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Imaging, Diagnosis, Prognosis

Clinical Significance of Serum Mesothelin in Patients with Mesothelioma and Lung Cancer

Alfonso Cristaudo, Rudy Foddis, Agnese Vivaldi, Giovanni Guglielmi, Nicola Dipalma, Rosangela Filiberti, Monica Neri, Marcello Ceppi, Michela Paganuzzi, Gian Paolo Ivaldi, Manlio Mencoboni, Pier Aldo Canessa, Nicolino Ambrosino, Antonio Chella, Luciano Mutti and Riccardo Puntoni
Alfonso Cristaudo
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Rudy Foddis
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Agnese Vivaldi
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Giovanni Guglielmi
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Nicola Dipalma
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Rosangela Filiberti
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Monica Neri
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Marcello Ceppi
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Michela Paganuzzi
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Gian Paolo Ivaldi
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Manlio Mencoboni
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Pier Aldo Canessa
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Nicolino Ambrosino
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Antonio Chella
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Luciano Mutti
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Riccardo Puntoni
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DOI: 10.1158/1078-0432.CCR-07-0629 Published September 2007
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    Fig. 1.

    Serum SMRP concentrations in the population under investigation.

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    Fig. 2.

    A, Mesomark performance in differentiating between mesotheliomas and controls. B, Mesomark performance in differentiating between mesothelioma cases stage I to II and controls.

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    Fig. 3.

    Survival of mesothelioma patients according to serum SMRP levels.

Tables

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  • Table 1.

    Characteristics of the study subjects

    MM (n = 107)LC (n = 215)BRD (n = 130)Controls (n = 262)*
    Age (mean ± SD)69.1 ± 9.965.4 ± 8.761.9 ± 10.553.9 ± 12.9
    Sex
        Male89 (83.2%)181 (84.2%)114 (87.7%)208 (79.4%)
        Female18 (16.8%)34 (15.8%)16 (12.3%)54 (20.6%)
    Asbestos exposure
        No exposure19 (17.8%)125 (58.1%)19 (14.6%)54 (20.6%)
        Possible5 (4.7%)21 (9.8%)2 (1.5%)5 (1.9%)
        Probable5 (4.7%)9 (4,2%)3 (2.3%)—
        Ascertained77 (72%)52 (24.2%)105 (80.8%)203 (77.5%)
        NOS†1 (0.8%)8 (3.7%)1 (0.8%)—
    • ↵* Two hundred and three out of these 262 patients were workers previously exposed to asbestos (for at least a decade). The remaining patients were either blood donors or patients hospitalized for orthopedic traumatic injury or eye disease.

    • ↵† Not otherwise specified.

  • Table 2.

    Serum SMRP concentration (nmol/L) according to tumor morphology and stage

    n (%)Mean ± SDMedian (range)
    Mesothelioma1073.05 ± 5.61.42 (0.21-40.84)
    Histology
        Epithelioid72 (67.3)3.72 ± 6.61.64 (0.21-40.84)
        Mixed7 (6.5)1.69 ± 0.71.79 (0.48-2.74)
        Sarcomatous10 (9.4)0.99 ± 0.61.02 (0.25-2.16)
        Desmoplastic3 (2.8)0.5 ± 0.30.49 (0.23-0.77)
        NOS*15 (14.0)2.37 ± 2.71.42 (0.42-10.32)
    Stage
        I-II43 (40.2)2.24 ± 3.81.25 (0.23-25.10)
        III-IV45 (42.0)3.93 ± 7.41.51 (0.21-40.84)
        NOS*19 (17.8)2.83 ± 3.41.06 (0.35-10.32)
    Lung cancer2151.05 ± 1.10.82 (0.10-11.84)
    Histology
        SCLC5 (2.3)0.96 ± 0.50.88 (0.44-1.65)
        Adenocarcinomas104 (48.4)1.14 ± 1.40.84 (0.10-11.84)
        Squamous62 (28.8)0.81 ± 0.50.70 (0.10-2.15)
        NSCLC26 (12.1)0.97 ± 1.00.70 (0.16-5.37)
        NOS*18 (8.4)1.44 ± 1.00.99 (0.53-3.61)
    Stage
        I-II43 (20.0)1.04 ± 0.80.85 (0.22-3.91)
        III-IV145 (67.4)1.06 ± 1.20.88 (0.10-11.84)
        NOS*27 (12.6)1.01 ± 0.70.79 (0.22-3.41)
    BRD1300.76 ± 0.40.68 (0.12-2.47)
        Asbestosis12 (9.2)0.70 ± 0.40.69 (0.15-1.74)
        BRD, asbestos†46 (35.4)0.75 ± 0.30.69 (0.20-1.58)
        BRD, no asbestos‡31 (23.9)0.72 ± 0.50.61 (0.20-2.17)
        COPD§25 (19.2)0.87 ± 0.50.70 (0.33-2.48)
        Others∥16 (12.3)0.81 ± 0.60.68 (0.12-1.83)
    Controls2620.76 ± 0.40.66 (0.16-2.36)
        Healthy exposed203 (77.5)0.75 ± 0.40.64 (0.16-2.36)
        Other controls¶59 (22.5)0.81 ± 0.40.72 (0.20-2.18)
    • ↵* Not otherwise specified.

