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Zito Marino F, Rossi G, Brunelli M, Malzone MG, Liguori G, Bogina G, Morabito A, Rocco G, Franco R, Botti G. Diagnosis of anaplastic lymphoma kinase rearrangement in cytological samples through a fluorescence in situ hybridization-based assay: Cytological smears versus cell blocks. Cancer Cytopathol 2017; 125:303-312. [PMID: 28195686 DOI: 10.1002/cncy.21835] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2016] [Revised: 12/15/2016] [Accepted: 12/19/2016] [Indexed: 12/20/2022]
Abstract
Anaplastic lymphoma kinase (ALK) status analysis of lung cytological specimens should be successfully encouraged in routine practice because biopsy specimens are not always available. To date, the US Food and Drug Administration has approved both fluorescence in situ hybridization (FISH) and immunohistochemistry (IHC) as diagnostic tests for identifying ALK-positive patients eligible for treatment with crizotinib. Although ALK IHC is an optimal diagnostic tool, FISH becomes mandatory in equivocal cases. ALK FISH of paraffin-embedded tissue material is still the gold standard, whereas the cytological specimen assay has not yet been completely standardized. Many controversial data have been reported on the adequacy of cytology cell blocks (CBs) versus conventional smears for FISH testing. This review discusses some critical issues related to ALK FISH of cytological samples, including the triaging of collected specimens to optimize the material, the use of CBs versus conventional smears, and alternative methods for an ALK rearrangement diagnosis. Conventional smears have the advantages of an immediate evaluation, no probe tissue-related artifactual loss, no fixation-related alterations, and usually sufficient material for an analytic preparation. On the other hand, CBs have several advantages, including the appropriate conservation of the tissue architecture, an absence of problems related to cell overlapping, and the ability to evaluate neoplastic cells in a dark field. Cancer Cytopathol 2017;125:303-312. © 2017 American Cancer Society.
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Affiliation(s)
- Federica Zito Marino
- Pathology Unit, Istituto Nazionale Tumori Fondazione G. Pascale, Naples, Italy.,Pathology Unit, Luigi Vanvitelli University of Campania, Naples, Italy
| | - Giulio Rossi
- Unit of Pathologic Anatomy, Azienda USL Valle d'Aosta, Aosta, Italy
| | - Matteo Brunelli
- Anatomic Pathology Section Department of Pathology, University of Verona, Verona, Italy
| | | | - Giuseppina Liguori
- Pathology Unit, Istituto Nazionale Tumori Fondazione G. Pascale, Naples, Italy
| | - Giuseppe Bogina
- Section of Pathologic Anatomy, Sacro Cuore Don Calabria Hospital, Negrar, Italy
| | - Alessandro Morabito
- Medical Oncology Unit, Department of Thoracic Surgical and Medical Oncology, Istituto Nazionale Tumori Fondazione G. Pascale, Naples, Italy
| | - Gaetano Rocco
- Division of Thoracic Surgery, Department of Thoracic Surgical and Medical Oncology, Istituto Nazionale Tumori Fondazione G. Pascale, Naples, Italy
| | - Renato Franco
- Pathology Unit, Luigi Vanvitelli University of Campania, Naples, Italy
| | - Gerardo Botti
- Pathology Unit, Istituto Nazionale Tumori Fondazione G. Pascale, Naples, Italy
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Wang W, Tang Y, Li J, Jiang L, Jiang Y, Su X. Detection ofALKrearrangements in malignant pleural effusion cell blocks from patients with advanced non-small cell lung cancer: A comparison of Ventana immunohistochemistry and fluorescence in situ hybridization. Cancer Cytopathol 2014; 123:117-22. [PMID: 25529354 DOI: 10.1002/cncy.21510] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2014] [Revised: 11/20/2014] [Accepted: 12/01/2014] [Indexed: 02/05/2023]
Affiliation(s)
- Weiya Wang
- Department of Pathology; West China Hospital of Sichuan University; Chengdu China
| | - Yuan Tang
- Department of Pathology; West China Hospital of Sichuan University; Chengdu China
