nine studies were included for a systematic review. Human Fb-3 levels seem to be able to separate healthy people with previous exposure to asbestiform fibers from MM patients. Fb-3 blood levels can distinguish MM effusions from other malignant and benign effusions. Furthers investigations on more significant groups of patients are desirable to validate and assess the validity of combining Fb-3 with other biomarkers.
Collapse
Affiliation(s)
- Caterina Ledda
- Occupational Medicine, Department of Clinical and Experimental Medicine, University of Catania, 95124 Catania, Italy
| | - Rosario Caltabiano
- Anatomic Pathology, Department of Medical and Surgical Sciences and Advanced Technologies, G.F. Ingrassia, University of Catania, 95124 Catania, Italy
| | - Francesca Vella
- Occupational Medicine, Department of Clinical and Experimental Medicine, University of Catania, 95124 Catania, Italy
| | - Serena Matera
- Occupational Medicine, Department of Clinical and Experimental Medicine, University of Catania, 95124 Catania, Italy
| | - Andrea Marconi
- Occupational Medicine, Department of Clinical and Experimental Medicine, University of Catania, 95124 Catania, Italy
| | - Carla Loreto
- Anatomy and Histology, Department of Biomedical Sciences and Biotechnologies, University of Catania, 95124 Catania, Italy
| | - Venerando Rapisarda
- Occupational Medicine, Department of Clinical and Experimental Medicine, University of Catania, 95124 Catania, Italy
| |
Collapse
|
4
|
Gillezeau CN, van Gerwen M, Ramos J, Liu B, Flores R, Taioli E. Biomarkers for malignant pleural mesothelioma: a meta-analysis. Carcinogenesis 2019; 40:1320-1331. [DOI: 10.1093/carcin/bgz103] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Revised: 05/13/2019] [Accepted: 06/04/2019] [Indexed: 02/07/2023] Open
Abstract
Abstract
Malignant pleural mesothelioma (MPM) is a rare but aggressive cancer, and early detection is associated with better survival. Mesothelin, fibulin-3 and osteopontin have been suggested as screening biomarkers. The study conducted a meta-analysis of the mean differences of mesothelin, osteopontin and fibulin-3 in blood and pleural samples. PubMed searches were conducted for studies that measured levels of mesothelin, osteopontin and fibulin-3 in participants with MPM compared with malignancy, benign lung disease or healthy participants. Thirty-two studies with mesothelin levels, 12 studies with osteopontin levels and 9 studies with fibulin-3 levels were included in the meta-analysis. Statistically significant mean differences were seen between MPM patients and all other comparison groups for mesothelin blood and pleural levels. Statistically significant differences in blood osteopontin levels were seen between participants with benign lung disease and healthy participants compared with participants with MPM, but not when comparing participants with cancer with MPM participants. There were not enough studies that reported osteopontin levels in pleural fluid to complete a meta-analysis. Statistically significant differences were seen in both blood and pleural levels of fibulin-3 in MPM patients compared with all other groups. On the basis of these results, mesothelin and fibulin-3 levels appear to be significantly lower in all control groups compared with those with MPM, making them good candidates for screening biomarkers. Osteopontin may be a useful biomarker for screening healthy individuals or those with benign lung disease but would not be useful for screening patients with malignancies.
