Cullen in his editorial review of the study believes that the practical value of the use of serum osteopontin levels as a diagnostic test must await the assessment of similar measurements in other disorders common after extensive exposure to asbestos, such as diffuse pleural thickening with or without benign effusion, advanced carcinoma of the lung with pleural involvement and rounded atelectasis, from which mesothelioma must commonly be differentiated.[24]. This evidence concerns the gene SPP1 and mesothelioma.