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Utility of Osteopontin and Serum Mesothelin in Malignant Pleural Mesothelioma Diagnosis and Prognosis Assessment

Authors' Affiliations: ¹ Institut National de la Sante et de la Recherche Medicale (INSERM) U774, Institut Pasteur de Lille; ² Pulmonary and Thoracic Oncology Department, ³ Department of Thoracic Surgery, and ⁴ Pathology Department, Centre Hospitalier Régional Universitaire of Lille; ⁵ Statistics Department, Medical School of Lille, Lille, France; ⁶ Department of Pulmonary Diseases, University of Medicine and Pharmacy, Iasi, Romania; ⁷ Equipe ERI3 INSERM Cancers et Populations, Centre Hospitalier Universitaire of Caen; ⁸ Centre François Baclesse, GRECAN EA-1772, Université of Caen, Caen, France; and ⁹ INSERM U601-IFR26, Nantes, France

Requests for reprints: Arnaud Scherpereel, Clinique des Maladies Respiratoires, Hôpital Calmette, Centre Hospitalier Régional Universitaire of Lille, 59037 Lille Cedex, France. Phone: 33-320-44-49-98; Fax: 33-320-44-56-11; E-mail: a-scherpereel{at}chru-lille.fr.

Purpose: Malignant mesothelioma is a highly aggressive tumor and is often diagnosed too late for a curative treatment. We compared diagnostic and prognostic values of mesothelin and osteopontin in 172 patients suspected of malignant pleural mesothelioma (MPM) and in a control group of 112 asymptomatic asbestos-exposed subjects.

Experimental Design: Osteopontin and mesothelin were assayed with commercial ELISA kits in a series of 43 patients with pleural metastases of various carcinomas, 33 patients with benign pleural lesions associated with asbestos exposure, 96 patients with MPMs, and 112 asbestos-exposed healthy subjects. Results were correlated with patient's diagnosis and survival.

Results: Serum osteopontin level was higher in MPM patients compared with healthy asbestos-exposed subjects and had a good capability to distinguish between these two populations. However, osteopontin was unable to distinguish between MPM and pleural metastatic carcinoma or benign pleural lesions associated with asbestos exposure. Neither plasma nor pleural fluid osteopontin were more powerful in this respect. Serum mesothelin had a good ability for diagnosing MPM but was unable to identify patients with nonepithelioid mesothelioma subtypes. Survival analysis identified tumor histologic subtype along with serum osteopontin and serum mesothelin as independent prognostic factors in mesothelioma patients.

Conclusions: Osteopontin has a lower diagnostic accuracy than mesothelin in patients suspected of MPM. Insufficient specificity limits osteopontin utility as diagnostic marker. Both molecules have a potential value as prognostic markers.

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