Collapse
Affiliation(s)
- Christina N Gillezeau
- Institute for Translational Epidemiology and Department of Population Health Science and Policy, New York, NY, USA
| | - Maaike van Gerwen
- Institute for Translational Epidemiology and Department of Population Health Science and Policy, New York, NY, USA
| | - Julio Ramos
- Institute for Translational Epidemiology and Department of Population Health Science and Policy, New York, NY, USA
| | - Bian Liu
- Institute for Translational Epidemiology and Department of Population Health Science and Policy, New York, NY, USA
| | - Raja Flores
- Department of Thoracic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Emanuela Taioli
- Institute for Translational Epidemiology and Department of Population Health Science and Policy, New York, NY, USA
| |
Collapse
|
5
|
Gao R, Wang F, Wang Z, Wu Y, Xu L, Qin Y, Shi H, Tong Z. Diagnostic value of soluble mesothelin-related peptides in pleural effusion for malignant pleural mesothelioma: An updated meta-analysis. Medicine (Baltimore) 2019; 98:e14979. [PMID: 30946324 PMCID: PMC6456135 DOI: 10.1097/md.0000000000014979] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Soluble mesothelin-related peptide (SMRP) is a widely studied tumor marker for diagnosing malignant pleural mesothelioma (MPM). This study discussed the diagnostic value of SMRPs in pleural effusion (PE) for MPM. METHODS Medline, Embase, Web of Science, and Cochrane library system were systematically searched on the data of SMRPs in PE for MPM diagnosis. Pooled diagnostic sensitivity, specificity, and symmetric receiver operating characteristic curve were calculated. RESULTS Thirteen studies fulfilled the inclusion criteria and a total of 3359 cases including 759 MPM cases, 1061 non-MM (malignant mesothelioma) malignant PE, and 1539 benign PE were brought into this meta-analysis. The pooled results of SMRPs in PE for diagnosing MPM were as follows: sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio were 0.68 (95% confidence interval [CI]: 0.64-0.72), 0.91 (95% CI: 0.86-0.94), 7.8 (95% CI: 5.0-12.0), 0.35 (95% CI: 0.31-0.40), and 22 (95% CI: 14-35), respectively. The area under the summary receiver operating characteristic curves (AUC) was 0.75 (95% CI: 0.72-0.80). Subgroup analyzes revealed that the AUC of cohort group using histological diagnosis could be improved to 0.86 (95% CI: 0.83, 0.89). The Deek's funnel plot asymmetry test showed no publication bias. CONCLUSION Although the sensitivity of SMRPs was low, PE-SMRPs can be a good indicator of the existence of MPM.
Collapse
Affiliation(s)
- Ruiyue Gao
- Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine and Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | | | | | | | | | | | | | | |
Collapse
|
6
|
Røe OD. Mesothelioma diagnosis and prognosis, are we moving beyond histology and performance status towards circulating biomarkers? J Thorac Dis 2018; 10:S1956-S1961. [PMID: 30023090 DOI: 10.21037/jtd.2018.06.12] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- Oluf Dimitri Røe
- Department of Clinical Research and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, NO 7491, Norway.,Cancer Clinic, Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, NO 7600, Norway.,Department of Oncology & Clinical Cancer Research Center, Department of Clinical Medicine, Aalborg University Hospital, Aalborg, DK 9000, Denmark
| |
Collapse
|
7
|
Asgarov K, Balland J, Tirole C, Bouard A, Mougey V, Ramos D, Barroso A, Zangiacomi V, Jary M, Kim S, Gonzalez-Pajuelo M, Royer B, de Haard H, Clark A, Wijdenes J, Borg C. A new anti-mesothelin antibody targets selectively the membrane-associated form. MAbs 2017; 9:567-577. [PMID: 28353419 DOI: 10.1080/19420862.2017.1288770] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Mesothelin is a glycosylphosphatidylinositol (GPI)-anchored membrane protein that shows promise as a target for antibody-directed cancer therapy. High levels of soluble forms of the antigen represent a barrier to directing therapy to cellular targets. The ability to develop antibodies that can selectively discriminate between membrane-bound and soluble conformations of a specific protein, and thus target only the membrane-associated antigen, is a substantive issue. We show that use of a tolerance protocol provides a route to such discrimination. Mice were tolerized with soluble mesothelin and a second round of immunizations was performed using mesothelin transfected P815 cells. RNA extracted from splenocytes was used in phage display to obtain mesothelin-specific antigen-binding fragments (Fabs) that were subsequently screened by flow cytometry and ELISA. This approach generated 147 different Fabs in 34 VH-CDR3 families. Utilizing competition assays with soluble protein and mesothelin-containing serum obtained from metastatic cancer patients, 10 of these 34 VH-CDR3 families were found to bind exclusively to the membrane-associated form of mesothelin. Epitope mapping performed for the 1H7 clone showed that it does not recognize GPI anchor. VH-CDR3 sequence analysis of all Fabs showed significant differences between Fabs selective for the membrane-associated form of the antigen and those that recognize both membrane bound and soluble forms. This work demonstrates the potential to generate an antibody specific to the membrane-bound form of mesothelin. 1H7 offers potential for therapeutic application against mesothelin-bearing tumors, which would be largely unaffected by the presence of the soluble antigen.
