Isahella
Biomarker Rise Thought to Precede Onset of Mesothelioma
The most up-to-date review out of Germany details the news that a rise in mesothelin (a tumor marker) could point the way to diagnosis of mesothelioma.
Pleural mesothelioma is known as a rare but hostile cancer associated primarily with industrial contact with asbestos. Research workers with the Institute of Occupational and Social Medicine in Aachen, Germany say their findings indicate that levels of the proteins mesothelin and osteopontin, recognized to be elevated in asbestos-exposed workers, may climb sharply within the months before the onset of symptoms. At the same time, an increase is not essentially a precursor to disease.
Mesothelin is a protein present in ordinary mesothelial cells. But because it is overexpressed in several varieties of cancer, including mesothelioma, ovarian and pancreatic cancers, is has increasingly been used as a biomarker to indicate the presence of cancer. Osteopontin is a multifunctional protein involved in a number of various biological processes and related to tumorgenesis. Even though it is not a specific biomarker for mesothelioma, some scientific tests have supported its use as one indicator in a panel of biomarkers.
The goal of the German study was to see what these biomarker levels might change before asbestos-exposed workers developed asbestos-related diseases like mesothelioma or lung cancer. Is there a level of change which is �normal� over time and not a signal that the worker must have an intensive clinical workup?
To answer that query, the research team analyzed 3,329 blood sampled from 2,262 participants. Just below 1,900 of the participants were formerly asbestos-exposed power industry workers, 266 of them were a mixed group with an unknown history of asbestos exposure, and 102 had no history of exposure to asbestos. The concentration of mesothelin and osteopontin in their blood was determined using commercial ELISA test kits.
�While age had a strong influence on marker levels, there is no association between exposure duration or benign asbestos-related disease and marker levels,� observed the researchers. They then separated out patients who had at the very least a 10% increase in mesothelin and/or osteopontin levels. The highest (95th percentile) of those patients had an annual increase of 0.402 nmol/l for mesothelin and 334 ng/ml for osteopontin but most still did not develop mesothelioma. However, two of the folks who did go on to develop mesothelioma and 5 of the people who got lung cancer had even higher levels than these before they developed symptoms. The mesothelioma patients in particular both had a �steep increase� in mesothelin levels.
The researchers say their findings suggest that having fixed cut-off values for determining who needs a physician�s evaluation and who can remain monitored are �insufficient� since some participants had appreciably elevated biomarker levels without disease. Conversely, the rapid and dramatic rise within the mesothelin levels of 2 of the mesothelioma patients prompted them to conclude the article this way: �While general conclusions cannot be drawn, we are able to say that the effects of both patients will be in line with a mesothelin increase between 6 and 18 months before clinical symptoms developed.�
The International Archives of Occupational and Environmental Health recently published this study.
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