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Published on: December 21, 2019
Soluble mesothelin-related protein in an asbestos-exposed population: the dust diseases board cohort study
Eun-Kee Park1, Alessandra Sandrini, Deborah H Yates
1Research and Education Unit, Dust Disease Board, Level 2, 82 Elizabeth Street, Sydney, NSW 2000, Australia.
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 (> or =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.
Insights
Soluble mesothelin-related protein (SMRP) shows a high false-positive rate for screening asbestos-exposed individuals. This study suggests SMRP is unlikely to be useful for detecting malignant mesothelioma.
Area of Science:
- Occupational Health
- Biomarker Research
- Oncology
Background:
- Soluble mesothelin-related protein (SMRP) is elevated in malignant mesothelioma (MM).
- The effectiveness of SMRP as a screening tool for MM remains undetermined.
Purpose of the Study:
- To assess the utility of SMRP in screening for malignancy within an asbestos-exposed cohort.
- To evaluate SMRP's diagnostic performance in individuals at risk for asbestos-related diseases.
Main Methods:
- A prospective study involving 538 asbestos-exposed subjects.
- Elevated SMRP levels (≥2.5 nM) triggered further diagnostic investigations, including PET/CT scans.
Main Results:
- Mean SMRP in healthy asbestos-exposed subjects was 0.79 nM.
- Fifteen subjects had elevated SMRP; one had resectable lung cancer, and another lung cancer case was missed.
- No cases of malignant mesothelioma were diagnosed; SMRP was significantly lower in healthy subjects compared to those with pleural plaques.
Conclusions:
- This is the first large-scale prospective study on SMRP for malignancy screening in asbestos-exposed individuals.
- A high false-positive rate was observed, indicating limited practical utility.
- SMRP is unlikely to be effective for screening malignant mesothelioma in this population.
