K. Adamič*a (Dr), A. Rozmana (Prof), M. Marc Malovrha (Prof)

a University Clinic of Respiratory and Allergic Diseases Golnik, Golnik, SLOVENIA

* katja.adamic@klinika-golnik.si


Patients with asbestos related pleural involvement may develop mesothelioma with a long latency period. Pleural mesothelioma has a poor prognosis due to poor response to currently known treatments and also because patients are often detected in the advanced stage of the disease. According to reports, with the help of fibulin-3 in plasma and pleural effusion, it is possible to distinguish patients with mesothelioma (even in the initial stage of the disease) from those with benign or malignant pleural effusion of other etiology. The purpose of our study was to examine the potential of plasma and pleural fibulin-3 as a biomarker of mesothelioma.


The prospective study included patients with exudative pleural effusion who underwent thoracoscopy between January 2013 and October 2014 at University Clinic Golnik. At the time of thoracoscopy blood and pleural effusion samples were obtained, in which the concentration of fibulin-3 was determined by enzyme-linked immunosorbent assay (USCN Life Science). Patients with malignant pleural involvement were followed to death, patients with benign or non-specific results were followed for at least three years.


Of the 90 patients, mesothelioma was confirmed in 32, pleural carcinosis in 24, and benign pleural disease in 34 patients, of which in 13 pleural involvement was due to asbestos exposure. We found significantly lower serum fibulin levels in patients with benign asbestos related pleural involvement compared to patients with pleural mesothelioma (p <0.02), carcinosis (p <0.03) and other benign diseases (p< 0.05). Despite the trend of lower pleural fibulin values in benign diseases compared to malignant ones, the difference was not statistically significant


Lower values of serum fibulin-3 in benign asbestos related pleural involvement compared to mesothelioma suggest the possible role of this biomarker in guiding the diagnostic decisions in these patients and enabling the recognition of mesothelioma in early stages.​

Disclosure of funding source(s): none