Biomarkers for Mesothelioma Screening: How Can We Identify Subjects Developing Mesothelioma in Asbestos-Exposed High-Risk Group?

Alfred G Knudson (1922–2016) was a man of great insight into the cancer genetics and a personal mentor of the author. Knudson developed the two-hit hypothesis [1, 2]. From this hypothesis, the concept of tumor suppressor gene was led. In 1954, a Norwegian pathologist, R. Eker found an animal model of inherited tumor [3]. The Eker rat developed bilateral, multiple, and dominantly inheritable renal tumors [4]. Utilizing syntenic homology between human and rat, a germline insertion was identified in the homologue of tuberous sclerosis complex (TSC) 2 gene (Tsc2) as the tumor predisposing mutation of the Eker rat. We, in researching hereditary kidney cancer in Eker rats, found that the product of the gene Erc, which appears with high frequency in simultaneous progressive process cancer, is secreted in the bloodstream, thereby providing a possible method for blood diagnosis. We reported that N-ERC/mesothelin could be a useful serum tumor marker for mesothelioma and have developed an ELISA kit (IBL. Co., Ltd. Gunma, Japan). “Environmental carcinogens” came to light in 1775 when the British surgeon Percival Pott reported scrotal cancer associated with chimney sweeps in “cancer stimulated by chimney soot” [5].