AIRWAVES
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As Lee points out in his accompanying editorial to the paper by Creaney and colleagues, 150 000 patients develop a pleural effusion in the UK each year and the differential diagnosis poses a challenge because over 50 disorders need to be considered. Serum soluble mesothelin related protein, or "mesothelin", has been shown to be a specific, but moderately sensitive, marker of the presence of mesothelioma. Creaney and colleagues show that measurements of mesothelin in pleural and/or peritoneal effusions can be useful in the differential diagnosis of mesothelioma in patients presenting with effusions (see figure). Lee concludes his editorial by pointing out that mesothelin is a useful marker for epitheloid mesothelioma, but not for other histological types of mesothelioma and further markers need to be developed to increase the diagnostic efficiency.
See p 561 and 569
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