| | - Jinnan Li
- Department of Pathology; West China Hospital of Sichuan University; Chengdu China
| | - Lili Jiang
- Department of Pathology; West China Hospital of Sichuan University; Chengdu China
| | - Yong Jiang
- Department of Pathology; West China Hospital of Sichuan University; Chengdu China
| | - Xueying Su
- Department of Pathology; West China Hospital of Sichuan University; Chengdu China
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Xiao YF, Yong X, Fan YH, Lü MH, Yang SM, Hu CJ. microRNA detection in feces, sputum, pleural effusion and urine: novel tools for cancer screening (Review). Oncol Rep 2013; 30:535-44. [PMID: 23754129 DOI: 10.3892/or.2013.2525] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2013] [Accepted: 04/15/2013] [Indexed: 12/13/2022] Open
Abstract
microRNAs (miRNAs) are short non-coding RNA sequences that play important roles in the regulation of gene expression. They have significant regulatory functions in basic cellular processes, including differentiation, proliferation and apoptosis. miRNAs are differentially expressed in tumors, compared with normal tissues. Importantly, miRNAs are also stable and abundantly present in body fluids and feces. The high reproducibility, sensitivity and specificity of miRNAs in body fluids and feces enable miRNAs to be used as potential molecular markers for cancer screening. An increasingly large number of research studies have reported the role of miRNAs in this field. In the present review, we focused mainly on the application of detecting miRNAs in stool, sputum, pleural effusion and urine, to detect colon, lung and urological cancers, highlighting the role of miRNAs in early diagnosis and prognosis.
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Affiliation(s)
- Yu-Feng Xiao
- Department of Gastroenterology, Xinqiao Hospital, Third Military Medical University, Chongqing 400037, PR China
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Carpagnano GE, Costantino E, Palladino GP, Lacedonia D, Martinelli D, Orlando S, Foschino-Barbaro MP. Microsatellite alterations and cell-free DNA analysis: could they increase the cytology sensitivity in the diagnosis of malignant pleural effusion? Rejuvenation Res 2012; 15:265-73. [PMID: 22551519 DOI: 10.1089/rej.2011.1260] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The exact diagnosis of malignant pleural effusions (PE) is difficult and often requires combined procedures, because the cytological examination of pleural fluid does not detect tumoral cells in 40% of malignant effusion cases. The aim of this study was to analyze microsatellite alterations (MA) in malignant PE and to determine their diagnostic value as an additional test to cytological examination. The increase in cell-free DNA levels was also evaluated as a signal of probable malignancy. METHODS A total of 84 patients with PE were enrolled and underwent PE and whole blood and exhaled breath condensate analyses. Free DNA was measured by spectrophotometer analyses. DNA was extracted from all samples and analyzed for MA, using the microsatellite markers at chromosomes 3p, 12p, 5q, and 17p. RESULTS The microsatellite analysis of PE exhibited a higher percentage of alterations in malignant PE than in benign PE. In addition to this, cell-free DNA in PE was seen to be significantly more elevated in malignant than in benign PE. The sensitivity of the sole cytology increased considerably when patients showed at least one MA or DNA>4 ng/μL in the PE. CONCLUSION In conclusion, it was seen that the combination of the cytological examination with microsatellite analyses and cell-free DNA in pleural fluid could increase the sensitivity of the diagnosis in patients with PE who have a suspected malignancy, obviating the need for other invasive diagnostic procedures.
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Affiliation(s)
- Giovanna E Carpagnano
- Institute of Respiratory Disease, Department of Medical and Occupational Sciences, University of Foggia, Foggia, Italy.
