High levels of the protein fibulin-3 in the blood or the pleural effusion — the fluid that often accumulates in the space between the lung and chest wall of patients with lung diseases — may be a useful diagnostic marker for malignant pleural mesothelioma (MPM), according to a recent meta-analysis.
The study, “Diagnostic Value Of Fibulin-3 For Malignant Pleural Mesothelioma: A Systematic Review And Meta-Analysis,” was published in the journal Oncotarget.
The current diagnosis of MPM relies on pleural biopsies, an invasive method that is often associated with errors, revealing the need for noninvasive biomarkers that can aid in the diagnosis of the disease.
Certain molecules have been considered as possible biomarkers, but there is still a lack of candidates that present both good specificity and sensitivity to be considered useful tools for MPM diagnosis.
Fibulin-3 is a protein that regulates cell migration and proliferation. Although previous studies have addressed whether fibulin-3 levels in the blood or pleural effusion could serve as an MPM biomarker, the results have been inconsistent, so it was still unclear whether this protein has any diagnostic value.
To answer this question, researchers reviewed eight previously published studies — one retrospective study, five prospective studies, and two studies with unspecified design — that had investigated fibulin-3 as a biomarker in samples from MPM patients.
The studies included and used blood samples (serum or plasma) and pleural effusion to investigate the diagnostic value of fibulin-3.
Although the analyzed studies provided different results, researchers found that diagnoses using blood fibulin-3 levels had an overall sensitivity of 0.87 and a specificity of 0.89. This meant that the presence of fibulin-3 in the blood identified 87 out of 100 MPM patients, and the absence of fibulin-3 identified 89 out of 100 patients who did not have MPM.
Detecting fibulin-3 in pleural effusion was not as effective in diagnosing MPM patients, but it could still identify 73 out of 100 positive cases and 80 out of 100 negative cases.
This revealed that fibulin-3 both in the blood and pleural effusion was a useful diagnostic marker for MPM. However, the researchers point out that the analyzed studies had some limitations and weaknesses and that more studies are necessary to confirm these results.
“The present study indicated that fibulin-3 was a useful diagnostic marker for MPM,” they wrote. “Due to the small number of eligible studies, and all of the eligible studies have higher risk for subject selection, further well-designed studies are needed to rigorously evaluate the diagnostic value of fibulin-3 for MPM.”