Determinazione della Mesotelina nel versamento pleurico: Contributo alla citologia nella diagnosi del Mesotelioma pleurico maligno

Background. Malignant pleural mesothelioma (MPM) is an aggressive tumour usually associated with the presence of pleural effusion (PE). Differential diagnosis of the PE can be difficult because cytological analysis shows low sensitivity and specificity. Measurement of solubile mesothelin peptides (MS) has been reported to provide a complementary tool to aid in the diagnosis of MPM. The current study was undertaken to assess whether the levels of MS in PE may provide an additional diagnostic value to cytology and clinical practice. Methods. MS was assessed by means of the MesoMarkTM ELISA kit on a fraction of PE extracted by thoracentesis. Cytology was evaluated on fixed smears stained by Papanicolaou's method. Results. We evaluated MS in 52 MPM-PE and 223 PE of other origin. The geometric mean of MS levels in PE was significantly higher in MPM-PE (19.0 nmol/L) than in total other PE (3.5 nmol/L). The cut-off level was 9.30 nmol/L with an AUC of 82.0 (P-value