Serum and Pleural Soluble Cell Adhesion Molecules in Mesothelioma Patients: A Retrospective Cohort Study

Our plain-English summary of Serum and Pleural Soluble Cell Adhesion Molecules in Mesothelioma Patients: A Retrospective Cohort Study, by S. Tsagkouli, I.G. Kyriakoulis, K.G. Kyriakoulis, et al (Cancers, 2022).

The study

• Authors: S. Tsagkouli, I.G. Kyriakoulis, K.G. Kyriakoulis, E. Fyta, A. Syrigos, P. Bakakos, A. Charpidou, E. Kotteas
• Journal: Cancers
• Published: 2022;14(12)
• Cited by: 2 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Mesothelioma, a malignant neoplasm of mesothelial cells, has overall poor prognosis. Cell adhesion molecules (CAMs) are proteins that contribute to the immune response. In this study the clinical utility and prognostic significance of serum and pleural fluid soluble CAM (sCAM) levels were assessed in patients with mesothelioma. Mesothelioma patients were retrospectively recruited (2016-2020). Clinical characteristics, serum and pleural sCAM levels (sE-cadherin, sE-selectin, intercellular adhesion molecule 1 (sICAM-1) and vascular cell adhesion molecule 1 (sVCAM-1)) and histopathological characteristics were gathered. A total of 51 healthy controls were also recruited for a secondary cross-sectional analysis. 92 mesothelioma patients were analyzed (mean age 64.5 years, 87% males, performance status 0-2). Patients with increased pleural sE-cadherin had higher risk for disease progression (adjusted HR 1.11 (1.02, 1.20), p = 0.013). Serum and pleural sE-selectin were decreased in patients with high-grade mesothelioma. Patients with increased serum or pleural sE-selectin levels had lower risk for death (adjusted HR 0.88 (0.81, 0.96), p = 0.003; 0.90 (0.82, 0.99), p = 0.039, respectively). Serum sE-cadherin, sE-selectin and sICAM-1 levels were significantly increased in mesothelioma patients compared to healthy controls. Further studies are needed to indicate the clinical utility of serum and pleural sCAMs in mesothelioma patients.

In plain English

This retrospective cohort study covered 92 adults with malignant pleural mesothelioma treated in Athens, Greece, from January 2016 to December 2020. It measured four soluble cell adhesion molecules (sE-cadherin, sE-selectin, sICAM-1, sVCAM-1) in serum and pleural fluid, and compared serum levels with 51 healthy controls. Records showed previous asbestos exposure in 40 patients (44%); fiber types were not studied. The hazard ratios below are adjusted, with 95% confidence intervals, per 10 ng/mL increase. Higher pleural sE-cadherin was associated with higher risk of disease progression (1.11, 1.02 to 1.20). Higher sE-selectin was associated with lower risk of death, in serum (0.88, 0.81 to 0.96) and in pleural fluid (0.90, 0.82 to 0.99). Serum and pleural sE-selectin were both lower in patients with high-grade tumors. Serum sE-cadherin, sE-selectin and sICAM-1 were higher in patients than in controls; sVCAM-1 showed no statistically significant difference. The authors concluded that the link between these molecules and patient outcomes is not yet clearly defined and that further studies are needed. They listed three limitations: the retrospective design, radiation therapy in 15 patients, and possible under-recording of asbestos exposure.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Retrospective cohort study of mesothelioma patients, with a secondary cross-sectional comparison against healthy controls
• Who was studied: 92 consecutive adult patients with malignant pleural mesothelioma treated at Sotiria Hospital, Athens, Greece, 2016 to 2020 (mean age 64.5 years, 80 men). Also 51 healthy controls.
• Exposure: The measured variables were serum and pleural levels of four soluble cell adhesion molecules, not asbestos. Previous asbestos exposure, taken from medical records and clinical history, was recorded in 40 of 92 patients (44%). No fiber types or doses were reported.
• Main results:
  • In mesothelioma patients, higher pleural sE-cadherin was associated with higher risk of disease progression: adjusted HR 1.11 (1.02, 1.20), p = 0.013. HRs are expressed per 10 ng/mL increase.
  • In patients, neither serum nor pleural sE-cadherin was associated with mortality.
  • Patients with high-grade tumors had lower sE-selectin than patients with low-grade mesothelioma. In serum the means were 52.7 vs. 75.8 ng/mL (p = 0.01). In pleural fluid they were 56.8 vs. 71.2 ng/mL (p = 0.033).
  • In patients, higher sE-selectin was associated with lower risk of death. In serum the adjusted HR was 0.88 (0.81, 0.96), p = 0.003. In pleural fluid it was 0.90 (0.82, 0.99), p = 0.039. Both are per 10 ng/mL increase.
  • Serum sE-cadherin was higher in patients than in healthy controls: mean 117.5 vs. 38.7 ng/mL, with an adjusted difference of 78.8 ng/mL (p < 0.001).
  • Serum sE-selectin was higher in patients than in controls: mean 63.2 vs. 49.3 ng/mL, with an adjusted difference of 13.9 ng/mL (printed as p < 0.036).
  • Serum sICAM-1 was higher in patients than in controls: mean 383.7 vs. 118.1 ng/mL, with an adjusted difference of 265.6 ng/mL (p < 0.001).
  • Serum sVCAM-1 showed no statistically significant difference between patients and controls (mean 95.6 vs. 96.6 ng/mL, p = 0.927).
  • In patients, sICAM-1 levels were not correlated with disease progression or mortality.
  • In patients, sVCAM-1 levels were not correlated with disease progression or mortality.
• The authors' conclusion: The authors concluded that the association of these molecules with clinical features, disease progression and mortality in mesothelioma is not yet clearly defined. They called for basic science studies and prospective randomized clinical trials.
• Limitations the authors state:
  • The retrospective design of the study
  • 15 patients received radiation therapy, which can interfere with cell adhesion molecules. The extent of its effect on the findings is unknown.
  • Asbestos exposure was taken from medical records and clinical history, so the number of exposed patients may be underestimated.

Topics

Medical terms in this study, explained in our Lexicon: Mesothelioma, Cohort Study, Neoplasm, Mesothelial Cells, Prognosis, Performance Status, Disease Progression.

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