Among the 32 MPM patients in our cohort, 23 had epithelioid mesothelioma, 2 had sarcomatoid, and 7 had biphasic types, consistent with the established distribution of histological subtypes.35 Significantly higher pleural effusion fibulin-3 levels were observed in sarcomatoid and biphasic subtypes compared to epithelioid mesothelioma. This evidence concerns the gene EFEMP1 and Pleural effusion.