    • ↵† Pleural plaques, asbestos-related pleural thickening.

    • ↵‡ Interstitial lung diseases, chronic pleuritis.

    • ↵§ Chronic obstructive pulmonary disease.

    • ↵∥ Pneumonia, tuberculosis, sarcoidosis, empyema, other benign non–asbestos-related lung and pleural disorders.

    • ↵¶ Blood donors or patients hospitalized for orthopedic traumatic injury or eye disease.

  • Table 3.

    Efficacy of SMRP in differentiating between MM or LC and controls

    Mesothelioma
    Lung cancer
    CutoffTPFNFPTNSeSpTPFNFPTNSeSp
    0.50094131857787.929.4174411887480.928.2
    0.600911615510785.140.81486715910368.831.2
    0.700832411514777.656.11209511714555.855.3
    0.80077309117172.065.31081079217050.264.9
    0.90076316919371.073.7861297019240.073.3
    1.00073345121168.280.5721435221033.580.2
    1.20060473722556.185.9501653722523.385.9
    1.40054532623650.590.1371782623617.290.1
    1.60049581524745.894.2281871524713.094.3
    1.8004364925340.296.61819792538.496.6
    2.4002978026227.1100.01020502624.7100.0
    • Abbreviations: TP, true positives; FN, false-negatives; FP, false-positives; TN, true negatives; Se, sensitivity; Sp, specificity.

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Clinical Cancer Research: 13 (17)
September 2007
Volume 13, Issue 17
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Clinical Significance of Serum Mesothelin in Patients with Mesothelioma and Lung Cancer
Alfonso Cristaudo, Rudy Foddis, Agnese Vivaldi, Giovanni Guglielmi, Nicola Dipalma, Rosangela Filiberti, Monica Neri, Marcello Ceppi, Michela Paganuzzi, Gian Paolo Ivaldi, Manlio Mencoboni, Pier Aldo Canessa, Nicolino Ambrosino, Antonio Chella, Luciano Mutti and Riccardo Puntoni
Clin Cancer Res September 1 2007 (13) (17) 5076-5081; DOI: 10.1158/1078-0432.CCR-07-0629

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Clinical Significance of Serum Mesothelin in Patients with Mesothelioma and Lung Cancer
Alfonso Cristaudo, Rudy Foddis, Agnese Vivaldi, Giovanni Guglielmi, Nicola Dipalma, Rosangela Filiberti, Monica Neri, Marcello Ceppi, Michela Paganuzzi, Gian Paolo Ivaldi, Manlio Mencoboni, Pier Aldo Canessa, Nicolino Ambrosino, Antonio Chella, Luciano Mutti and Riccardo Puntoni
Clin Cancer Res September 1 2007 (13) (17) 5076-5081; DOI: 10.1158/1078-0432.CCR-07-0629
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