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Zhang X, Liu G, Zhu X, Wang W. [The detection methods of EGFR mutations in non-small cell lung cancer]. ZHONGGUO FEI AI ZA ZHI = CHINESE JOURNAL OF LUNG CANCER 2011; 14:297-302. [PMID: 21426678 PMCID: PMC5999667 DOI: 10.3779/j.issn.1009-3419.2011.03.18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Xinyu Zhang
- Department of Pharmacy, Bengbu Medical College, Bengbu, China
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Cell-free miR-24 and miR-30d, potential diagnostic biomarkers in malignant effusions. Clin Biochem 2010; 44:216-20. [PMID: 21093424 DOI: 10.1016/j.clinbiochem.2010.11.002] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2010] [Revised: 11/04/2010] [Accepted: 11/08/2010] [Indexed: 11/27/2022]
Abstract
OBJECTIVES The study was trying to figure out the possible role of cell-free miR-24 and miR-30d as diagnostic biomarkers for malignant effusions. METHODS A total of 110 effusion samples (28 benign and 82 malignant) were collected and cell-free total RNA was extracted. Quantitative RT-PCR was carried out to measure the expression levels of miR-24 and miR-30d, with an exogenous supplemented plant miRNA, ath-miR156a as the reference RNA. RESULTS Malignant pleural effusions had higher expression levels of cell-free miR-24 and miR-30d than benign effusions. In the ascites group, only miR-30d was found to be significantly up-regulated in the supernatant of effusions. Combination of cell-free miR-24 and miR-30d could discriminate malignant ascites from benign with improved potency comparing to single miR-30d. CONCLUSIONS Cell-free miR-30d and miR-24 are potential diagnostic biomarkers for malignant and benign effusions.
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Xie L, Chen X, Wang L, Qian X, Wang T, Wei J, Yu L, Ding Y, Zhang C, Liu B. Cell-free miRNAs may indicate diagnosis and docetaxel sensitivity of tumor cells in malignant effusions. BMC Cancer 2010; 10:591. [PMID: 21029414 PMCID: PMC2988750 DOI: 10.1186/1471-2407-10-591] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2010] [Accepted: 10/28/2010] [Indexed: 01/10/2023] Open
Abstract
Background Circulating cell-free microRNAs have been identified as potential cancer biomarkers. However, the existence and the potential application of cell-free miRNAs in effusion samples are still uncertain. In order to explore the potential role of cell-free miRNA in malignant effusions, we selected 22 miRNAs differentially expressed in the serum of lung cancer patients and studied their expression levels in body cavity effusion samples. Methods We measured the expression of 22 miRNAs using qRT-PCR in two samples, which were pooled with 18 malignant and 12 benign effusions, respectively. After discarding 9 lowly expressed miRNAs, a panel of 13 miRNAs were measured in 29 samples (benign n = 11, malignant n = 18). We also carried out a WST-8 test to evaluate the docetaxel sensitivity of tumor cells directly isolated from 15 malignant effusions. Results We compared the miRNA expression levels between benign and malignant effusions using a Mann-Whitney U test and found miR-24, miR-26a and miR-30d were expressed differently between the two groups (P = 0.006, 0.021 and 0.011, respectively). Cells isolated from effusions rich in cell-free miR-152 were more sensitive to docetaxel (r = 0.60, P = 0.016). Conclusions Collectively, our study demonstrated that cell-free miRNAs in the supernatant of effusions may aid in the diagnosis of malignancy and predict chemosensitivity to docetaxel.
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Affiliation(s)
- Li Xie
- The Comprehensive Cancer Center of Drum Tower Hospital Affiliated to Medical School of Nanjing University & Clinical Cancer Institute of Nanjing University, Zhongshan Road 321#, Nanjing 2l0008, PR China
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Abstract
Malignant pleural effusions (MPEs) complicate the clinical course of patients with a broad array of malignancies, which are most often due to lymphomas or carcinomas of the breast, lung, gastrointestinal tract or ovaries. Patients may present with a MPE as the initial manifestation of a cancer or develop an effusion during the advanced phases of a known malignancy. In either circumstance, the median survival after presentation with a MPE is 4 months. Effusions may result from direct pleural invasion (MPE) or indirect effects (paraneoplastic effusions), such as impairment of fluid efflux from the pleural space by lymphatic obstruction or pleural effects of cancer radiation or drug therapy. Because only 50% of patients with cancer who develop a pleural effusion during their clinical course have a MPE, careful evaluation of the effusion to establish its aetiology is required to direct therapy. Management is palliative with interventions directed towards decreasing the volume of intrapleural fluid and the severity of associated symptoms.
