Prognostic significance of soluble mesothelin in malignant pleural mesothelioma: a meta-analysis

Abstract

BackgroundSoluble mesothelin is beneficial to detect the progression and the treatment response of malignant pleural mesothelioma. However, the prognostic value of soluble mesothelin in malignant pleural mesothelioma remains unclear.MethodsHazard ratio with 95% CI was used to evaluate the prognostic value of soluble mesothelin and the effect of clinicopathological characteristics on the survival of malignant pleural mesothelioma.ResultsEight eligible studies involving 579 patients were selected for this meta-analysis. The results showed that soluble mesothelin level was significantly correlated with the survival of malignant pleural mesothelioma (pooled HR: 1.958, 95%CI: 1.531-2.504, p = 0.000; heterogeneity test: I2 = 1.1%, p = 0.421). In addition, the survival of malignant pleural mesothelioma was significantly correlated with some clinicopathological characteristics such as tumor histology (HR = 3.214, 95% CI = 2.071-4.988, p = 0.000; heterogeneity test: I2 = 0.0%, p = 0.623) and tumor stage (HR = 2.007; 95% CI = 1.477-2.727; p = 0.000; heterogeneity test: I2 = 0.0%, p = 0.966).ConclusionsThe survival of malignant pleural mesothelioma is significantly correlated with tumor histology and tumor stage. Furthermore, high soluble mesothelin level may lead to a poor prognosis for malignant pleural mesothelioma patients.

Evaluation of soluble mesothelin-related peptides and MSLN genetic variability in asbestos-related diseases

“…12,14 Several studies also investigated SMRP as a prognostic biomarker in MM. 18,[21][22][23] SMRP levels were markedly increased at disease progression. 21 In a meta-analysis, increased SMRP was associated with shorter overall survival and worse prognosis.…”

“…It is involved in important cellular processes, including cell adhesion, proliferation, invasion, and epithelial-to-mesenchymal transition. 18,19 Mesothelin is a glycophosphatidylinositol-linked membrane protein, but it also has three isoforms that are present in the circulation. 12,15,20 Enzyme-linked immunosorbent assay (ELISA) can detect different isoforms, usually referred to as soluble mesothelin related peptides (SMRP).…”

“…21 In a meta-analysis, increased SMRP was associated with shorter overall survival and worse prognosis. 18 Numerous studies also noted that serial longitudinal SMRP measurements may be more informative than SMRP levels at diagnosis. 22,23 Mesomark TM ELISA kit was already approved by the FDA for the measurement of SMRP and monitoring of MM.…”

Asbestos-Related Diseases and Blood Biomarkers

“…One of the most investigated biomarkers in MM is mesothelin, a circulating form of a glycoprotein attached to the cell surface, that is considered to have a role in cell adhesion, proliferation, invasion, and possibly in cell-to-cell signalling. Mesothelin is highly expressed in MM as well as in several other cancers [14][15][16][17][18]. It exists in different forms that can be detected in serum in the form of soluble mesothelinrelated peptides (SMRP) by enzyme-linked immunosorbent assay (ELISA) using monoclonal antibody techniques [19].Many studies have investigated mesothelin as a possible tumour biomarker for diagnosing MM, evaluating response to treatment, as well as for detecting the progression of this malignoma [16,[20][21][22][23][24][25][26].…”

Overexpressed genes in malignant pleural mesothelioma: implications in clinical management

“…Its prognostic value has been strongly debated: many following studies confirmed this association (13-15) but others did not endorse serum mesothelin prognostic significance (26,87). While a recent meta-analysis performed on 579 MPM patients further corroborates the inverse association of serum SMRP concentration with the OS (16). The mixed results observed are due to the small samples size and to the heterogeneity of the treatment among the studies and lead to the necessity of further investigations.…”