The value of mesothelin in pleural effusion vs histology by medical thoracoscopy (original) (raw)

European Respiratory Journal, 2011

Abstract

Pleural effusions (PE) are frequently the presenting symptom of neoplastic disease. Serum mesothelin related peptide (SMRP) is a new biomarker for the diagnosis of mesothelioma. The aim of this study was to investigate the diagnostic significance of mesothelin in PE of unknown origin. Pleural fluid, obtained from 104 patients between March 2008 and October 2009, were compared with histology of pleural biopsy taken during consecutive medical thoracoscopy. We had: 34 PE from mesotheliomas (25 epitheliomorphic, 9 sarcomatoid), 35 from pleural metastasis, 35 from benign diseases. SMRP concentrations was obtained using an ELISA test. SMRP levels in PE were significantly higher in patients with epitheliomorphic mesothelioma (mean ±SD, 46,55 nM ± 44,29) than in patients with sarcomatoid mesothelioma (16.11 nM± 25.02) (p=0.061), pleural metastasis (7.52 nM± 10.77) (p Pleural SMRP levels higher than 19.6 nM were observed in 18/25 (72%) patients with epiteliomorphic mesothelioma, in 5/35 (14.3%) with pleural metastasis, in 2/9 (22.2%) with sarcomatoid mesothelioma, 1/35 (2.9%) with benign diseases. SMRP has the potential to add clinically significant information in the work-up of patients with a PE of unknown origin.

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