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Abstract
Malignant pleural effusions (MPEs) are an important complication for patients with intrathoracic and extrathoracic malignancies. Median survival after diagnosis of an MPE is 4 months. Patients can present with an MPE as a complication of far-advanced cancer or as the initial manifestation of an underlying malignancy. Common cancer types causing MPEs include lymphomas, mesotheliomas, and carcinomas of the breast, lung, gastrointestinal tract, and ovaries. However, almost all tumor types have been reported to cause MPEs. New imaging modalities assist the evaluation of patients with a suspected MPE; however, positive cytologic or tissue confirmation of malignant cells is necessary to establish a diagnosis. Even in the presence of known malignancy, up to 50% of pleural effusions are benign, underscoring the importance of a firm diagnosis to guide therapy. Rapidly evolving interventional and histopathologic techniques have improved the diagnostic yield of standard cytology and biopsy. Management of an MPE remains palliative; it is critical that the appropriate management approach is chosen on the basis of available expertise and the patient's clinical status. This review summarizes the pathogenesis, diagnosis, and management of MPE. Studies in the English language were identified by searching the MEDLINE database (1980-2007) using the search terms pleura, pleural, malignant, pleurodesis, and thoracoscopy.
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Affiliation(s)
- John E Heffner
- Department of Medicine, Providence Portland Medical Center, Oregon Health and Science University, 5040 NE Hoyt St, Ste 540, Portland, OR 97213, USA.
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Zhang X, Zhao Y, Wang M, Yap WS, Chang AYC. Detection and comparison of epidermal growth factor receptor mutations in cells and fluid of malignant pleural effusion in non-small cell lung cancer. Lung Cancer 2007; 60:175-82. [PMID: 18061305 DOI: 10.1016/j.lungcan.2007.10.011] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2007] [Revised: 10/03/2007] [Accepted: 10/06/2007] [Indexed: 10/22/2022]
Abstract
Cells or cell-free fluid of malignant pleural effusion could be important clinical specimen for epidermal growth factor receptor (EGFR) mutation screening in advanced non-small cell lung cancer (NSCLC) patients. However, their usefulness in mutation detection has not been well compared. In this study we recruited 26 East Asian NSCLC patients with malignant pleural effusion, determined the mutation status of EGFR in both cells and matched cell-free fluid with the use of sequencing and mutant-enriched PCR. After comparing the mutation spectrums, we found both the cells and cell-free pleural fluid may be feasible clinical specimen for EGFR mutation detection in unresectable NSCLC given sensitive genotyping assays employed. Direct sequencing could miss a significant portion of mutations in these heterogeneous specimens. More sensitive methods, such as mutant-enriched PCR and gene scan, could provide more reliable mutational information.
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Affiliation(s)
- Xiaozhu Zhang
- Johns Hopkins Singapore International Medical Centre, Singapore 308433, Singapore.
