Arnold David T, Maskell Nick A
Academic Respiratory Unit, School of Clinical Sciences, University of Bristol, Bristol, UK.
Ann Clin Biochem. 2018 Jan;55(1):49-58. doi: 10.1177/0004563217741145. Epub 2017 Nov 13.
Mesothelioma is an aggressive cancer of pleural and peritoneal cells that is difficult to diagnose and monitor. Numerous studies have attempted to identify a blood- or pleural fluid-based biomarker that could be used in the diagnostic pathway. More recently, there has been interest in the ability of serum/plasma biomarkers to monitor mesothelioma, given the development of newer treatments and limitations of radiological assessment. The majority of research has focused on soluble mesothelin, a soluble glycoprotein expressed by mesothelial cells. Although soluble mesothelin lacks the sensitivity to be used as a standalone diagnostic marker, serial measurements may be informative, with rising concentrations indicating disease progression and poor survival. High concentrations of other soluble glycoproteins, such as osteopontin, fibulin-3 and vascular endothelial growth factor are independently associated with poor prognosis at baseline, although further research is required to ascertain any role outside of clinical trials. More recent literature has focused on the development of novel biomarkers from discovery cohorts. Although many DNA and mRNA biomarkers show promise in the diagnosis or screening of mesothelioma, none have been prospectively evaluated for use in clinical practice. In this review article, we highlight the potential utility of biomarkers and evaluate the existing literature.
间皮瘤是一种侵袭性的胸膜和腹膜细胞癌，难以诊断和监测。众多研究试图确定一种可用于诊断途径的基于血液或胸水的生物标志物。最近，鉴于新治疗方法的发展和放射学评估的局限性，血清/血浆生物标志物监测间皮瘤的能力受到关注。大多数研究集中在可溶性间皮素，这是一种由间皮细胞表达的可溶性糖蛋白。尽管可溶性间皮素缺乏用作独立诊断标志物的敏感性，但连续测量可能具有参考价值，浓度升高表明疾病进展和预后不良。其他可溶性糖蛋白，如骨桥蛋白、纤连蛋白-3和血管内皮生长因子的高浓度在基线时独立与预后不良相关，尽管需要进一步研究以确定其在临床试验之外的任何作用。最近的文献集中在从发现队列中开发新型生物标志物。尽管许多DNA和mRNA生物标志物在间皮瘤的诊断或筛查中显示出前景，但尚无一项在临床实践中进行前瞻性评估。在这篇综述文章中，我们强调生物标志物的潜在效用并评估现有文献。
