New Biomarkers Could Mean Earlier, More Accurate Mesothelioma Diagnosis

In what could be a breakthrough in the development of a reliable diagnostic test for mesothelioma, Danish scientists have identified what they say are four key biomarkers that distinguish the asbestos cancer from non-malignant conditions. If the new research from Copenhagen University can be validated, it may dramatically shorten the time it takes to identify mesothelioma and start aggressive therapies.

“Our goal was to identify microRNAs (miRNAs) that can aid in the differential diagnosis of MPM [malignant pleural mesothelioma] from RMPs [reactive mesothelial proliferations],” investigator Eric Santoni-Rugiu, MD, PhD, of the Laboratory of Molecular Pathology at Copenhagen University Hospital in Denmark said in a press release.

MiRNAs are small cellular components that act as master switches for protein synthesis inside cells. The presence or absence of certain miRNAs has been shown to be a reliable predictor, or biomarker, of how cells will function.

After screening 742 miRNAs, Dr. Santoni-Rugiu and his colleagues pinpointed four that they believe are the best candidates for pleural mesothelioma diagnosis. They then tested these four miRNAs – miR-126, miR-143, miR-145, and miR-652 – on tissue samples from either confirmed mesothelioma cases or confirmed benign conditions to verify their value. The International Mesothelioma Interest Group (IMIG) recommends that any diagnostic test for mesothelioma be at least 80% accurate. The Copenhagen researchers found that their four-miRNA test had an overall accuracy of 94%.

“Overall, these results indicate that these four miRNAs may be suitable biomarkers for distinguishing MPM from RMPs,” they conclude. The group suggests that combining miRNA analysis with immunohistochemical testing of mesothelioma tissue samples could potentially improve the diagnostic accuracy even further and could even be used to help predict patient survival.

Malignant pleural mesothelioma is an aggressive malignancy that starts on the pleural lining surrounding the lungs. Although very rare, it is disproportionately common in people with a history of exposure to asbestos. Because there is no definitive diagnostic test for mesothelioma and early symptoms tend to be vague, many patients are not diagnosed until the disease is in its later stages. Fewer than 20 percent of mesothelioma patients are candidates for surgery.

Source: Andersen, M et al, “Diagnostic Poential of miR-126, miR-143, miR-145, and miR-652 in Malignant Pleural Mesothelioma”, June 9, 2014, The Journal of Molecular Diagnostics, Epub ahead of print