Biomarker Can Help Identify Pleural Mesothelioma

Fibulin-3 can distinguish from asbestos exposure or lung fluids unrelated to mesothelioma

WEDNESDAY, Oct. 10 (HealthDay News) -- Fibulin-3 levels in plasma and lung fluids can discriminate patients with mesothelioma from others with asbestos exposure or those whose lung effusions are unrelated to mesothelioma, according to a study published in the Oct. 11 issue of the New England Journal of Medicine.

Harvey I. Pass, M.D., from the New York University Langone Medical Center in New York City, and colleagues examined whether fibulin-3 levels in plasma were a good biomarker for pleural mesothelioma in 92 patients with mesothelioma, 136 asbestos-exposed persons without cancer, 93 patients with effusions not due to mesothelioma, and 43 healthy controls. Fibulin-3 levels were also measured in effusions (from 74 patients with mesothelioma, 39 with benign effusions, and 54 with malignant effusions not related to mesothelioma) or in both plasma and effusions.

The researchers found that plasma fibulin-3 levels were significantly higher in patients with pleural mesothelioma than in asbestos-exposed persons without mesothelioma. In pleural effusions, fibulin-3 levels were significantly higher in patients with pleural mesothelioma than in patients with effusions not due to mesothelioma. Further validation showed fibulin-3 staining in 100 percent of 26 tumor samples. In comparing patients with and without mesothelioma, plasma fibulin-3 levels had a sensitivity of 96.7 percent and a specificity of 95.5 percent at a cut-off of 52.8 ng/mL fibulin-3. On blinded validation of a sample of plasma specimens from 96 asbestos-exposed patients and 48 patients with mesothelioma, the area under the curve was 0.87.

"The results of our study suggest that levels of fibulin-3 in plasma and effusions may aid in determining the diagnosis and prognosis of pleural mesothelioma," Pass and colleagues conclude.

Several authors disclosed financial conflicts of interest, including mesothelioma-related expert testimony, patents, and ties to the biotechnology and pharmaceutical industries.

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