Fibulin-3 levels in malignant pleural mesothelioma are associated with prognosis but not diagnosis

Michaela Kirschner, Emily Pulford, Mir Hoda, Anita Rozsas, Kim Griggs, Yuen Cheng, J James Edelman, Steven Kao, Rebecca Hyland, Yawen Dong, Victoria Laszlo, Thomas Klikovits, Michael Vallely, Michael Grusch, Balazs Hegedus, Balazs Dome, Walter Klepetko, Nico van Zandwijk, Sonja Klebe, Glen Reid

Research output: Contribution to journalArticlepeer-review

67 Citations (Scopus)


Background:Fibulin-3 (FBLN3) was recently presented as a promising novel biomarker for malignant pleural mesothelioma (MPM), warranting independent validation studies.Methods:ELISA was used to measure cellular and secreted FBLN3 in cell lines, in plasma of xenograft tumour-bearing mice, in plasma from two independent series of MPM and non-MPM patients and in pleural fluid from a third series. Diagnostic and prognostic potential of FBLN3 was assessed by receiver operating characteristics curve analysis and Kaplan-Meier method, respectively.Results:FBLN3 was expressed in all MPM and benign mesothelial cell lines tested, and a correlation was observed between cellular protein expression and secreted levels. Human FBLN3 was detectable in plasma of tumour-bearing mice, suggesting that MPM cells contribute to levels of circulating FBLN3. Plasma FBLN3 was significantly elevated in MPM patients from the Sydney cohort, but not the Vienna cohort, but the diagnostic accuracy was low (63%, (95% CI: 50.1-76.4) and 56% (95% CI: 41.5-71.0), respectively). Although FBLN3 levels in pleural effusions were not significantly different between cases and controls, FBLN3 levels in pleural effusion fluid were found to be independently associated with prognosis (hazard ratio of 9.92 (95% CI: 2.14-45.93)).Conclusions:These data confirm the potential prognostic value of pleural effusion FBLN3, but question the diagnostic value of this protein in MPM patients.

Original languageEnglish
Pages (from-to)963-969
Number of pages7
JournalBritish Journal of Cancer
Issue number6
Publication statusPublished - 15 Sept 2015


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