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Mesothelin in effusions marks out malignancy

An ELISA assay for mesothelin should make it easier and faster to identify malignant mesothelioma from patients’ pleural effusions, especially in centres with limited expertise in cytopathological diagnosis.

Researchers have found that the test, which has already been used to detect soluble mesothelin–a marker for the cancer—in serum, can be successfully applied to effusions.

In a six year prospective study they used the assay on pleural and peritoneal effusions collected from consecutive patients at outpatient respiratory clinics in two centres in Perth, Western Australia.

The assay had a diagnostic specificity of 98% at a cut off value of 20 mM soluble mesothelin and cross validated sensitivity of 67% in pleural effusions from patients with confirmed malignant mesothelioma. Mesothelin concentrations in pleural effusions and matched serum samples correlated significantly and were raised 3 weeks to 10 months before diagnosis in 70% (7/10) of patients, in half (4/8) of whom amounts were . . . [Full text of this article]