Limitations of detection of malignancy in pleural effusions using ELISA‐based TRAP assay: comparison with cytological examination

Lee, Wen-Ying

doi:10.1111/j.1365-2303.2005.00259.x

Cited by 10 publications

(6 citation statements)

References 28 publications

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“…Telomerase was studied for the diagnosis of malignant pleural effusions (Yang et al 1998). However, contamination of lymphocytes, which could express the telomerase, may weaken its diagnostic value (Lee 2005). New markers such as human mammaglobin/mammaglobin B and mucin were explored for the detection of malignant cells in effusions (Yu et al 2001, Fiegl et al 2004).…”

Section: Discussionmentioning

confidence: 99%

MN/CA9: a potential gene marker for detection of malignant cells in effusions

Li¹,

Passebosc-Faure²,

Feng³

et al. 2007

Biomarkers

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Many cancers cause malignant effusions. The presence of malignant cells in effusions has implications in diagnosis, tumour staging and prognosis. The detection of malignant cells currently presents a challenge for cytopathologists. New adjunctive methods are needed. Although the effusions provide excellent materials for molecular assay, the available molecular markers are extremely limited, which hinders its clinical application. MN/CA9 has proved to be a valuable marker in many cancers such as lung, breast, colon, kidney, etc. The present study was to evaluate MN/CA9 as a new molecular marker for the detection of cancer cells in pleural effusions. Seventy-one pleural effusions including 59 malignant effusions from patients with cancer, and 12 patients with benign diseases as a control, were subjected to RT-PCR for detection of MN/CA9 gene expression. MN/CA9 gene expression was detected in 53/59 (89.8%) pleural effusions from cancer patients (15/16 for breast cancers, 10/11 for lung cancers, 4/4 for ovary cancers, 2/3 for colon-rectal cancers, 5/6 for cancers of unknown site, 7/8 for mesothelioma and 10/11 for other cancers). Furthermore, MN/CA9 was positive in 13/18 (72.2%) of cytologically negative effusions of cancer patients. MN/CA9 was detected in only 1/12 (8.3%) effusions from the control patients (p < 0.01). The sensitivity and specificity of MN/CA9 gene expression were, respectively, 89.8% and 91.7%. Our preliminary results suggest that MN/CA9 could be a potential marker for the detection of malignant cells in effusions. A large-scale study is needed to confirm these results.

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Section: Discussionmentioning

confidence: 99%

MN/CA9: a potential gene marker for detection of malignant cells in effusions

Li¹,

Passebosc-Faure²,

Feng³

et al. 2007

Biomarkers

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“…Determination of telomerase activity has been demonstrated to be a potentially useful and noninvasive method to detect malignant pleural effusion 23. However, false‐positive telomerase activity because of lymphocytic contamination may weaken its diagnostic value 24. Unlike traditional tumor markers used routinely in clinical practice, CAIX expression is a phenotype of metabolic changes in cancer cells 15, 16.…”

Section: Discussionmentioning

confidence: 99%

Detection of carbonic anhydrase IX protein in the diagnosis of malignant pleural effusion by enzyme‐linked immunosorbent assay and immunocytochemistry

Liao

Lee

2012

Cancer Cytopathology

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BACKGROUND: Carbonic anhydrase IX (CAIX) is a hallmark of metabolic change in cancer cells. The aim was to evaluate the utility of CAIX expression for the detection of malignant pleural effusions by enzyme-linked immunosorbent assay (ELISA) and immunocytochemistry. METHODS: A total of 97 pleural effusions including 54 benign effusions, 10 atypical effusions, and 33 malignant effusions, classified based on cytological diagnosis and etiology, were subjected to ELISA to measure protein level and to immunocytochemistry in cell blocks to determine CAIX expression. RESULTS: CAIX levels were significantly higher in the malignant group compared with the benign group. Receiver operating characteristic curve analysis of benign and malignant pleural effusion for CAIX indicated an area under the curve of 0.82 with a value of 1882 pg/dL as the best threshold for distinguishing benign from malignant effusions, which yields a sensitivity, specificity, and accuracy of 63.6%, 94.4%, and 82.8%, respectively. None of the benign effusion expressed CAIX by immunocytochemistry.

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“…We can not completely rule out the possibility of technical error or that perhaps some peritoneal lavage fluids did not contain cancer cells. However, the peritoneal lavage fluid can also be contaminated with lymphocytes or other blood cells in the presence of inflammation or ulceration [29] . The presence of these cells may give rise to false-positive results in TRAP assay [30] .…”

Section: Discussionmentioning

confidence: 99%

Clinical significance of telomerase activity in peritoneal lavage fluid from patients with gastric cancer and its relationship with cellular proliferation

Wu²,

Guo³

et al. 2007

WJG

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AIM:To evaluate the efficacy of telomerase activity assay and peritoneal lavage cytology (PLC) examination in peritoneal lavage fluid for the prediction of peritoneal metastasis in gastric cancer patients, and to explore the relationship between telomerase activity and proliferating cell nuclear antigen expression. METHODS:Telomeric repeated amplification protocol (TRAP)-enzyme-linked immunosorbent assay (ELISA) was performed to measure the telomerase activity in 60 patients with gastric cancer and 50 with peptic ulcer. PLC analysis of the 60 patients with gastric cancer was used for comparison. The proliferating cell nuclear antigen (PCNA) in gastric carcinoma was immunohistochemically examined. RESULTS:The telomerase activity and PLC positive rate in peritoneal lavage fluid from patients with gastric cancer was 41.7% (25/60), and 25.0% (15/60), respectively. The positive rate of telomerase activity was significantly higher than that of PLC in the group of pT4 (15/16 vs 9/16, P < 0.05), P1-3 (13/13 vs 9/13, P < 0.05) and diffuse type (22/42 vs 13/42, P < 0.05).The patients with positive telomerase activity, peritoneal metastasis, and serosal invasion had significantly higher levels of average PCNA proliferation index (PI), (55.00 ± 6.59 vs 27.43 ± 7.72, 57.26 ± 10.18 vs 29.15 ± 8.31, and 49.82 ± 6.74 vs 24.65 ± 7.33, respectively, P < 0.05). CONCLUSION:The TRAP assay for telomerase activity is a useful adjunct for cytologic method in the diagnosis of peritoneal micrometastasis and well related to higher proliferating activity of gastric cancer. The results of this study also suggest a promising future therapeutic strategy for treating peritoneal dissemination based on telomerase inhibition.

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Limitations of detection of malignancy in pleural effusions using ELISA‐based TRAP assay: comparison with cytological examination

Abstract: The ELISA-based TRAP assay is relatively insensitive; therefore, it is unsuitable as a routine diagnostic tool for pleural effusion. False-positive telomerase activity due to lymphocytic contamination may weaken its diagnostic value for malignant effusions in a tuberculosis-endemic area.

Cited by 10 publications

References 28 publications

MN/CA9: a potential gene marker for detection of malignant cells in effusions

MN/CA9: a potential gene marker for detection of malignant cells in effusions

Detection of carbonic anhydrase IX protein in the diagnosis of malignant pleural effusion by enzyme‐linked immunosorbent assay and immunocytochemistry

Clinical significance of telomerase activity in peritoneal lavage fluid from patients with gastric cancer and its relationship with cellular proliferation

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