Collapse
Affiliation(s)
- Kamal Asgarov
- a University of Bourgogne-Franche-Comte , Besançon Cedex , France.,b ITAC Platform of Clinical Investigation Center-Biotherapy , Besançon Cedex , France
| | - Jeremy Balland
- a University of Bourgogne-Franche-Comte , Besançon Cedex , France.,b ITAC Platform of Clinical Investigation Center-Biotherapy , Besançon Cedex , France
| | - Charline Tirole
- a University of Bourgogne-Franche-Comte , Besançon Cedex , France.,b ITAC Platform of Clinical Investigation Center-Biotherapy , Besançon Cedex , France
| | - Adeline Bouard
- a University of Bourgogne-Franche-Comte , Besançon Cedex , France.,b ITAC Platform of Clinical Investigation Center-Biotherapy , Besançon Cedex , France
| | - Virginie Mougey
- a University of Bourgogne-Franche-Comte , Besançon Cedex , France.,c Blood Bank Bourgogne-Franche-comté , Porto , Portugal
| | | | | | - Vincent Zangiacomi
- b ITAC Platform of Clinical Investigation Center-Biotherapy , Besançon Cedex , France
| | - Marine Jary
- e J.Minjoz University Hospital , Besançon Cedex , France
| | - Stefano Kim
- e J.Minjoz University Hospital , Besançon Cedex , France
| | | | - Bernard Royer
- a University of Bourgogne-Franche-Comte , Besançon Cedex , France.,b ITAC Platform of Clinical Investigation Center-Biotherapy , Besançon Cedex , France.,e J.Minjoz University Hospital , Besançon Cedex , France
| | | | | | | | - Christophe Borg
- a University of Bourgogne-Franche-Comte , Besançon Cedex , France.,b ITAC Platform of Clinical Investigation Center-Biotherapy , Besançon Cedex , France.,c Blood Bank Bourgogne-Franche-comté , Porto , Portugal.,e J.Minjoz University Hospital , Besançon Cedex , France
| |
Collapse
|
8
|
Otoshi T, Kataoka Y, Ikegaki S, Saito E, Matsumoto H, Kaku S, Shimada M, Hirabayashi M. Pleural effusion biomarkers and computed tomography findings in diagnosing malignant pleural mesothelioma: A retrospective study in a single center. PLoS One 2017; 12:e0185850. [PMID: 28968445 PMCID: PMC5624636 DOI: 10.1371/journal.pone.0185850] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2017] [Accepted: 09/20/2017] [Indexed: 11/18/2022] Open
Abstract
In this study, we aimed to examine the clinical value of the pleural effusion (PE) biomarkers, soluble mesothelin-related peptide (SMRP), cytokeratin 19 fragment (CYFRA 21–1) and carcinoembryonic antigen (CEA), and the utility of combining chest computed tomography (CT) findings with these biomarkers, in diagnosing malignant pleural mesothelioma (MPM). We conducted a retrospective cohort study in a single center. Consecutive patients with undiagnosed pleural effusions who underwent PE analysis between September 2014 and August 2016 were reviewed. This study included 240 patients (32 with MPM and 208 non-MPM). SMRP and the CYFRA 21-1/CEA ratio had a sensitivity and specificity for diagnosing MPM of 56.3% and 86.5%, and 87.5% and 74.0%, respectively. Using receiver operating characteristics (ROC) curve analysis of the ability of these markers to distinguish MPM from all other PE causes, the area under the ROC curve (AUC) for SMRP and the CYFRA 21-1/CEA ratio was 0.804 and 0.874, respectively. The sensitivity and specificity of SMRP combined with the CYFRA 21-1/CEA ratio were 93.8% and 64.9%, respectively. The sensitivity of the combination of SMRP, the CYFRA 21-1/CEA ratio, and the presence of Leung’s criteria (a chest CT finding that is suggestive of malignant pleural disease) was 93.8%. In conclusion, the combined PE biomarkers had a high sensitivity for diagnosing MPM, although the addition of chest CT findings did not improve the sensitivity of SMRP combined with the CYFRA 21-1/CEA ratio. Combination of these biomarkers helped to rule out MPM effectively among patients at high risk of suffering MPM and would be valuable especially for old frail patients who have difficulty in undergoing invasive procedures such as thoracoscopy.
