Related Experiment Video
Updated: Apr 26, 2026
Generation and Expansion of Primary, Malignant Pleural Mesothelioma Tumor Lines
Published on: April 21, 2022
Comparison of fibulin-3 and mesothelin as markers in malignant mesothelioma
Jenette Creaney1, Ian M Dick2, Tarek M Meniawy2
1National Centre for Asbestos Related Diseases, School of Medicine and Pharmacology, University of Western Australia, Nedlands, Western Australia, Australia The Australian Mesothelioma Tissue Bank, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia.
Background:
Pleural malignant mesothelioma (MM) is a deadly tumour predominantly associated with asbestos exposure. A reliable diagnostic and prognostic marker for MM will significantly enhance clinical care and is an area of intense research. Soluble mesothelin is the most studied and an FDA-approved biomarker for MM. A recent report showed promising results using fibulin-3 as a new diagnostic marker. The aim of this study was to compare the utility of fibulin-3 versus mesothelin, singly or in combination.
Methods:
Fibulin-3 and soluble mesothelin were determined by ELISA in the plasma and pleural fluid of 153 patients presenting with a pleural effusion including 82 with MM, 36 with non-MM malignant effusions and 35 with benign effusions. Biomarker concentrations were determined in the plasma of an additional 49 cases with benign asbestos-related disease.
Results:
Mesothelin provides better diagnostic accuracy than fibulin-3 for MM whether measured in plasma or pleural effusion: area under the curve (AUC) for plasma was 0.822 (95% CI 0.76 to 0.87) compared with 0.671 (0.61 to 0.73), respectively, and for pleural fluid AUC was 0.815 (0.74 to 0.87) compared with 0.588 (0.51 to 0.67), respectively. Effusion fibulin-3 was an independent significant prognostic factor for survival in MM patients; HR 2.08 (1.14 to 3.82), p=0.017. MM patients with effusion fibulin-3 levels below the median survived significantly longer than those with levels above the median (14.1 vs 7.9 months, p=0.012). Mesothelin and neutrophil to lymphocyte ratio were not significant prognostic markers.
Conclusions:
Soluble mesothelin is a superior diagnostic biomarker for MM compared with fibulin-3, whereas fibulin-3 provides superior prognostic information compared with mesothelin.
Insights
Soluble mesothelin is a better diagnostic marker for malignant mesothelioma (MM) than fibulin-3. However, fibulin-3 offers superior prognostic information for MM patients, indicating its value in predicting survival outcomes.
Area of Science:
- Oncology
- Biomarker Research
- Asbestos-related Diseases
Background:
- Pleural malignant mesothelioma (MM) is a significant asbestos-induced cancer.
- Accurate diagnostic and prognostic markers are crucial for MM patient management.
- Soluble mesothelin is an established FDA-approved MM biomarker, while fibulin-3 is a potential new marker.
Purpose of the Study:
- To compare the diagnostic and prognostic utility of fibulin-3 and soluble mesothelin in pleural malignant mesothelioma.
- To evaluate fibulin-3 and mesothelin, both individually and in combination, as biomarkers for MM.
Main Methods:
- Plasma and pleural fluid samples were collected from 153 patients with pleural effusions (82 MM, 36 non-MM malignant, 35 benign).
- Fibulin-3 and soluble mesothelin levels were quantified using ELISA.
- Additional plasma samples from 49 patients with benign asbestos-related disease were analyzed.
Main Results:
- Soluble mesothelin demonstrated superior diagnostic accuracy for MM compared to fibulin-3 in both plasma (AUC 0.822 vs 0.671) and pleural fluid (AUC 0.815 vs 0.588).
- Fibulin-3 in pleural effusion was a significant independent prognostic factor for MM survival (HR 2.08, p=0.017).
- MM patients with lower effusion fibulin-3 levels had significantly longer survival (14.1 vs 7.9 months).
Conclusions:
- Soluble mesothelin is a more effective diagnostic biomarker for MM than fibulin-3.
- Fibulin-3 provides superior prognostic information for MM, predicting patient survival.
- The combination of these markers may offer comprehensive diagnostic and prognostic insights.
