Biomarkers for malignant pleural mesothelioma: a meta-analysis.

Carcinogenesis 2019 June 5 [Link]

Gillezeau C, van Gerwen M, Ramos J, Liu B, Flores R, Taioli E


Malignant Pleural Mesothelioma (MPM) is a rare by aggressive cancer, and early detection is associated with better survival. Mesothelin, fibulin-3, and osteopontin have been suggested as screening biomarkers. The study conducted a meta-analysis of the mean differences of mesothelin, osteopontin, and fibulin-3 in blood and pleural samples. PubMed searches were conducted for studies that measured levels of mesothelin, osteopontin, and fibulin-3 in participants with MPM compared to with malignancy, benign lung disease, or healthy participants. Thirty-two studies with mesothelin levels, 12 studies with osteopontin levels and nine studies with fibulin-3 levels were included in the meta-analysis. Statistically significant mean differences were seen between MPM patients and all other comparison groups for mesothelin blood and pleural levels. Statistically significant differences in blood osteopontin levels were seen between participants with benign lung disease and healthy participants compared to participants with MPM, but not when comparing cancer participants to MPM participants. There were not enough studies that reported osteopontin levels in pleural fluid to complete a meta-analysis. Statistically significant differences were seen in both blood and pleural levels of fibulin-3 in MPM patients compared to all other groups. Based on these results, mesothelin and fibulin-3 levels appear to be significantly lower in all control groups compared to those with MPM, making them good candidates for screening biomarkers. Osteopontin may be a useful biomarker for screening healthy individuals or those with benign lung disease, but would not be useful for screening patients with malignancies.