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Pleural Effusion Biomarkers And Computed Tomography Findings In Diagnosing Malignant Pleural Mesothelioma: A Retrospective Study In A Single Center

Takehiro Otoshi, Yuki Kataoka, S. Ikegaki, Emiko Saito, Hirotaka Matsumoto, S. Kaku, M. Shimada, M. Hirabayashi
Published 2017 · Medicine

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In this study, we aimed to examine the clinical value of the pleural effusion (PE) biomarkers, soluble mesothelin-related peptide (SMRP), cytokeratin 19 fragment (CYFRA 21–1) and carcinoembryonic antigen (CEA), and the utility of combining chest computed tomography (CT) findings with these biomarkers, in diagnosing malignant pleural mesothelioma (MPM). We conducted a retrospective cohort study in a single center. Consecutive patients with undiagnosed pleural effusions who underwent PE analysis between September 2014 and August 2016 were reviewed. This study included 240 patients (32 with MPM and 208 non-MPM). SMRP and the CYFRA 21-1/CEA ratio had a sensitivity and specificity for diagnosing MPM of 56.3% and 86.5%, and 87.5% and 74.0%, respectively. Using receiver operating characteristics (ROC) curve analysis of the ability of these markers to distinguish MPM from all other PE causes, the area under the ROC curve (AUC) for SMRP and the CYFRA 21-1/CEA ratio was 0.804 and 0.874, respectively. The sensitivity and specificity of SMRP combined with the CYFRA 21-1/CEA ratio were 93.8% and 64.9%, respectively. The sensitivity of the combination of SMRP, the CYFRA 21-1/CEA ratio, and the presence of Leung’s criteria (a chest CT finding that is suggestive of malignant pleural disease) was 93.8%. In conclusion, the combined PE biomarkers had a high sensitivity for diagnosing MPM, although the addition of chest CT findings did not improve the sensitivity of SMRP combined with the CYFRA 21-1/CEA ratio. Combination of these biomarkers helped to rule out MPM effectively among patients at high risk of suffering MPM and would be valuable especially for old frail patients who have difficulty in undergoing invasive procedures such as thoracoscopy.
This paper references
10.1007/s12032-013-0543-6
Diagnostic value of mesothelin in pleural fluids: comparison with CYFRA 21-1 and CEA
R. Filiberti (2013)
Mesothelin is more useful in pleural effusion than in serum in the diagnosis of pleural mesothelioma.
P. Ferro (2013)
10.1046/j.1440-1843.1998.00069.x
Computed tomographic findings of environmental asbestos‐related malignant pleural mesothelioma
U. Yilmaz (1998)
10.3109/07357907.2012.749265
Evaluation of Soluble Mesothelin-related Peptide as a Diagnostic Marker of Malignant Pleural Mesothelioma Effusions: Its Contribution to Cytology
P. Canessa (2013)
10.1164/rccm.200801-063OC
Mapping the risk of mesothelioma due to neighborhood asbestos exposure.
N. Kurumatani (2008)
10.1016/S0720-048X(01)00426-0
Computed tomography features in malignant pleural mesothelioma and other commonly seen pleural diseases.
M. Metintas (2002)
10.1186/1471-2105-16-S9-S3
Differential diagnosis of pleural mesothelioma using Logic Learning Machine
S. Parodi (2015)
10.1164/rccm.200811-1729OC
Clinical impact and reliability of pleural fluid mesothelin in undiagnosed pleural effusions.
H. E. Davies (2009)
10.1515/CCLM.2011.242
Clinical significance of pleural effusion mesothelin in malignant pleural mesothelioma
S. Yamada (2011)
Fundamental evaluation of Lumipulse mesothelin
M Nakamachi (2011)
Soluble mesothelinrelated protein in pleural effusion from patients with malignant pleural mesothelioma
N Fujimoto (2010)
10.1037/H0026256
Weighted kappa: nominal scale agreement with provision for scaled disagreement or partial credit.
J. Cohen (1968)
10.1136/thx.2010.136978
Investigation of a unilateral pleural effusion in adults: British Thoracic Society pleural disease guideline 2010
C. Hooper (2010)
10.2214/AJR.154.3.2106209
CT in differential diagnosis of diffuse pleural disease.
A. Leung (1990)
10.1136/thx.2006.068114
Soluble mesothelin in effusions: a useful tool for the diagnosis of malignant mesothelioma
J. Creaney (2007)
Cytokeratin 19 fragment/carcinoembryonic antigen ratio in pleural effusion is a useful marker for detecting malignant pleural mesothelioma.
H. Suzuki (2010)
10.1016/j.resinv.2013.02.002
Hyaluronic acid in the pleural fluid of patients with malignant pleural mesothelioma.
N. Fujimoto (2013)
10.1007/s12032-013-0649-x
Clinical value of mesothelin in pleural effusions versus histology by medical thoracoscopy: brief report
P. Canessa (2013)
10.1378/CHEST.119.4.1138
Diagnostic value of CYFRA 21-1 tumor marker and CEA in pleural effusion due to mesothelioma.
M. Paganuzzi (2001)
Soluble mesothelinrelated peptides in the diagnosis of malignant pleural mesothelioma
A Scherpereel (2006)
10.7326/0003-4819-155-8-201110180-00009
QUADAS-2: A Revised Tool for the Quality Assessment of Diagnostic Accuracy Studies
P. Whiting (2011)
10.1016/j.medcli.2008.11.047
Pleural fluid mesothelin for the differential diagnosis of exudative pleural effusions.
C. Alemán (2009)
10.1378/CHEST.109.2.414
Combined use of pleural adenosine deaminase with lymphocyte/neutrophil ratio. Increased specificity for the diagnosis of tuberculous pleuritis.
L. Burgess (1996)
10.3892/ETM_00000048
Soluble mesothelin-related protein in pleural effusion from patients with malignant pleural mesothelioma.
N. Fujimoto (2010)
Mesothelin in serum and pleural effusion in the diagnosis of malignant pleural mesothelioma with non-positive cytology.
M. C. Franceschini (2014)
Fundamental evaluation of Lumipulse mesothelin [ in Japanese ]
M Nakamachi (2011)
10.1164/RCCM.200511-1789OC
Soluble mesothelin-related peptides in the diagnosis of malignant pleural mesothelioma.
A. Scherpereel (2006)
10.1007/s00432-010-0834-7
Clinical investigation of malignant mesothelioma in Japan
N. Fujimoto (2010)
10.1056/NEJMsr1203730
The prevention and treatment of missing data in clinical trials.
R. J. Little (2012)
10.1155/2014/413946
Pleural Fluid Mesothelin as an Adjunct to the Diagnosis of Pleural Malignant Mesothelioma
J. Creaney (2014)
10.1016/j.lungcan.2015.05.014
Treatment patterns and survival analysis in 9014 patients with malignant pleural mesothelioma from Belgium, the Netherlands and England.
R. Damhuis (2015)
10.1183/09031936.00148211
A prospective trial evaluating the role of mesothelin in undiagnosed pleural effusions
C. Hooper (2012)
10.1378/CHEST.94.5.1037
Concentration of hyaluronic acid in pleural fluid as a diagnostic aid for malignant mesothelioma.
T. Pettersson (1988)
10.1016/J.ATHORACSUR.2007.07.042
Soluble mesothelin-related peptide level elevation in mesothelioma serum and pleural effusions.
H. Pass (2008)



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