Collapse
Affiliation(s)
- Takehiro Otoshi
- Department of Respiratory Medicine, Hyogo Prefectural Amagasaki General Medical Center, Amagasaki, Hyogo, Japan
- * E-mail:
| | - Yuki Kataoka
- Department of Respiratory Medicine, Hyogo Prefectural Amagasaki General Medical Center, Amagasaki, Hyogo, Japan
| | - Shunkichi Ikegaki
- Department of Respiratory Medicine, Hyogo Prefectural Amagasaki General Medical Center, Amagasaki, Hyogo, Japan
| | - Emiko Saito
- Department of Respiratory Medicine, Hyogo Prefectural Amagasaki General Medical Center, Amagasaki, Hyogo, Japan
| | - Hirotaka Matsumoto
- Department of Respiratory Medicine, Hyogo Prefectural Amagasaki General Medical Center, Amagasaki, Hyogo, Japan
| | - Sawako Kaku
- Department of Respiratory Medicine, Hyogo Prefectural Amagasaki General Medical Center, Amagasaki, Hyogo, Japan
| | - Masatoshi Shimada
- Department of Respiratory Medicine, Hyogo Prefectural Amagasaki General Medical Center, Amagasaki, Hyogo, Japan
| | - Masataka Hirabayashi
- Department of Respiratory Medicine, Hyogo Prefectural Amagasaki General Medical Center, Amagasaki, Hyogo, Japan
| |
Collapse
|
9
|
Chen Z, Gaudino G, Pass HI, Carbone M, Yang H. Diagnostic and prognostic biomarkers for malignant mesothelioma: an update. Transl Lung Cancer Res 2017; 6:259-269. [PMID: 28713671 DOI: 10.21037/tlcr.2017.05.06] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Malignant mesothelioma (MM) is an aggressive and lethal cancer, mostly related to inhalation of asbestos and erionite fibers. MM is associated with poor prognosis, because of its resistance to current therapies, even if higher survival occurs in patients diagnosed and treated when at stage I of the disease. However, these do not exceed 5% of the total number of cases, due to the inadequacy of the existing biomarkers for early and accurate diagnosis. Therefore, new effective biomarkers are needed for MM detection at earlier stages and to develop tailored therapies. Here we review the most promising biomarkers in MM to date: mesothelin, soluble mesothelin-related peptides (SMRPs), megakaryocyte potentiating factor (MPF), Osteopontin (OPN), Fibulin-3, high mobility group B1 (HMGB1), microRNAs (miRNAs), multiplex protein signatures. The validation of these biomarkers will allow their use, alone or in combination, for monitoring individuals from cohorts at risk of MM and attaining early detection of MM that is instrumental in improving patient survival.
