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Performance of biomarkers SMRP, CA125, and CYFRA 21-1 as potential tumor markers for malignant mesothelioma and lung cancer in a cohort of workers formerly exposed to asbestos

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Abstract

The aim of the study is to examine the cancer-predictive values of SMRP (soluble mesothelin-related peptides), CA125, and CYFRA21-1 as potential tumor markers for lung cancer and malignant mesothelioma in a cohort of workers formerly exposed to asbestos. A voluntary surveillance program has been established for German workers with former asbestos exposure. A subgroup of 626 subjects with a mean age of 63 years (range 53–70 years) at baseline was enrolled in an extended health examination program with high-resolution computer tomography (HRCT) of the chest and blood drawing between 1993 and 1997. Serum concentrations of SMRP, CA125, and CYFRA21-1 were measured in archived serum samples in 2005 and 2006. A mortality follow-up was conducted through 2007. So far, 12 cases with lung cancer and 20 cases with malignant mesothelioma have been observed in this cohort. The average time between sample collection and diagnosis was 4.7 years. Analyzed biomarkers showed low sensitivities (5–25%) and positive predictive values (4–30%) for both cancer sites. Marker combinations resulted in sensitivities between 5 and 50% and positive predictive values ranging from 3 to 14%. Even in those cases, where biomarker concentrations were available within 36 months before diagnosis, no trend for increasing biomarker levels was observed. The analyzed tumor markers were characterized by high specificities, but low sensitivities. SMRP, CA125, and CYFRA21-1 alone or in combination were less suitable to serve as predictors for the diagnosis of lung cancer or malignant mesothelioma. However, a prospective study with annual sampling might reveal a better predictive value of these markers.

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Acknowledgments

The authors would like to thank German Social Accident Insurance (DGUV) for supporting this study. The authors also thank Dr. Matthias Imöhl for help with the determination of CA125 and CYFRA21-1 and Kathy Bischof for her review of and comments on the manuscript. This study was supported by German Social Accident Insurance (DGUV), Grant No. FB 111. This work was supported in part by a grant from FDI (Fujirebio Diagnostics, Malvern, PA, USA).

Conflict of interest

The authors report no conflicts of interests.

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Authors and Affiliations

  1. Institute for Occupational and Social Medicine, Medical Faculty, RWTH Aachen University, Aachen, Germany

    M. Gube, P. Brand, A. Müller-Lux & T. Kraus

  2. Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-Universität Bochum (IPA), Bochum, Germany

    D. Taeger, D. G. Weber, B. Pesch, G. Johnen, I. M. Gross, T. Wiethege, A. Weber & T. Brüning

  3. Institute for Occupational, Social and Environmental Medicine, University of Erlangen-Nuremberg, Erlangen-Nuremberg, Germany

    H. J. Raithel

  4. Institut für Arbeitsmedizin und Sozialmedizin am Universitätsklinikum Aachen, Rheinisch, Westfälische Technische Hochschule, Pauwelsstraße 30, 52074, Aachen, Germany

    M. Gube

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  1. M. Gube
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  2. D. Taeger
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Correspondence to M. Gube.

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Gube, M., Taeger, D., Weber, D.G. et al. Performance of biomarkers SMRP, CA125, and CYFRA 21-1 as potential tumor markers for malignant mesothelioma and lung cancer in a cohort of workers formerly exposed to asbestos. Arch Toxicol 85, 185–192 (2011). https://doi.org/10.1007/s00204-010-0580-2

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  • DOI: https://doi.org/10.1007/s00204-010-0580-2

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