Pass Harvey I, Wali Anil, Tang Naimei, Ivanova Alla, Ivanov Sergey, Harbut Michael, Carbone Michele, Allard Jeffrey
Department of Cardiothoracic Surgery, Division of Thoracic Surgery, New York University School of Medicine, New York, New York 10016, USA.
Ann Thorac Surg. 2008 Jan;85(1):265-72; discussion 272. doi: 10.1016/j.athoracsur.2007.07.042.
Soluble mesothelin-related peptide (SMRP) is a potential marker for malignant pleural mesothelioma (MPM), which may be useful for screening high-risk asbestos-exposed individuals.
We evaluated SMRP in serum from MPM patients (n = 90), lung cancer patients (n = 170), age and tobacco-matched asbestos-exposed individuals (n = 66), and in MPM pleural effusions (n = 45), benign effusions (n = 30), and non-MPM effusions (n = 20) using the MesoMark enzyme-linked immunosorbent assay kit (Fujirebio Diagnostics, Malvern, PA). Receiver operating characteristic (ROC) curves were used to define true and false positive rates at various cutoffs.
Mean serum SMRP levels were higher in MPM compared with lung cancer (5.67 +/- 0.82 nM [mean +/- standard error of the mean vs 1.99 +/- 0.43 nM, p < 0.001), and stage I MPM SMRP levels (n = 12; 2.09 +/- 0.41 nM) were significantly higher than those in asbestos-exposed individuals (0.99 +/- 0.09 nM, p = 0.02, respectively). Stage 2 to 4 SMRP serum levels were significantly higher than those for stage 1 MPM. The area under the ROC curve for serum SMRP was 0.81 for differentiating MPM and asbestos-exposed individuals; cutoff = 1.9 nM (sensitivity = 60%, specificity = 89%). The MPM pleural effusion SMRP was significantly higher than benign or other non-MPM pleural effusions (65.57 +/- 11.33 nM vs 27.46 +/- 11.25 nM [p = 0.003] and 18.99 +/- 7.48 nM [p = 0.044], respectively).
These data support SMRP as a promising marker for MPM in both serum and pleural effusion fluid, and justify prospective screening studies of SMRP in combination with other markers for screening of asbestos-exposed cohorts.
可溶性间皮素相关肽（SMRP）是恶性胸膜间皮瘤（MPM）的一种潜在标志物，可能有助于筛查高危石棉暴露个体。
我们使用MesoMark酶联免疫吸附测定试剂盒（富士瑞必欧诊断公司，宾夕法尼亚州马尔文），评估了MPM患者（n = 90）、肺癌患者（n = 170）、年龄和吸烟情况匹配的石棉暴露个体（n = 66）血清中的SMRP，以及MPM胸腔积液（n = 45）、良性胸腔积液（n = 30）和非MPM胸腔积液（n = 20）中的SMRP。采用受试者操作特征（ROC）曲线来确定不同临界值下的真阳性率和假阳性率。
MPM患者的血清SMRP平均水平高于肺癌患者（5.67±0.82 nM[平均值±平均标准误]对1.99±0.43 nM，p<0.001），I期MPM的SMRP水平（n = 12；2.09±0.41 nM）显著高于石棉暴露个体（0.99±0.09 nM，p = 0.02）。2至4期的SMRP血清水平显著高于I期MPM。血清SMRP的ROC曲线下面积在区分MPM和石棉暴露个体时为0.81；临界值=1.9 nM（敏感性=60%，特异性=89%）。MPM胸腔积液中的SMRP显著高于良性或其他非MPM胸腔积液（分别为65.57±11.33 nM对27.46±11.25 nM[p = 0.003]和18.99±7.48 nM[p = 0.044]）。
这些数据支持SMRP作为血清和胸腔积液中MPM的一种有前景的标志物，并证明对SMRP与其他标志物联合进行前瞻性筛查研究以筛查石棉暴露人群是合理的。