Collapse
Affiliation(s)
- Zhongjian Chen
- University of Hawaii Cancer Center, Honolulu, HI, USA.,Department of pharmacy, Zhejiang Cancer Hospital, Hangzhou 310022, China
| | | | - Harvey I Pass
- Department of Cardiothoracic Surgery, New York University, NYU Langone Medical Center, New York, USA
| | | | - Haining Yang
- University of Hawaii Cancer Center, Honolulu, HI, USA
| |
Collapse
|
10
|
Cortes-Dericks L, Schmid RA. CD44 and its ligand hyaluronan as potential biomarkers in malignant pleural mesothelioma: evidence and perspectives. Respir Res 2017; 18:58. [PMID: 28403901 PMCID: PMC5389171 DOI: 10.1186/s12931-017-0546-5] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2017] [Accepted: 04/06/2017] [Indexed: 12/11/2022] Open
Abstract
Malignant pleural mesothelioma (MPM) is a rare and highly drug resistant tumor arising from the mesothelial surfaces of the lung pleura. The standard method to confirm MPM is the tedious, time-consuming cytological examination of cancer biopsy. Biomarkers that are detectable in pleural effusion or patient serum are reasonable options to provide a faster and noninvasive diagnostic approach. As yet, the current biomarkers for MPM lack specificity and sensitivity to discriminate this neoplasm from other lung tumors. CD44, a multifunctional surface receptor has been implicated in tumor progression in different cancers including MPM. The interaction of CD44 with its ligand, hyaluronan (HA) has demonstrated an important role in modulating cell proliferation and invasiveness in MPM. In particular, the high expression levels of these molecules have shown diagnostic relevance in MPM. This review will summarize the biology and diagnostic implication of CD44 and HA as well as the interaction of both molecules in MPM that will demonstrate their potential as biomarkers. Augmentation of the current markers in MPM may lead to an earlier diagnosis and management of this disease.
Collapse
Affiliation(s)
- Lourdes Cortes-Dericks
- Department of Clinical Research, Division of General Thoracic Surgery, University Hospital Berne, Berne, Switzerland.
| | - Ralph Alexander Schmid
- Department of Clinical Research, Division of General Thoracic Surgery, University Hospital Berne, Berne, Switzerland
| |
Collapse
|
11
|
Malignant Mesothelioma Biomarkers: From Discovery to Use in Clinical Practice for Diagnosis, Monitoring, Screening, and Treatment. Chest 2016; 152:143-149. [PMID: 28007619 DOI: 10.1016/j.chest.2016.12.004] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Revised: 11/22/2016] [Accepted: 12/08/2016] [Indexed: 12/22/2022] Open
Abstract
Malignant pleural mesothelioma is a highly aggressive tumor associated with asbestos exposure. There are few effective treatment options for mesothelioma, and patients have a very poor prognosis with a median survival of < 12 months from diagnosis. Biomarkers have been proposed as a cost-effective means of cancer management, and the search for a mesothelioma biomarker has been ongoing for the last 30 years. Many traditional soluble (glyco)protein biomarkers have been evaluated over this time, and an ever-increasing list of new biomarkers, including messenger RNA, DNA, microRNA, and antibodies, is being reported from biomarker discovery projects. To date, soluble mesothelin is the only tumor biomarker to receive US Food and Drug Administration approval for clinical use in mesothelioma. Mesothelin is a glycoprotein normally expressed on the surface of mesothelial cells, and in the cancerous state it can be present in circulation. Mesothelin has a limited expression on normal, nonmalignant tissue and is thus an attractive therapeutic target for mesothelin-positive tumors. In this review we will focus on the discovery and clinical usages of mesothelin and provide an update on other mesothelioma biomarkers and show how such biomarker studies might impact on the management of this deadly tumor in the future.
