Validity of mesothelin in occupational medicine practice

Dear Editor, Malignant mesothelioma (MM) is a rare cancer with poor survival.The estimated 5-year relative survival after diagnosis is 7% on average across Europe [1].Malignant mesothelioma is frequently diagnosed in an advanced stage of the disease and an accurate diagnosis is difficult.We therefore appreciate the study of Smolková et al. -recently published in this journal -to assess the benefit of serum soluble mesothelin-related peptides (SMRPs) in detection and diagnosis of the MM [2].However, the analysis by Smolková et al. is incorrect and misleading.The total number of 309 patients with a history of occupational asbestos exposure were analyzed.Among 16 MM patients, 12 had increased SMRPs levels and among the non-MM patients 35 had increased SMRPs levels and 258 of them did not.This will lead to the contingency table as shown in the Table 1.Using this as the basis for the following calculations we get the published sensitivity of 0.75 but not the specificity of 0.962.The specificity

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