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Background  For the detection of malignant mesothelioma additional markers are needed besides the established panel consisting of calretinin and mesothelin. The aim of this study was the identification and verification of long non-coding RNAs (lncRNAs) as complementing circulating markers.    Methods  Candidate lncRNAs were identified in silico using previously published RNA expression profiles and verified using quantitative PCR (qPCR) in mesothelioma cell lines as well as human plasma samples from mesothelioma patients and asbestos-exposed controls.    Results   GAS5  (growth arrest-specific transcript 5) as a single marker is marked by a low sensitivity of 14%, but the combination of  GAS5  with calretinin and mesothelin increased the panel’s sensitivity from 64 to 73% at a predefined specificity of 97%. Circulating  GAS5  is not affected by pleurectomy before blood collection, age, or smoking status.    Conclusions   GAS5  is verified as an appropriate circulating marker for the supplement of calretinin and mesothelin to detect malignant mesothelioma. Although the sensitivity of  GAS5  is too low for the use as a single marker, the addition of  GAS5  as a third marker improves the performance of the established marker panel. The benefit of  GAS5  for the detection of malignant mesothelioma at early stages needs to be validated in a prospective study.

biomarker research

Circulating long non-coding RNA GAS5 (growth arrest-specific transcript 5) as a complement marker for the detection of malignant mesothelioma using liquid biopsies