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Soluble Mesothelin-related Protein in an Asbestos-exposed Population

The Dust Diseases Board Cohort Study

¹ Research and Education Unit, Dust Diseases Board, Sydney, Australia; ² Department of Thoracic Medicine, St. Vincent's Hospital, Sydney, Australia; ³ National Research Center for Asbestos Related Disease, Western Australian Institute of Medical Research, University of Western Australia, and Sir Charles Gairdner Hospital, Nedlands, Perth, Australia; and ⁴ Faculty of Medicine, School of Medical Sciences, University of New South Wales, Sydney, Australia

Correspondence and requests for reprints should be addressed to Dr. Deborah H. Yates, M.D., F.R.A.C.P., F.R.C.P., Research and Education Unit, Dust Disease Board, Level 2, 82 Elizabeth Street, Sydney, NSW 2000, Australia. E-mail: deborahy88{at}hotmail.com

Rationale: Soluble mesothelin-related protein (SMRP) is raised in epithelial-type malignant mesothelioma (MM), but the utility of SMRP in screening for MM is unknown.

Objectives: We aimed to evaluate SMRP in an asbestos-exposed cohort.

Methods: A total of 538 subjects were studied. Those with elevated SMRP (2.5 nM) underwent further investigation including positron emission tomography/computed tomography.

Measurements and Main Results: Mean (±SD) SMRP in healthy subjects exposed to asbestos (n = 223) was 0.79 (±0.45) nM. Fifteen subjects had elevated SMRP, of whom one had lung cancer, which was successfully resected. Another with lung cancer was undetected by SMRP. No subjects were diagnosed with MM. Mean SMRP in healthy subjects was significantly lower than in subjects with pleural plaques alone (P < 0.01).

Conclusions: This is the first large-scale prospective study of SMRP for screening for malignancy in asbestos-exposed individuals. A high false-positive rate was observed. SMRP seems unlikely to prove useful in screening for MM.

Key Words: soluble mesothelin-related protein • mesothelioma • asbestos-related disorders • screening • diagnostic accuracy • biomarkers

AT A GLANCE COMMENTARY Scientific Knowledge on the Subject Soluble mesothelin-related protein (SMRP) is a biomarker reported to be useful in the diagnosis of malignant mesothelioma (MM). Its use a screening tool in a population at risk of MM has not been evaluated. What This Study Adds to the Field This is the first large-scale prospective study of SMRP for screening for malignancy in asbestos-exposed individuals. A high false-positive rate was observed. SMRP seems unlikely to prove useful in screening for MM.

 

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