We have developed a novel enzyme-linked immunosorbent assay (ELISA) system for the detection of N-ERC/mesothelin in the serum of mesothelioma patients and have begun to examine its clinical usefulness. N-ERC/mesothelin is a 31-kDa protein that forms the N-terminal fragment of the full-length 71-kDa ERC/mesothelin protein, and is physiologically secreted into the blood of mesothelioma patients where it can be detected using our sandwich ELISA containing two antibodies (rabbit polyclonal anti-ERC/mesothelin antibody-282 and mouse monoclonal antibody 7E7). Our ELISA system has thus far detected much higher serum levels of N-ERC/mesothelin in mesothelioma patients than in healthy controls or patients with other lung or pleural diseases. In conclusion, N-ERC/mesothelin is a promising candidate tumor marker for mesothelioma.