Prognostic significance of soluble mesothelin in malignant pleural mesothelioma: a meta-analysis

Background: Soluble mesothelin is beneficial to detect the progression and the treatment response of malignant pleural mesothelioma. However, the prognostic value of soluble mesothelin in malignant pleural mesothelioma remains unclear. Methods: Hazard ratio with 95% CI was used to evaluate the prognostic value of soluble mesothelin and the effect of clinicopathological characteristics on the survival of malignant pleural mesothelioma. Results: Eight eligible studies involving 579 patients were selected for this meta-analysis. The results showed that soluble mesothelin level was significantly correlated with the survival of malignant pleural mesothelioma (pooled HR: 1.958, 95% CI: 1.531-2.504, p = 0.000; heterogeneity test: I-2 = 1.1%, p = 0.421). In addition, the survival of malignant pleural mesothelioma was significantly correlated with some clinicopathological characteristics such as tumor histology (HR = 3.214, 95% CI = 2.071-4.988, p = 0.000; heterogeneity test: I-2 = 0.0%, p = 0.623) and tumor stage (HR = 2.007; 95% CI = 1.477- 2.727; p = 0.000; heterogeneity test: I-2 = 0.0%, p = 0.966). Conclusions: The survival of malignant pleural mesothelioma is significantly correlated with tumor histology and tumor stage. Furthermore, high soluble mesothelin level may lead to a poor prognosis for malignant pleural mesothelioma patients.