Pleural Fluid Mesothelin as an Adjunct to the Diagnosis of Pleural Malignant Mesothelioma

In this retrospective study we show that elevated mesothelin level in an effusion is a strong predictive indicator of the presence of malignancy, MM

Jenette Creaney

2014

Scholarcy highlights

  • Pleural malignant mesothelioma is an aggressive asbestos-induced malignancy
  • Over the 67-month period of the study 2156 consecutive pleural effusion samples were collected from 1331 individuals, approximately 40% of whom were female
  • Using receiver operator characteristic curve analysis, pleural effusion mesothelin generated an area under the curve of 0.877 for differentiating between patients with MM and all other patients in the study
  • In the 40 MM cases not reported as MM by cytology, mesothelin levels were elevated in 11/17 cases reported as atypical or suspicious; 6/15 of those reported as having an inflammatory infiltrate; and 3/8 nondiagnostic or negative samples)
  • As the diagnosis of pleural MM can be difficult by effusion cytology or biopsy and may take weeks or months to establish, the use of effusion biomarkers has the potential to aid in diagnosis and to add to clinical decision making
  • Effusion mesothelin level may influence clinical decision making in patients with effusions
  • If the cytological analysis shows atypical or suspicious cells, measurement of pleural fluid mesothelin might be sufficient to support the cytological diagnosis and will expedite further clinical decision making, especially regarding thoracoscopy and biopsy

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