Serum mesothelin has a higher diagnostic utility than hyaluronic acid in malignant mesothelioma

We assessed comparatively the diagnostic value of two potential malignant pleural mesothelioma (MPM) markers: hyaluronic acid (HA) and soluble mesothelin.Materials and methodWe measured serum and pleural fluid values of mesothelin and hyaluronic acid in 76 patients with MPM, 33 patients with pleural metastases of carcinomas (Mets group) and 27 patients with benign pleural effusion related to asbestos exposure (BPLAE).ResultsUsing a serum HA cut-off of 100 μg/L, 8 patients/33 (24.2%) were positive in the Mets group versus 20/76 (26.3%) in the MPM group and only 1/27 BPLAE patients. The area under ROC curve for serum HA in MPM versus Mets or BPLAE groups was only 0.617 while it was 0.755 for mesothelin. In pleural fluid, both markers had similar diagnostic values.ConclusionsSerum mesothelin is more sensitive than hyaluronic acid in diagnosing MPM and there is no benefit in combining both markers.