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Sunaga N, Tomizawa Y, Yanagitani N, Iijima H, Kaira K, Shimizu K, Tanaka S, Suga T, Hisada T, Ishizuka T, Saito R, Dobashi K, Mori M. Phase II prospective study of the efficacy of gefitinib for the treatment of stage III/IV non-small cell lung cancer with EGFR mutations, irrespective of previous chemotherapy. Lung Cancer 2007; 56:383-9. [PMID: 17368623 DOI: 10.1016/j.lungcan.2007.01.025] [Citation(s) in RCA: 114] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2007] [Revised: 01/24/2007] [Accepted: 01/28/2007] [Indexed: 11/26/2022]
Abstract
PURPOSE Mutations in the epidermal growth factor receptor (EGFR) gene are associated with increased sensitivity of non-small cell lung cancer (NSCLC) to gefitinib, an EGFR tyrosine kinase inhibitor. The objective of this study was to prospectively evaluate the efficacy of gefitinib in patients with stage III/IV NSCLC whose tumors carried EGFR mutations, irrespective of previous chemotherapy. EXPERIMENTAL DESIGN Genomic DNA was extracted from tumor specimens and EGFR mutations in exons 19 and 21 analyzed by direct sequencing. Patients with stage III/IV NSCLC whose tumors had the EGFR mutations received gefitinib (250 mg/day orally). Response, toxicity and survival data were assessed. RESULT From November 2004-May 2006, 21 patients with EGFR mutations received gefitinib (median age: 59 years; 17 females; 19 non-smokers; all had adenocarcinomas). Two patients discontinued gefitinib and withdrew from the study 3 weeks after gefitinib initiation (interstitial pneumonitis, 1 patient; facial acne, 1 patient). Of 19 patients, 3 achieved complete response, 13 exhibited partial response and 3 had stable disease. Response and disease control rates were 76% (95% confidence interval [CI] 53-92) and 90% (95% CI 70-99), respectively. The most common adverse event was skin toxicity (67%); however, no grade 4 skin toxicities were seen. Ten patients relapsed and three died at a median follow-up period of 12.6 months (range 5.6-23.8 months); median progression-free survival was 12.9 months. CONCLUSION Analysis of tumor EGFR mutations in patients with NSCLC could be used to identify patients suitable for treatment with gefitinib to obtain optimum response and disease control rates.
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Affiliation(s)
- Noriaki Sunaga
- Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, and Department of Respiratory Medicine, National Nishigunma Hospital, Japan.
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Kimura H, Fujiwara Y, Sone T, Kunitoh H, Tamura T, Kasahara K, Nishio K. EGFR mutation status in tumour-derived DNA from pleural effusion fluid is a practical basis for predicting the response to gefitinib. Br J Cancer 2006; 95:1390-5. [PMID: 17060940 PMCID: PMC2360588 DOI: 10.1038/sj.bjc.6603428] [Citation(s) in RCA: 99] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Epidermal growth factor receptor (EGFR) mutations are strong determinants of tumour response to EGFR tyrosine kinase inhibitors in non-small-cell lung cancer (NSCLC). Pleural effusion is a common complication of lung cancer. In this study, we assessed the feasibility of detection of EGFR mutations in samples of pleural effusion fluid. We obtained 43 samples, which was the cell-free supernatant of pleural fluid, from Japanese NSCLC patients, and examined them for EGFR mutations. The epidermal growth factor receptor mutation status was determined by a direct sequencing method (exons 18–21 in EGFR). EGFR mutations were detected in 11 cases (E746_A750del in seven cases, E746_T751del insA in one case, L747_T751del in one case, and L858R in two cases). The EGFR mutations were observed more frequently in women and non-smokers. A comparison between the EGFR mutant status and the response to gefitinib in the 27 patients who received gefitinib revealed that all seven patients with partial response and one of the seven patients with stable disease had an EGFR mutation. No EGFR mutations were detected in the patients with progressive disease. The results suggest that DNA in pleural effusion fluid can be used to detect EGFR mutations and that the EGFR mutation status may be useful as a predictor of the response to gefitinib.
