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Disorders of the Pleura |

Association Between Mesothelin Expression in Tissues and Its Level in Pleural Effusion and in Serum of Malignant Pleural Mesothelioma Patients FREE TO VIEW

Massimiliano Sivori, MD
Author and Funding Information

Ospedale San Bartolomeo Sarzana (sp)ASL 5 Spezzino, Sarzana, Italy


Chest. 2014;146(4_MeetingAbstracts):430A. doi:10.1378/chest.1988994
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Abstract

SESSION TITLE: Malignant Pleural Disease Posters

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 29, 2014 at 01:30 PM - 02:30 PM

PURPOSE: MESOTHELIN (MS) IS A CELL SURFACE GLYCOPROTEIN OVER-EXPRESSED IN MALIGNANT MESOTHELIOMA(MM) AND SHEDDED IN BODY FLUIDS. MS IS PROPOSED FOR THE DIAGNOSIS,MONITORING AND TARGETED THERAPIES IN MM PATIENTS. THE ASSOCIATION BETWEEN EXPRESSION IN TISSUES(MS-TISSUE) ITS LEVEL IN PLEURAL EFFUSION (MS-PE) AND IN SERUM(MS-SE),MAY BE REMARKABLE FOR DIAGNOSING AND FOR ADDRESSING MS THERAPY(IN ABSENCE OF THORACOSCOPY),IN ORDER TO KNOW THE ROLE OF FREE MS TARGETED THERAPY RESISTANCE AND TO KNOW THE MS BIOLOGY.

METHODS: WE STUDIED 42 MPM (28 EPITHELIOID,7 SARCOMATOID AND 7 BIPHASIC).BIOPSY,PE AND BLOOD SAMPLES WERE COLLECTED FROM EACH PATIENT SIMULTANEOUSLY.MS TISSUES WERE ASSESSED BY IHC USING THE ANTIBODY "NLC-MESO 5B2". MS-PE/SE WAS MEASURED BY "MESOMARK ELISA KIT" . CUT-OFF DISCRIMINATION USED WAS 12.70 nM AND 1.08 nM FOR MS-PE AND MS-SE,RESPECTIVELY . MS TISSUES WERE ARBITRARILY SCORED AS:NEGATIVE (ABSENCE OF REACTIVITY),FOCAL (PARTIALLY POSITIVE MEMBRANE) AND HIGH(INTENSE ALL POSITIVE MENBRANE).

RESULTS: MS-TISSUES POS WERE 34/42(SENSITIVITY=81%). OF THEM ,26/28(93%) WERE EPITHELIOID(17 HIGH,9 FOCAL) AND 7/7 WERE BIPHASIC (4 HIGH IN BOTH EPITHELIOID AND SARCOMATOID COMPONENT AND 3 HIGH IN EPITHELIOID ALONE). MS WAS NEVER FOUND IN SARCOMATOID SUBTYPES. MS-PE WAS POS IN 31/42 ( SENSITIVITY=74%) AND MS-SE IN 18/42 (SENSITIVITY=43%) TOTAL SPECIMENS. MS-SE WAS NEVER POS IN NEG MS-PE. IN EPITHELIOID , MS-PE WAS POS IN 22/28 (79%) (12 HIGH,8 FOCAL,2 NEGATIVE) AND NEG IN 6 (5 HIGH AND 1 FOCAL) SPECIMENS.MS-SE WAS POS IN 10/28 (365) 87 HIGH ,3 FOCAL) AND NEG IN 18 (10 HIGH,6 FOCAL , 2 NEG) SPECIMENS. IN BIPHASIC ,MS-PE WAS ALWAYS POS,WHILE MS-SE WAS POS 6/7 SPECIMENS. FINALLY ,5/7 SARCOMATOID WERE NEG AND 2 WERE POS FOR BOTH MS-PE/SE. THE CONCORDANCE BETWEEN MS-TISSUES WITH MS-PE WAS 79% (28 POS/POS,5 NEG/NEG),WITH MS-SE WAS 40% (17 POS/POS,7 NEG/NEG) AND BETWEEN MS-PE/SE WAS 71% (19 POS/POS,11 NEG/NEG).

CONCLUSIONS: THE SENSITIVITY OF MS -TISSUES WAS HIGHER IN BIPHASIC AND EPITHELIOID THAN SARCOMATOID MPM.CONCORDANCE OF MS-TISSUES WAS HIGHER WITH MS-PE THAN MS-SE. MS DETECTION IN PE AND/OR SE MAY SUPPORT MS-TISSUE ANALYSIS BUT NOT REPLACE IT .

CLINICAL IMPLICATIONS: THE QUANTIFICATION OF MS CAN BE APPLIED IN THE WORK-UP OF PATIENTS WITH A PE OF UNKNOWN ORIGINAND AN INCREASED LEVEL SUGGESTS A STRONG SUSPICION OF MPM. THE MS IS MOST LIKELY PRODUCED BY THE EPITHELIOID MPM SUBTYPE,WHEREAS IT IS NOT PRODUCED BY THE OTHER MPM SUBTYPES.

DISCLOSURE: The following authors have nothing to disclose: Massimiliano Sivori

No Product/Research Disclosure Information


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