The limited availability of data may result in underestimation. Taking into consideration the consumption pattern of asbestos in recent decades, the incorporation of later cohorts will improve the estimation.

Background: Because mesothelioma initially progresses on the surface of the pleura and peritoneum without forming masses, it has been difficult to diagnose at an early stage. It would be very useful to identify a tumor marker that could be used for screening to enable more diagnoses to be made at an early, treatable stage. Materials and Methods: We had previously identified N-ERC/mesothelin as a potential biomarker for mesothelioma. In the current work, we used a newly developed ELISA system to gain data on N-ERC/mesothelin levels in various clinical settings. A total of 102 healthy volunteers were recruited. In addition, 39 patients were diagnosed with mesothelioma, 53 patients were diagnosed with diseases that should be distinguished from mesothelioma, and 201 subjects were diagnosed with asbestos-related nonmalignant diseases (including simple exposure to asbestosis) who were treated at any of the cooperating hospitals were enrolled. Results: Serum N-ERC/mesothelin levels measured by a new ELISA system showed that the median values from patients with mesothelioma were extremely high compared with levels obtained from other patients. Analysis in terms of histologic type showed that serum levels of N-ERC/mesothelin were elevated in epithelioid type mesothelioma, especially. In four important models of clinical settings, the sensitivity and specificity of N-ERC/mesothelin were about 71% to 90% and 88% to 93%, respectively. Conclusion: N-ERC/mesothelin is a very promising tumor marker for mesothelioma, especially epithelioid mesothelioma.Mesothelioma initially progresses along the surfaces of the pleura and peritoneum without forming masses; it is anatomically difficult to diagnose at an early stage and to completely remove with surgery. Moreover, mesothelioma typically has a long incubation period before it becomes clinically evident among high-risk individuals with severe exposure to asbestos. Sugarbaker et al.(1) has reported a groundbreaking result: for patients with early stage disease, 5-year survival after trimodality therapy exceeded 40%. This finding that early disease may be effectively treated emphasizes the importance of identifying a tumor marker that is practical for screening and can allow physicians to make an early diagnosis.Recently, osteopontin, soluble mesothelin-related protein, and serum mesothelin have been reported as candidates for a mesothelioma tumor marker (2 -7). We have postulated (8) that another product may be useful as a tumor marker: N-ERC/ mesothelin, a NH 2 terminal 31-kDa fragment of mesothelin gene products that was first cloned as a megakaryocytepotentiating factor in humans and that is physiologically secreted into blood. Since the time of that report, we have established a new ELISA system that detects the NH 2 terminal fragments of ERC/mesothelin products at a higher sensitivity and specificity. The current work was done to obtain data for Materials and MethodsPreparation of novel anti-ERC/mesothelin antibodies. The anti -N-ERC/mesothelin monoclonal antibody (Mo...

This updated study confirmed a significant excess of asbestos-related mortality from diseases such as lung cancer and nonmalignant respiratory diseases among workers in a refitting shipyard in Japan.

The quantitative analysis of 8-hydroxy-2'-deoxyguanosine (oh8dG) in human peripheral blood cells was carried out to find integrated biomarkers for estimating cancer risk. The change of the oh8dG levels over time in two healthy volunteers was measured to evaluate a intraindividual variance and each individual value was confirmed to be almost constant when they maintained usual life style. We applied this measurement to asbestosis patients who had worked in dockyard for 19-42 years. The oh8dG were detected in all samples and ranged from 0.77 to 1.28/10(5) deoxyguanosine (dG)8. No significant differences was observed in mean values of oh8dG between patients (1.00 +/- 0.17/10(5)dG) and hospital control group without asbestos exposure (1.03 +/- 0.20/10(5)dG) No association was found with the status of cigarette smoking. The oh8dG level in peripheral blood cells is therefore not a sensitive biomarker for past asbestos exposure at low levels.

The educational program was effective in improving the nurses' knowledge and attitude toward malignant pleural mesothelioma care and decreasing the difficulty in MPM care, therefore this program has potential for nurses' in-service education throughout Japan.