Collapse
|
12
|
Evaluation of New Biomarkers in the Prediction of Malignant Mesothelioma in Subjects with Environmental Asbestos Exposure. Lung 2016; 194:409-17. [DOI: 10.1007/s00408-016-9868-1] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2015] [Accepted: 03/21/2016] [Indexed: 10/22/2022]
|
13
|
Cui A, Jin XG, Zhai K, Tong ZH, Shi HZ. Diagnostic values of soluble mesothelin-related peptides for malignant pleural mesothelioma: updated meta-analysis. BMJ Open 2014; 4:e004145. [PMID: 24566531 PMCID: PMC3939651 DOI: 10.1136/bmjopen-2013-004145] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
OBJECTIVE Although the values of soluble mesothelin-related peptides (SMRPs), including mesothelin and megakaryocyte potentiating factor, in serum and/or pleural fluid for diagnosing malignant pleural mesothelioma (MPM) have been extensively studied, the exact diagnostic accuracy of these SMRPs remains controversial. The purpose of the present meta-analysis is to update the overall diagnostic accuracy of SMRPs in serum and, furthermore, to establish diagnostic accuracy of SMRPs in pleural fluid for MPM. DESIGN Systematic review and meta-analysis. METHODS A total of 30 articles of diagnostic studies were included in the current meta-analysis. Sensitivity, specificity and other measures of accuracy of SMRPs in serum and pleural fluid for the diagnosis of MPM were pooled using random effects models. Summary receiver operating characteristic curves were used to summarise overall test performance. RESULTS The summary estimates of sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and diagnostic OR were 0.61, 0.87, 5.71, 0.43 and 14.43, respectively, for serum and 0.79, 0.85, 4.78, 0.30 and 19.50, respectively, for pleural fluid. It was also found that megakaryocyte potentiating factor in serum had a superior diagnostic accuracy compared with mesothelin for MPM. CONCLUSIONS SMRPs in both serum and pleural fluid are helpful markers for diagnosing MPM with similar diagnostic accuracy. The negative results of SMRP determinations are not sufficient to exclude non-MPM, and the positive test results indicate that further invasive diagnostic steps might be necessary for the diagnosis of MPM.
Collapse
Affiliation(s)
- Ai Cui
- Department of Respiratory and Critical Care Medicine, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Xiao-Guang Jin
- Department of Respiratory and Critical Care Medicine, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Kan Zhai
- Center of Medical Research, Beijing Institute of Respiratory Diseases, Beijing, China
| | - Zhao-Hui Tong
- Department of Respiratory and Critical Care Medicine, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Huan-Zhong Shi
- Department of Respiratory and Critical Care Medicine, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
- Center of Medical Research, Beijing Institute of Respiratory Diseases, Beijing, China
| |
Collapse
|
14
|
Canessa PA, Ferro P, Manta C, Sivori M, Franceschini MC, Fedeli F, Roncella S. Clinical value of mesothelin in pleural effusions versus histology by medical thoracoscopy: brief report. Med Oncol 2013; 30:649. [PMID: 23873013 DOI: 10.1007/s12032-013-0649-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2013] [Accepted: 06/19/2013] [Indexed: 10/26/2022]
Abstract
The aim of this study based on the third phase of the architecture of diagnostic research was to assess the sensitivity and specificity of soluble mesothelin-related peptide (SMRP) in pleural exudative effusions (PE) compared to the histology obtained by medical thoracoscopy as the diagnostic gold standard examination. We assessed 104 consecutive thoracoscopies. SMRP concentrations were obtained using an ELISA test. We had 34 mesotheliomas (25 epithelioid and 9 sarcomatoid), 35 pleural metastases, and 35 benign diseases. PE-SMRP were significantly higher in patients with epitheliomorphic mesothelioma (mean ± SD 46.55 ± 44.29 nM) than in patients with sarcomatoid mesothelioma (16.11 ± 25.02 nM; p = 0.061), pleural metastasis (7.52 ± 10.77 nM; p < 0.0001), or benign diseases (5.82 ± 8.86 nM; p < 0.0001). Using ROC curve analysis, PE-SMRP offered an AUC of 0.767 in its ability to differentiate between patients with mesothelioma and all other diagnoses. The diagnostic sensitivity and specificity of PE-SMRP for distinguishing mesothelioma from all other causes of pleural effusion, at a cut-off value of 19.6 nM, were 58.8 and 97.1 %, respectively. PE-SMRP higher than the assumed cut-off of 19.6 nM were observed in 18/25 (72.0%) epitheliomorphic mesotheliomas, 2/9 (22.2%) sarcomatoid mesotheliomas, 5/35 (14.3%) pleural metastases, and 1/35 (2.9%) benign diseases. We conclude that PE-SMRP adds some clinical information in the work-up of patients with a PE of unknown origin: (1) thoracoscopy should always be done in patients with a positive mesothelin; (2) a negative mesothelin does not exclude a malignant disease.
