Blood Clot Biomarkers Could Predict Risk After Mesothelioma Surgery

Researchers have identified a set of plasma protein biomarkers that could help predict which people with pleural mesothelioma are at risk of developing life-threatening blood clots after surgery. The study, published in Scientific Reports, addresses one of the most dangerous complications of mesothelioma surgery: venous thromboembolism (VTE), which contributes to a 30-day post-surgical mortality rate of up to 11.8%.

The work is early-stage, involving 18 patients, but it represents the first attempt to use proteomics to predict VTE risk specifically in people undergoing mesothelioma surgery.

The Problem: Blood Clots After Surgery

Surgery remains a cornerstone of treatment for people with pleural mesothelioma, whether through pleurectomy/decortication (which removes the tumor and the lining of the lung) or extrapleural pneumonectomy (which removes the lung entirely). Both procedures carry significant risks, and blood clots are among the most serious.

Roughly 32% of people who undergo pleurectomy for mesothelioma develop VTE, a rate far higher than for most other surgical procedures. Blood clots can travel to the lungs (pulmonary embolism), the brain, or other organs, and they are the leading cause of post-surgical death in this population.

Existing tests like C-reactive protein (CRP), D-dimer, and platelet counts can indicate general inflammation or clotting activity, but they are not specific enough to reliably identify which patients will develop VTE. Surgeons currently lack a targeted way to stratify risk before the procedure.

What the Study Found

The research team used quantitative mass spectrometry, a technique that measures the abundance of hundreds of proteins in a blood sample simultaneously, to compare plasma samples from three groups: six people with mesothelioma who developed VTE after surgery, six people with mesothelioma who did not, and six people with lung cancer as controls.

Through a multilayered evaluation process, the team identified candidate protein biomarkers that were more abundant in the plasma of patients who went on to develop blood clots. The specific proteins and their clinical performance will require validation in larger cohorts, but the authors describe the findings as a first step toward personalized treatment planning for people undergoing mesothelioma surgery.

Why It Matters for Patients

For people facing mesothelioma surgery, the decision involves weighing survival benefits against surgical risks. If a blood test could identify which patients are at highest risk of blood clots before the procedure, surgeons could adjust their approach: more aggressive clot prevention with anticoagulants, closer post-operative monitoring, or in some cases, reconsidering the surgical plan.

The study’s small size limits immediate clinical application, but it establishes a framework that larger studies can build on. The authors write that their findings “can potentially guide subsequent, larger-scale investigations.”