Published ahead of print on June 26, 2008, doi:10.1164/rccm.200802-258OC Am. J. Respir. Crit. Care Med., Volume 178, Number 8, October 2008, 832-837 A more recent version of this article appeared on October 15, 2008
Submitted on February 12, 2008 Soluble Mesothelin Related Protein (SMRP) in an Asbestos Exposed PopulationEun-Kee Park1,1 Research and Education Unit, Dust Diseases Board, Sydney, NSW, Australia, 2 Research and Education Unit, Dust Diseases Board, Sydney, NSW, Australia; Department of Thoracic Medicine, St. Vincent's Hospital, Sydney, NSW, Australia, 3 School of Medical Sciences, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia, 4 National Research Center for Asbestos Related Disease, Western Australian Institute of Medical Research, University of Western Australia, Sir Charles Gairnder Hospital, Perth, WA, Australia * To whom correspondence should be addressed. E-mail: deborahy88{at}hotmail.com.
Rationale: Soluble mesothelin related protein (SMRP) is raised in epithelial type malignant mesothelioma (MM), but the utility of SMRP in screening for MM is unknown.
Objectives: We aimed to evaluate SMRP in asbestos exposed subjects.
Methods: 538 subjects were studied. Those with elevated SMRP ( Key words: soluble mesothelin related protein, mesothelioma, asbestos-related disorders, diagnostic accuracy, sreening
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2.5nM) underwent further investigation including positron-emission tomography/computed tomography.
Measurements and Main Results: Mean (± SD) SMRP in healthy subjects exposed to asbestos (n=223) was 0.79 (± 0.45) nM. 15 subjects had elevated SMRP, of whom one had lung cancer which was successfully resected. Another with lung cancer was undetected by SMRP. No subjects were diagnosed with MM. Mean SMRP in healthy subjects was significantly lower than in subjects with PPs (p<0.01).
Conclusions: This is the first large scale prospective study of SMRP for screening for malignancy in asbestos-exposed individuals. A high false positive rate was observed. SMRP seems unlikely to prove useful in screening for MM.