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Affiliation(s)
- H Kimura
- Shien-Lab, National Cancer Center Hospital, Tsukiji 5-1, Chuo-ku, Tokyo, Japan
- Respiratory Medicine, Kanazawa University Hospital, Takara-machi13-1, Kanazawa, Ishikawa, Japan
| | - Y Fujiwara
- Medical Oncology, National Cancer Center Hospital, Tsukiji 5-1, Chuo-ku, Tokyo, Japan
| | - T Sone
- Respiratory Medicine, Kanazawa University Hospital, Takara-machi13-1, Kanazawa, Ishikawa, Japan
| | - H Kunitoh
- Medical Oncology, National Cancer Center Hospital, Tsukiji 5-1, Chuo-ku, Tokyo, Japan
| | - T Tamura
- Medical Oncology, National Cancer Center Hospital, Tsukiji 5-1, Chuo-ku, Tokyo, Japan
| | - K Kasahara
- Respiratory Medicine, Kanazawa University Hospital, Takara-machi13-1, Kanazawa, Ishikawa, Japan
| | - K Nishio
- Shien-Lab, National Cancer Center Hospital, Tsukiji 5-1, Chuo-ku, Tokyo, Japan
- Pharmacology Division, National Cancer Center Research Institute, Tsukiji 5-1-1, Chuo-ku, Tokyo, Japan
- Center for Medical Genomics, National Cancer Center Research Institute, Tsukiji 5-1-1, Chuo-ku, Tokyo, Japan
- Shien-Lab, National Cancer Center Hospital, Tsukiji 5-1, Chuo-ku, Tokyo, Japan. E-mail:
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Huang MJ, Lim KH, Tzen CY, Hsu HS, Yen Y, Huang BS. EGFR mutations in malignant pleural effusion of non-small cell lung cancer: a case report. Lung Cancer 2006; 49:413-5. [PMID: 15913841 DOI: 10.1016/j.lungcan.2005.02.016] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2005] [Revised: 02/18/2005] [Accepted: 02/18/2005] [Indexed: 11/30/2022]
Abstract
EGFR mutations have been shown to correlate with the clinical responsiveness to epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI). The detection of EGFR mutations in non-small cell lung cancer (NSCLC) is important from the perspective of targeted anticancer therapy. We report the first case showing that the status of EGFR mutations can be successfully determined in malignant pleural effusion of NSCLC using polymerase chain reaction (PCR) technique, and correlated to the clinical responsiveness to gefitinib, an EGFR-TKI. This case demonstrated the importance of molecular cytology in the era of targeted therapy.
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Affiliation(s)
- Ming-Jer Huang
- Division of Hematology and Oncology, Department of Internal Medicine, Mackay Memorial Hospital, CMU, Taipei, Taiwan
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Woenckhaus M, Grepmeier U, Werner B, Schulz C, Rockmann F, Wild PJ, Röckelein G, Blaszyk H, Schuierer M, Hofstaedter F, Hartmann A, Dietmaier W. Microsatellite analysis of pleural supernatants could increase sensitivity of pleural fluid cytology. J Mol Diagn 2005; 7:517-24. [PMID: 16237222 PMCID: PMC1888495 DOI: 10.1016/s1525-1578(10)60583-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Pleural effusions may result from various inflammatory, hemodynamic, or neoplastic conditions. A common diagnostic problem lies in distinguishing malignant from benign pleural effusions using routine cytological evaluation. We studied pleural fluid samples obtained from 14 patients with histologically confirmed malignancy and from 6 patients with benign pleural effusions using 12 microsatellite markers from 8 different chromosomal regions. Supernatants and cellular sediments of all 20 pleural fluid samples were analyzed. Routine cytological examination was 100% specific for malignancy but was only 57% sensitive. Microsatellite analyses of pleural fluid supernatants showed genetic alterations in tumor patients only. However, 50% of pleural effusions that were considered negative for malignancy by routine cytological analysis showed either loss of heterozygosity or microsatellite instability. The sensitivity of pleural fluid examination rose to 79% when routine cytological assessment was supplemented by molecular studies. Our data suggest that microsatellite analysis increases the sensitivity of cytological pleural fluid examination in assessing potential malignancy and that combining cytological and molecular methods may improve yield and certainty in diagnostically challenging cases.
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Affiliation(s)
- Matthias Woenckhaus
- Department of Pathology, University of Regensburg, Franz-Josef-Strauss-Allee 11, D-93053 Regensburg, Germany.
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