Diagnostic value of soluble mesothelin-related peptides for malignant mesothelioma: A meta-analysis

Background: Serum concentrations of soluble mesothelin-related peptides (SMRP) have been reported to be higher in patients with malignant mesothelioma than in healthy subjects and in patients with non-malignant mesothelioma diseases. The aim of the present meta-analysis was to establish the overall, diagnostic accuracy of the measurement of SMRPs for diagnosing malignant mesothelioma. Methods: After a systematic review of English language studies, sensitivity, specificity, and other measures of accuracy of serum SMRPs in the diagnosis of malignant mesothelioma were pooled using random-effects models. Summary receiver operating characteristic curves were used to summarize overall test performance. Results: Eleven publications from 12 studies met our inclusion criteria. The summary estimates for SMRPs in the diagnosis of malignant mesothelioma in the studies included were sensitivity 0.64 (95% confidence interval 0.61-0.68), specificity 0.89 (0.88-0.90), positive likelihood ratio 7.10 (4.44-11.35), negative likelihood ratio 0.39 (0.31-0.48), and diagnostic odds ratio 19.35 (10.95-34.17). Conclusions: Serum SMRP determination plays a role in the diagnosis of malignant mesothelioma. The results of SMRP assays should be interpreted in parallel. with clinical findings and the results of conventional tests. (C) 2009 Elsevier Ltd. All rights reserved.