Department of Toxicology, Center for Research and Advanced Studies of National Polytechnic Institute, CINVESTAV, Av. Instituto Politécnico Nacional 2508, Col. San Pedro Zacatenco, 07360, Mexico City, Mexico.
Occupational Health Research Unit, Siglo XXI National Medical Center (CMNSXXI), Mexican Institute of Social Security (IMSS), Av. Cuauhtémoc 330, Col. Doctores, 06720, México, México.
Lung. 2019 Oct;197(5):641-649. doi: 10.1007/s00408-019-00244-1. Epub 2019 Jul 2.
Malignant pleural mesothelioma (MPM) is a highly lethal cancer caused by exposure to asbestos. Currently, the diagnosis is a challenge, carried out by means of invasive methods of limited sensitivity. This is a case-control study to evaluate the individual and combined performance of minimally invasive biomarkers for the diagnosis of MPM.
A study of 166 incident cases of MPM and 378 population controls of Mestizo-Mexican ethnicity was conducted. Mesothelin, calretinin, and megakaryocyte potentiating factor (MPF) were quantified in plasma by ELISA. The samples were collected from 2011 to 2016.
Based on ROC analysis and a preset specificity of 95%, the combination of the three biomarkers reached an AUC of 0.944 and a sensitivity of 82% in men. In women, an AUC of 0.937 and a sensitivity of 87% were reached. In nonconditional logistic regression models, the adjusted ORs in men were 7.92 (95% CI 3.02-20.78) for mesothelin, 20.44 (95% CI 8.90-46.94) for calretinin, and 4.37 (95% CI 1.60-11.94) for MPF. The ORs for women were 28.89 (95% CI 7.32-113.99), 17.89 (95% CI 3.93-81.49), and 2.77 (95% CI 0.47-16.21), respectively.
To our knowledge, this is the first study evaluating a combination of mesothelin, calretinin, and MPF, and demonstrating a sex effect for calretinin. The biomarker panel showed a good performance in a Mestizo-Mexican population, with high sensitivity and specificity for the diagnosis of MPM.
恶性胸膜间皮瘤（MPM）是一种由接触石棉引起的高度致命癌症。目前，诊断是一个挑战，通过敏感性有限的侵入性方法进行。这是一项病例对照研究，旨在评估用于诊断 MPM 的微创生物标志物的个体和联合性能。
对 166 例 MPM 病例和 378 例梅斯蒂索-墨西哥裔人群对照进行了研究。通过 ELISA 定量测定血浆中的间皮素、钙调蛋白和巨核细胞增强因子（MPF）。样本采集于 2011 年至 2016 年。
基于 ROC 分析和预设的 95%特异性，三种生物标志物的组合在男性中达到 AUC 为 0.944 和敏感性为 82%。在女性中，达到 AUC 为 0.937 和敏感性为 87%。在非条件逻辑回归模型中，男性的调整 OR 分别为间皮素 7.92（95%CI 3.02-20.78）、钙调蛋白 20.44（95%CI 8.90-46.94）和 MPF 4.37（95%CI 1.60-11.94）。女性的 OR 分别为 28.89（95%CI 7.32-113.99）、17.89（95%CI 3.93-81.49）和 2.77（95%CI 0.47-16.21）。
据我们所知，这是第一项评估间皮素、钙调蛋白和 MPF 组合的研究，并证明钙调蛋白存在性别效应。该生物标志物组合在梅斯蒂索-墨西哥人群中表现出良好的性能，对 MPM 的诊断具有较高的敏感性和特异性。
