Mesothelin and osteopontin as diagnostic and prognostic markers of malignant pleural mesothelioma in Egyptian patients undergoing pleurodesis

Abstract Purpose In malignant pleural mesothelioma (MPM), early assessment of disease status is important. We evaluated the role of mesothelin and osteopontin biomarkers in distinguishing MPM from benign pleural disease. We also, evaluated whether mesothelin and osteopontin were related to successful pleurodesis or not. Materials and methods Mesothelin and osteopontin were assayed in blood and pleural fluid with commercial ELISA kits in a series of 20 patients with malignant mesothelioma and 20 patients with benign pleural effusion (10 patients with tuberculous pleural effusion and 10 patients with benign asbestos pleural effusion). Results were correlated with histological subtypes and pleurodesis outcome. Results Both mesothelin and osteopontin in blood and pleural fluid showed statistically high levels in malignant pleural mesothelioma than benign pleural effusion with a cutoff point of 3.5 nmol/L for pleural mesothelin and 3.3 nmol/L for serum mesothelin and of 280 ng/ml for pleural osteopontin and 260 ng/ml for serum osteopontin. Also, there are statistically significant high levels of mesothelin in epitheliod subtype than sarcomatoid and mixed mesothelioma. Cases of MPM who have a cutoff value of more than (4 nmol/L) for pleural mesothelin and (3.4 nmol/L) for serum mesothelin and (370 ng/ml) for pleural osteopontin and (350 ng/ml) for serum osteopontin had failed pleurodesis but cases that have values less than the cutoff points had successful pleurodesis. Conclusion The combined assays of blood and pleural fluid mesothelin and osteopontin biomarkers have a high diagnostic and prognostic yield in malignant pleural mesothelioma patients undergoing pleurodesis.