Hyaluronan and N-ERC/mesothelin as key biomarkers in a specific two-step model to predict pleural malignant mesothelioma

Purpose: Diagnosis of malignant mesothelioma is challenging. The first available diagnostic material is often an effusion and biochemical analysis of soluble markers may provide additional diagnostic information. This study aimed to establish a predictive model using biomarkers from pleural effusions, to allow early and accurate diagnosis. Patients and Methods: Effusions were collected prospectively from 190 consecutive patients at a regional referral centre. Hyaluronan, N-ERC/mesothelin, C-ERC/mesothelin, osteopontin, syndecan-1, syndecan-2, and thioredoxin were measured using ELISA and HPLC. A predictive model was generated and validated using a second prospective set of 375 effusions collected consecutively at a different referral centre. Results: Biochemical markers significantly associated with mesothelioma were hyaluronan (odds ratio, 95% CI: 8.82, 4.82–20.39), N-ERC/mesothelin (4.81, 3.19–7.93), CERC/mesothelin (3.58, 2.43–5.59) and syndecan-1 (1.34, 1.03–1.77). A two-step model ...

目的：恶性间皮瘤的诊断具有挑战性。首个可用的诊断材料通常为积液，而可溶性标志物的生化分析或可提供额外诊断信息。本研究旨在利用胸腔积液中的生物标志物建立预测模型，以实现早期准确诊断。

患者与方法：前瞻性收集某区域转诊中心190例连续患者的积液样本。采用酶联免疫吸附试验（ELISA）和高效液相色谱法（HPLC）测定透明质酸、N-ERC/间皮素、C-ERC/间皮素、骨桥蛋白、syndecan-1、syndecan-2及硫氧还蛋白的水平。基于上述数据构建预测模型，并利用另一转诊中心前瞻性收集的375例连续积液样本进行验证。

结果：与间皮瘤显著相关的生化标志物包括透明质酸（比值比，95%置信区间：8.82，4.82–20.39）、N-ERC/间皮素（4.81，3.19–7.93）、C-ERC/间皮素（3.58，2.43–5.59）及syndecan-1（1.34，1.03–1.77）。一种两步法模型……