Collapse
Affiliation(s)
- Pier Aldo Canessa
- SC Pneumologia, Ospedale San Bartolomeo, via Cisa Sud, 19038, Sarzana, SP, Italy.
| | | | | | | | | | | | | |
Collapse
|
15
|
Filiberti R, Parodi S, Libener R, Ivaldi GP, Canessa PA, Ugolini D, Bobbio B, Marroni P. Diagnostic value of mesothelin in pleural fluids: comparison with CYFRA 21-1 and CEA. Med Oncol 2013; 30:543. [PMID: 23532816 DOI: 10.1007/s12032-013-0543-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2013] [Accepted: 03/13/2013] [Indexed: 12/17/2022]
Abstract
CYFRA 21-1 and CEA have been applied for the differential diagnosis of malignant pleural mesothelioma (MPM). The soluble mesothelin-related peptide (SMRP) has been proposed as a specific marker for distinguishing MPM from benign diseases and other malignancies in pleural effusions (PEs). In this study, we evaluated the usefulness of SMRP in PEs in the detection of mesotheliomas by comparing it with that of CYFRA 21-1, CEA, and with cytological examination. One hundred and seventy-seven consecutive patients (57 MPM, 64 metastatic tumors, and 56 benign diseases) were evaluated using commercial tests. The performance of the markers was analyzed by standard ROC analysis methods, using the area under a ROC curve (AUC) as a measure of accuracy. CYFRA 21-1 better differentiated malignant from benign effusions. The corresponding area under the receiver operating characteristic curve was 0.87, while it was 0.74 for SMRP and 0.64 for CEA (p < 0.001). Conversely, SMRP differentiated MPM from all other PEs better than both CYFRA 21-1 and CEA (AUC = 0.84, 0.76, and 0.32, respectively, p = 0.003). Low levels of CEA were associated with a MPM diagnosis. The AUC for differentiating MPM from metastases was 0.81 for SMRP, 0.61 for CYFRA 21-1, and 0.20 for CEA (p < 0.001). In cases with negative or suspicious cytology, SMRP and CYFRA 21-1 identified 36/71 and 46/66 malignant PEs (29 and 31 MPM, respectively). Only 1 MPM showed a high CEA concentration. No single marker showed the best performance in any comparison. Results suggest that SMRP could improve CYFRA 21-1 and CEA accuracy in the differential diagnosis of MPM.
Collapse
MESH Headings
- Aged
- Aged, 80 and over
- Antigens, Neoplasm/biosynthesis
- Antigens, Neoplasm/chemistry
- Biomarkers, Tumor/biosynthesis
- Biomarkers, Tumor/chemistry
- Diagnosis, Differential
- Female
- GPI-Linked Proteins/biosynthesis
- GPI-Linked Proteins/chemistry
- Humans
- Keratin-19/biosynthesis
- Keratin-19/chemistry
- Lung Neoplasms/chemistry
- Lung Neoplasms/diagnosis
- Lung Neoplasms/metabolism
- Male
- Mesothelin
- Mesothelioma/chemistry
- Mesothelioma/diagnosis
- Mesothelioma/metabolism
- Mesothelioma, Malignant
- Middle Aged
- Pleural Effusion, Malignant/diagnosis
- Pleural Effusion, Malignant/metabolism
- Receptors, Cell Surface/biosynthesis
- Receptors, Cell Surface/chemistry
- Receptors, Cell Surface/metabolism
Collapse
Affiliation(s)
- Rosa Filiberti
- Epidemiology, Biostatistics and Clinical Trials, IRCCS AOU San Martino-IST, Largo R. Benzi, 10, Genoa 16132, Italy.
| | | | | | | | | | | | | | | |
Collapse
|