Tuesday, February 19th, 2008.

Lung Cancer. 2008 Feb 15 [Epub ahead of print] [Link]

Roe OD, Creaney J, Lundgren S, Larsson E, Sandeck H, Boffetta P, Nilsen TI, Robinson B, Kjaerheim K.

Department of Oncology, St. Olavs Hospital, Trondheim University Hospital, Norway; Norwegian University of Science and Technology (NTNU), Department of Cancer Research and Molecular Medicine, Trondheim, Norway.

Abstract

Soluble mesothelin-related protein (SMRP) in serum is potentially a sensitive marker of malignant mesothelioma (MM) diagnosis and progression, and may be useful as screening marker. Mesothelin expression in tumors is regarded as a sensitive marker for diagnosis and disease progression, and is a candidate prognostic marker.

Levels of SMRP, CA125 and CYFRA 21-1 in pre-diagnostic (1–30 years) serum samples from 47 mesothelioma cases and 141 matched controls were analysed. Mesothelin expression in tumors was assessed.

The association between biomarker level and mesothelioma risk and survival was analysed, adjusting for asbestos exposure.

Survival related to tumor mesothelin expression, age, sex, histological type, location, asbestos exposure and pre-clinical SMRP was analysed.

There was no significant association between biomarker levels and mesothelioma risk when analysed as continuous variables or as tertiles. Biomarker levels <10, 10–19 and ≥20 years before diagnosis were not significantly associated to mesothelioma risk. Mesothelin expressed in >50% of tumor cells was seen in 36 of 47 (77%) tumors. Mesothelin expression in <50% of tumor cells was a significant negative prognostic marker in all cases of malignant mesothelioma (median survival = 6 months vs. 12 months, hazard ratio (HR) = 2.49, 95%CI 1.17–5.27), and also when only epithelial mesothelioma was analysed (median = 6 months vs. 14 months, HR = 2.36, 95%CI 1.07–5.22). When adjusted for age and gender, the prognosis was still dismal, but non-significant (HR = 1.85, 95%CI 0.85–4.05).

High age (>65 years) was an independent negative prognostic factor that was related to both mesothelin expression and asbestos exposure. Mesothelioma of the epithelial type of the peritoneum had a significantly longer survival than epithelial type in pleura and was also related to mesothelin expression.

Keywords: CA125; Case–control study; CYFRA 21-1; Immunohistochemistry; Mesothelin; Mesothelioma; SMRP; Tumor markers

Glossary

screening

the search for disease, such as cancer, in people without symptoms. For example, the principal screening measure for breast cancer is mammography. Screening may refer to coordinated programs in large populations.

prognosis

(prog-no-sis) a prediction of the course of disease; the outlook for the cure of the patient. For example, women with breast cancer that was detected early and who received prompt treatment have a good prognosis.

pleura

(pler-uh) the membrane around the lungs and lining of the chest cavity. (Pleural mesothelioma.)

oncology

(on-call-o-jee) the branch of medicine concerned with the diagnosis and treatment of cancer.

diagnosis

identifying a disease by its signs or symptoms, and by using imaging procedures and laboratory findings. The earlier a diagnosis of cancer is made, the better the chance for long-term survival.

cancer

malignancy; a group of diseases typified by abnormal, generally out-of-control, cell growth.

tumor

an abnormal lump or mass of tissue. Tumors can be benign (not cancerous) or malignant (cancerous).

mesothelioma

a tumor derived from mesothelial tissue, such as the peritoneum (lining the abdomen) or pleura (lining the lungs). More on mesothelioma.

« Mesothelioma Line Main Page.