Expression Of Mesothelin Can Indicate The Prognosis Of Malignant Pleural Mesothelioma

[Background]Malignant pleural mesothelioma(MPM)is a fatal,and rarely occurred in pleural mesothelium cell tumor.The median survival of' MPM is 9-12 months and its early prognostic markers remains uncertain.The objective of this study was to determine that the level of mesothelin expression can be as a predictor of prognosis in MPM patients.The present study was performed to explore the possibility that the expression level of mesothelin can be as a useful predictor of prognosis in MPM patients.[Methods]A total of 38 patients diagnosed with MPM and follow-up data is complete in the Second Hospital of Shandong University between May 2007 and December 2014 was enrolled,Level of mesothelin expression was detected in 38 MPM tissue specimens by immunohistochemistry analysis,and analyse the association of mesothelin expression with the clinical data including age,gender,smoking,status,stage,pathological type,at least 1 cycle chemotherapy.The relationship of MPM prognosis and mesothelin expression was evaluated by univariate and multivariate Cox regression,Kaplan-Meier survival curves.[Results]Association between mesothelin expression and clinicopathological features in MPMA total of 38 patients was enrolled,Median patient age was 66.11±9.45 years.25 cases(66%)had a smoking history.29(76%)patients were epithelioid type and the others were non-epithelioid type,which included sarcomatoid and biphasic.The high-level expression of mesothelin was significantly associated with higher in smokers(p=0.030)and non-epithelioid type(p=0.002).2.Relationship between mesothelin expression and overall survivalThe smokers has shorter overall survival(OS)(9,63 ±1.11 months)than those who do not smoke(17.02 ±1.47 months)(p=0.014).Other significant difference of OS was between epithelioid type(14.62 ±1.32 months)and non-epithelioid(6.17± 1.37 months)(p<0.001).Patients with high expression(7.47± 1.48 months)of mesothelin had shorter OS than those with low expression(14.72 ± 1.30 months)(p=0.005).However,no significant difference of OS was observed in subgroup of gender,age,stage and received at least 1 cycle chemotherapy.The smoking status(p=0.023),pathological type(p<0.001),and mesothelin expression(p=0.009)had significant effects on OS.it was confirmed that non-epithelioid type(p=0.030)and high mesothelin expression(p=0.033)were independent negative prognostic factors of OS for patients with MPM.[Conclusion]1.The expression of mesothelin was significantly associated with the smoking status and the pathological type.2.Patients with high mesothelin has shorter overall survival than those with low mesothelin expression.In the multivariate analysis,the present study determined that mesothelin is an dependent prognostic factor in MPM patients and might be a novel potential target for immunotherapy in MPM.