THE SENSITIVITY OF HYALURONAN ANALYSIS OF PLEURAL FLUID FROM PATIENTSWITH MALIGNANT MESOTHELIOMA AND A COMPARISON OF DIFFERENT METHODS

Background. Hyaluronan map be used as a marker for malignant mesotheli oma, thus indicating its mesodermal origin. Methods. The sensitivity a s a diagnostic test of three different methods for hyaluronan analyses of pleural fluid was examined in patients with biopsy-verified malign ant pleural mesothelioma. Results. A quantitative high-performance liq uid-chromatography (HPLC) method was performed on fluids from 43 patie nts. Using a cutoff level of 100 mg/l, higher levels were noted in 30 (70%) patients, with a median value of 220 mg/l (mean, 560 mg/l; range , 20-6600 mg/l). An identical median value (220 mg/l) was obtained wit h a radioassay method when simultaneously performed on paired samples from 21 patients (correlation coefficient, 0.91). A qualitative precip itation test using 0.5% cetylpyridinium chloride combined with a quant itative viscosimetric method was significantly less sensitive (P < 0.0 1). Conclusion. Hyaluronan analyses is beneficial in distinguishing ma lignant mesothelioma if methods such as the evaluated HPLC or radioass ay with a sensitivity of 70% toward mesothelioma are used and other kn own causes of elevated content are considered.