National Research Centre for Asbestos Related Diseases, School of Medicine and Pharmacology, University of Western Australia, Sir Charles Gairdner Hospital, 4th Floor, G Block, Verdun St, Nedlands, WA 6009, Australia.
Lung Cancer. 2011 Oct;74(1):55-60. doi: 10.1016/j.lungcan.2011.02.007. Epub 2011 Mar 12.
Blood-based markers for malignant mesothelioma (MM), particularly soluble mesothelin and osteopontin, are currently of great clinical interest. As there is some concern about the sensitivity of osteopontin in serum versus plasma, we compared them in the same patient population to mesothelin.
Soluble mesothelin and osteopontin concentrations were determined by commercial assays in blood samples from 66 patients with pleural MM, 47 patients with non-malignant asbestos-related lung or pleural disease, 42 patients with other benign pleural and lung diseases and 21 patients with lung cancer.
Soluble mesothelin and osteopontin in serum and plasma were significantly elevated in MM patients compared to patients with benign lung and pleural disease. At a level of specificity of 95% relative to patients with benign disease, the sensitivity of mesothelin in serum and plasma at presentation with symptoms was 67%, and for osteopontin in the plasma was 40% and in the serum was 20% for MM patients. Combining the serum mesothelin and plasma osteopontin markers using a logistic regression model did not significantly increase the area under the receiver operator curve.
Plasma osteopontin has a superior diagnostic accuracy to serum. As the choice of blood sample type has limit effect on soluble mesothelin sensitivity, plasma should be collected for biomarker evaluation in patients suspected of having mesothelioma.
血液恶性间皮瘤（MM）标志物，特别是可溶性间皮素和骨桥蛋白，目前具有重要的临床意义。由于对骨桥蛋白在血清和血浆中的敏感性存在一些担忧，我们在同一患者人群中对其与间皮素进行了比较。
通过商业检测方法，在 66 例胸膜 MM 患者、47 例非恶性与石棉相关的肺部或胸膜疾病患者、42 例其他良性胸膜和肺部疾病患者以及 21 例肺癌患者的血液样本中，分别测定了可溶性间皮素和骨桥蛋白的浓度。
与良性肺部和胸膜疾病患者相比，血清和血浆中的可溶性间皮素和骨桥蛋白在 MM 患者中显著升高。在针对良性疾病的特异性为 95%的水平下，在出现症状时，血清和血浆中间皮素的敏感性分别为 67%，而血浆中骨桥蛋白的敏感性为 40%，血清中为 20%。使用逻辑回归模型对血清间皮素和血浆骨桥蛋白标志物进行组合，并未显著增加接收者操作特征曲线下的面积。
与血清相比，血浆中的骨桥蛋白具有更高的诊断准确性。由于血液样本类型的选择对可溶性间皮素的敏感性有一定的限制作用，因此应采集血浆用于疑似间皮瘤患者的生物标志物评估。
