Arnold David T, De Fonseka Duneesha, Hamilton Fergus W, Rahman Najib M, Maskell Nick A
Academic Respiratory Unit, School of Clinical Sciences, University of Bristol, Southmead Hospital, Learning and Research Centre, Westbury-on-Trym, Bristol BS10 5NB, UK.
Southmead Hospital, North Bristol NHS Trust, Bristol BS10 5NB, UK.
Br J Cancer. 2017 Mar 14;116(6):731-741. doi: 10.1038/bjc.2017.22. Epub 2017 Feb 7.
Radiological markers of treatment response and prognostication in malignant pleural mesothelioma have limitations due to the morphology of the disease. Serum or pleural fluid biomarkers that could act as an adjunct to radiological assessment would be of significant value. The aim of this review was to collate and summarise the literature relating to this topic.
A systematic review was performed on the databases Pubmed and EMBASE to identify relevant studies. Two independent researchers read the abstracts and used the Quality in Prognostic Studies tool to assess the quality of the evidence.
Forty-five studies were identified from the current literature. Twenty studies investigated the role of serum soluble mesothelin with majority suggesting that it has variable utility as a baseline test but when measured serially correlates with treatment response and prognosis. Several studies demonstrated that serum osteopontin correlated with survival at baseline. Other biomarkers have shown prognostic utility in individual studies but are yet to be reproduced in large cohort studies.
From the available literature no serum or pleural fluid biomarker was identified that could be recommended currently for routine clinical practice. However, a falling serum soluble mesothelin might correlate with treatment response and improved survival.
由于恶性胸膜间皮瘤的疾病形态，其治疗反应和预后的放射学标志物存在局限性。可作为放射学评估辅助手段的血清或胸水生物标志物具有重要价值。本综述的目的是整理和总结与该主题相关的文献。
对PubMed和EMBASE数据库进行系统综述以识别相关研究。两名独立研究人员阅读摘要并使用预后研究质量工具评估证据质量。
从当前文献中识别出45项研究。20项研究调查了血清可溶性间皮素的作用，大多数研究表明其作为基线检测的效用各异，但连续测量时与治疗反应和预后相关。多项研究表明血清骨桥蛋白在基线时与生存相关。其他生物标志物在个别研究中显示出预后效用，但尚未在大型队列研究中得到重现。
从现有文献中未发现目前可推荐用于常规临床实践的血清或胸水生物标志物。然而，血清可溶性间皮素下降可能与治疗反应和生存改善相关。
