Combined CA125 and mesothelin levels for the diagnosis of malignant mesothelioma

Author:  Creaney J; van Bruggen I; Hof M; et al.

Creaney J, van Bruggen I, Hof M, et al.
CHEST. July 2007. Published Online.

CA125 has been known to be elevated in the serum of some patients diagnosed with mesothelioma. Creaney and colleagues investigated whether the MESOMARK (mesothelin) level and the CA125 value in combination increased the performance of either marker alone. The study investigated 117 patients with malignant mesothelioma, 86 patients who were asbestos exposed and 30 who had a benign pleural effusion. CA125 was elevated above the cut off of 21 U/mL in 42% of patients diagnosed with mesothelioma.

In this same subset of patients mesothelin was elevated in 48% of patients, cut off for mesothelin was 2.5 nM. When looking at the markers in the other patient groups tested, there was only 1 patient from the benign asbestos related disease and pleural effusion groups that had an elevated mesothelin level, compared to 69 patients in the same groups who had an elevated CA125 value. In the healthy asbestos exposed group there was no elevation in mesothelin versus 2 patients who had an elevated CA125 value. When combining the two markers together only 18% of the patients had an elevation in both the CA125 and mesothelin values. The addition of CA125 to mesothelin does not increase the sensitivity of mesothelin alone.

(At 98% Specificity, Sensitivity for Mesothelin 49%, for CA125 9%, for the combination of markers, 42%).


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