Role of Soluble Mesothelin Related Peptide (SMRP) Tumour Marker as a Prognostic Value of Mesothelioma Patients Pre and Post Operative

Abstract

Background: Soluble mesothelin-related peptides (SMRP) are a potential tumor marker for malignant mesothelioma. It that has been proposed for differential diagnosis from pleural metastatic cancer, as well as prognosis and treatment monitoring of malignant pleural mesothelioma (MM). Aim of The work: To Study The Value Of SMRP as a tumor marker in prediction the response to treatment and the prognosis in patient of malignant mesothelioma who undergone pleurectomy decortication as more accepted surgical procedure in comparison to who only had chemotherapy. Patient and Methods: Through a clinicl trial started from April 2017 till November 2018 With a minimum follow-up of 6 months was required and up to 12 months, there were sixty patients of mesothelioma. First thirty underwent pleurectomy decortication during their management. In the remaing thirty only chemotherapy was the only therapeutic decision. Serum samples collected pre and post management in each group. Change of SMRP was studied as a predictor of overall survival and the quality of life in according to degree of pain and dyspnea control. Results: There were no statistically significant differences in according to demographic criteria in both groups. Which was essential for accuracy of the study. Most of the patients were epitheloid mesothelioma, there were only three sarcomatoid MPM in the study.There was statistically significant difference in according to the percentage of change of SMRP in between surgery and chemotherapy (p value;0.04 ) which reflected on survival of P/D patients as its median was 22 months. According to mortality there were 6 in surgical group and 11 in chemotherapy group. Change of SMRP also correlated with statistical significant difference in according to pain and dyspnea (pre& post operative) (p value; 0.03 and 0.01 respectively) with no significant difference in patients had chemotherapy. Conclusion: SMRP may be a useful tumor marker for detecting the progression of malignant mesothelioma and expecting the response to treatment in according to overall survival and post operative quality of life.