Predicting Malignant Mesothelioma by Analyzing Serum N-ERC/Mesothelin, C-ERC/Mesothelin, Hyaluronan, Osteopontin, and Syndecan-1 Levels

Clinical utility of diagnostic biomarkers in malignant pleural mesothelioma: a systematic review and meta-analysis

“…All studies reported a higher level of OPN in MPM patients compared to controls. However, two studies reported no difference in OPN levels when compared to other diseases [34,50]. These results stress that serum OPN is not optimal for differential diagnosis as it lacks specificity.…”

“…However, due to a lack in sensitivity (67.4% when compared to benign pleural disease) and specificity (60.8% when compared to metastases), in general, mesothelin seems to be more performant than MPF in serum (AUC ROC =0.81 and 0.78, respectively) (figure 1b) [34,50,56,59]. A significant link between higher MPF levels and the epithelioid subtype as well as the association with advanced stage was found [34,59].…”

“…The risk of bias does call for some concern. Firstly, some studies excluded patients based on suspicion of infection [18-23], previous therapy for other malignancies [24], other benign or malignant diseases [12,13,16,[25][26][27][28][29][30][31][32][33], mixed and sarcomatoid mesothelioma [13], or unclear diagnosis [34][35][36][37], which can lead to a more positive evaluation of the diagnostic capacities of the biomarker. Most studies only included untreated patients.…”

“…Only four studies investigated MPF, which all reported an elevation in MPM patients [34,50,56,59]. In a large population (85 MPM patients and 275 controls), a high correlation between MPF and mesothelin was reported [59].…”

“…The reported cut-off values vary tremendously, ranging from 16.06 ng•mL −1 to 139.1 ng•mL −1 . Studies focussing on differential diagnosis with benign PEs performed very poorly, with AUC ROC values no better than random (figure 1c) [34,49]. Studies including AE and HC individuals as controls performed remarkably better (AUC ROC =0.89 and 0.86, respectively) [31,62].…”