RELATIONSHIP OF SERUM MESOTHELIN AND MIDKINE LEVELS IN THE DIAGNOSIS AND PROGNOSIS IN PATIENTS WITH MALIGNANT MESOTHELIOMA

Guntulu Ak1, Selma Metintas2, Yuji Tada3, Hideaki Shimada4, Kenzo Hiroshima5, Masatoshi Tagawa6, Muzaffer Metintaş1

1Eskisehir

Osmangazi University Lung and Pleural Cancers Research and Clinical Center, Eskisehir, Turkey; [email protected] 2Eskisehir Osmangazi University Medical Faculty Department of Public Health, Eskisehir, Turkey 3Department of Respirology, Graduate School of Medicine, Chiba University, Chiba, Japan 4Department of Surgery, School of Medicine, Toho University, Tokyo, Japan 5Department of Pathology, Tokyo Women's Medical University, Yachiyo, Japan 6Division of Pathology and Cell Therapy, Chiba Cancer Center Research Institute, Chiba, Japan

Background. We aimed to evaluate the value of mesothelin –the biomarker with a wellestablished role in the diagnosis of malignant mesothelioma (MM) and midkine (MK) is a protein encoded by the MDKgene in humans in MM diagnosis. Methods. The mesothelin and midkine levels were determined in the serum of 95 MM patients, 56 patients with metastatic malignant pleural disease (MMPD), 27 patients with benign pleural diseases (BPD) and 20 benign asbestosis pleurisy (BAP) by ELISA method. The cut-off level was taken as 1.5nmol/L for mesothelin and 421 pg/mL for midkine. Results. The sensitivity and specificity of mesothelin was 51.6% and 71.4%, 51.6% and 71.4%, and 51.6% and 85% for discrimination of MM from MMPD, BPD and BAP, respectively. The sensitivity and specificity of midkine was 61.1% and 41.1%, 61.1% and 40%, and 61.1% and 85% for discrimination of MM from MMPD, BPD and BAP, respectively. The combined use of these two biomarkers did not result an increase in the effectiveness of making diagnosis. Although mesothelin level was found to change depending on the cell type and stage of MM, it was not related with prognosis. On the other hand, midkine was associated with a poor prognosis with being independent from the cell type and stage. Conclusions. Mesothelin showed a moderate sensitivity and a high specificity to discriminate the MM from benign pleural diseases. Midkine had slightly higher sensitivity, but same specificity value with respect to mesothelin to discriminate the MM from benign asbestos pleurisy. Besides midkine was a useful prognostic marker.

Poster Presentation; iMig 2014 Cape Town; SA