Mesothelioma is a cancer caused by asbestos. The symptoms of mesothelioma do not affect patients until 10 to 50 years after the exposure to asbestos. It is often not until the disease has significantly progressed that symptoms start and, by this point, treatment options may be limited so early diagnosis of mesothelioma is key to giving patients the best prognosis.
The SMRP test is used to diagnose mesothelioma and help to develop a treatment plan. The test looks for abnormally high levels of SMRP or soluble mesothelin-related peptides in the blood. These peptides are produced when proteins in the mesothelial membranes are broken down and this is what happens in someone with mesothelioma.
As the disease progresses and more mesothelin is broken down, the SMRP levels rise and can be found in the blood serum and lung fluid of patients. A blood test can then be done to analyse these levels.
Being able to diagnose mesothelioma with a blood test is preferable to taking a biopsy as it is less invasive for the patient and in some cases, patients are unable to undergo the biopsy procedure. However, the blood test needs to give an accurate result.
How accurate is SMRP for mesothelioma?
There are some people who oppose the use of SMRP testing for mesothelioma. Firstly, the SMRP levels vary in individual patients. So, what could be a high level of SMRP in the general population, could actually be a natural level in one person. Therefore, you may think a patient has a positive SMRP test but it is their normal level.
Genetics play a part
Doctors in Slovenia have said that genetics may also play a part in a person’s SMRP level. They suggest that looking at abnormalities in the gene that encodes the protein mesothelin, MSLN, may assist.
It was found that people with an abnormality on both of the MSLN gene alleles had much high levels of SMRP.
Therefore, it was found that when using an SMRP test for mesothelioma, genetics should also be tested.
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Goricar, K, “Evaluation of soluble mesothelin-related peptides and MSLN genetic variability in asbestos-related diseases”, March 7, 2020, Radiology and Oncology, https://www.ncbi.nlm.nih.gov/pubmed/32187018