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Rapid Rise in Biomarker May Precede Onset of Mesothelioma Symptoms
The most recent analysis 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 a uncommon but hostile cancer coupled primarily with industrial contact with asbestos. Research workers with the Institute of Occupational and Social Medicine in Aachen, Germany say their findings insinuate that levels of the proteins mesothelin and osteopontin, recognized to be elevated in asbestos-exposed workers, may climb sharply within the months previous to the onset of symptoms. As well, a rise isn't automatically a precursor to disease.
Mesothelin is a protein present in normal mesothelial cells. But since it is overexpressed in several kinds 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 no of diverse biological processes and related to tumorgenesis. Although it isn't a specific biomarker for mesothelioma, some experiments have supported its use as one indicator in a panel of biomarkers.
The goal of the German study was to work out how much these biomarker levels might change before asbestos-exposed workers developed asbestos-related diseases like mesothelioma or lung cancer. Is there a level of change that may be �normal� over time and not a proof of the fact that worker should have an intensive clinical workup?
To answer that query, the research team analyzed 3,329 blood sampled from 2,262 participants. Just under 1,900 of the participants were formerly asbestos-exposed power industry workers, 266 of them were a mixed group with an unidentified 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 powerful influence on marker levels, there was no association between exposure duration or benign asbestos-related disease and marker levels,� observed the researchers. They then separated out patients who had a minimum of a 10% increase in mesothelin and/or osteopontin levels. The highest (95th percentile) of these patients had an annual increase of 0.402 nmol/l for mesothelin and 334 ng/ml for osteopontin but most still didn't develop mesothelioma. However, two of the folks who did go on to develop mesothelioma and five of the folks who got lung cancer had even higher levels than these before they developed symptoms. The mesothelioma patients specifically both had a �steep increase� in mesothelin levels.
The research workers say their findings hint that having fixed cut-off values for deciding who needs a doctor�s evaluation and who can remain monitored are �insufficient� since some participants had significantly elevated biomarker levels with no disease. Nonetheless, the rapid and dramatic rise in the mesothelin levels of two of the mesothelioma sufferers prompted them to conclude the article this way: �While general conclusions can't be drawn, we can say that the effects of the two patients will be in step with a mesothelin increase between six and eighteen months before clinical symptoms developed.�
The International Archives of Occupational and Environmental Health recently published this study.
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