Diagnostic and prognostic utilities of humoral fibulin-3 in malignant pleural mesothelioma: Evidence from a meta-analysis

Abstract

Fibulin-3 has emerged as a promising novel biomarker in conforming or monitoring malignant pleural mesothelioma (MPM). This study sought to evaluate the diagnostic and prognostic efficacies of humoral fibulin-3 for MPM. Seven eligible publications comprising 468 MPM cases for diagnosis, and 138 for prognosis were identified. Results manifested that humoral fibulin-3 sustained a pooled sensitivity of 0.62 (95% CI: 0.45–0.77) and specificity of 0.82 (95% CI: 0.73–0.89) in discriminating MPM patients from cancer-free individuals, corresponding to an AUC (area under the curve) of 0.81. For the survival analysis, fibulin-3 expression was not markedly associated with overall survival (OS) time of the MPM patients [HR (hazard ratio): 1.84, 95% CI: 0.75–4.56, P = 0.185]. In the subgroup analyses stratified by test matrix and ethnicity, data revealed that serum-based fibulin-3 examination achieved superior accuracy than plasma-based analysis (sensitivity: 0.77 versus 0.54; specificity: 0.85 versus 0.77; AUC: 0.92 versus 0.69); additionally, testing of fibulin-3 in Europeans retained higher efficacy than those in Americans and Australians. Taken together, fibulin-3 confers a relatively high diagnostic efficacy and is acceptable to be an auxiliary biomarker to aid in MPM identification.

Diagnostic and prognostic biomarkers for malignant mesothelioma: an update

“…The pooled sensitivity and specificity of the fibulin-3 assay was 62% (95% CI 45-77%) and of 82% (95% CI 73-89%), respectively and MM cases were discriminated from controls with AUC of ROC of 0.81 (70). These data demonstrate the high diagnostic efficacy of fibulin-3, supporting previous evidence of the role of this protein as a promising diagnostic biomarker for MM (5,71,73).…”

“…Novel, and potentially more sensitive and specific MM biomarkers were evaluated, including MPF(31), OPN (60,64,66), fibulin-3 (70,72,73), HMGB1 (82), with promising results. In addition, a variety of deregulated miRNAs [reviewed in (109)], including the miR-score signature with prognostic significance (98), as well as different approaches based on proteomics technology, have been proposed as suitable MM markers (100,109).…”

“…Human fibulin-3 is a secreted glycoprotein encoded by the epidermal growth factor (EGF)-containing fibulin-like extracellular matrix protein-1 (EFEMP-1) gene, involved in the regulation of MM cell proliferation and migration (70).…”

“…A comprehensive meta-analysis was conducted on 7 studies in 468 MM cases to establish the clinical diagnostic value of fibulin-3 for MM (70). The pooled sensitivity and specificity of the fibulin-3 assay was 62% (95% CI 45-77%) and of 82% (95% CI 73-89%), respectively and MM cases were discriminated from controls with AUC of ROC of 0.81 (70).…”

Serum mesothelin and other biomarkers: what have we learned in the last decade?

“…Several studies have investigated the diagnostic value of fibulin-3 for MPM and based on these fibulin-3 results a useful diagnostic marker for MPM (30)(31)(32)(33)(34).…”