PT  - JOURNAL ARTICLE
AU  - Creaney, Jenette
AU  - Olsen, Nola J.
AU  - Brims, Fraser
AU  - Dick, Ian M.
AU  - Musk, Arthur W.
AU  - de Klerk, Nicholas H.
AU  - Skates, Steven J.
AU  - Robinson, Bruce W.S.
TI  - Serum Mesothelin for Early Detection of Asbestos-Induced Cancer Malignant Mesothelioma
AID  - 10.1158/1055-9965.EPI-10-0346
DP  - 2010 Sep 01
TA  - Cancer Epidemiology Biomarkers & Prevention
PG  - 2238--2246
VI  - 19
IP  - 9
4099  - http://cebp.aacrjournals.org/content/19/9/2238.short
4100  - http://cebp.aacrjournals.org/content/19/9/2238.full
SO  - Cancer Epidemiol Biomarkers Prev2010 Sep 01; 19
AB  - Background: Malignant mesothelioma is an aggressive, almost uniformly fatal tumor, primarily caused by exposure to asbestos. Since the recent discovery that serum mesothelin is a sensitive and highly specific biomarker for mesothelioma, one of the key issues raised is whether mesothelin levels represent a useful screening test for asbestos-exposed at-risk individuals. In this study, soluble mesothelin was determined in sequential serum samples collected from asbestos-exposed individuals before the development of mesothelioma.Methods: Archival serum samples from 106 individuals who developed mesothelioma, 99 asbestos-exposed individuals from the Wittenoom Cancer Surveillance Program, and 109 non–asbestos-exposed individuals from the Busselton Health Survey were identified. Serum mesothelin concentrations were determined using the MESOMARK assay.Results: Longitudinal mesothelin levels determined in healthy asbestos-exposed individuals over a period of 4 years were stable (Pearson's r = 0.96; P < 0.0001). There was no correlation between mesothelin concentration and cumulative asbestos exposure. Mesothelin concentrations were greater than the threshold value of 2.5 nmol/L in the penultimate serum sample before the diagnosis of mesothelioma in 17 of 106 people. Using an increase above the 95% confidence interval of the mean of a given individual's longitudinal mesothelin results, 33 of 82 individuals had increasing mesothelin levels before diagnosis.Conclusion: In a population with a high pretest probability of developing mesothelioma, the serum biomarker mesothelin is elevated in absolute terms in 15% and in relative terms in 40% of the group.Impact: Future studies examining a combination of biomarkers could improve sensitivity of screening. Cancer Epidemiol Biomarkers Prev; 19(9); 2238–46. ©2010 AACR.