Clinical evaluation of serum sialyl SSEA-1 (SLX) in diagnosis of cancers

In order to evaluate the usefulness of sialyl SSEA-1 (SLX) as a tumor marker of digestive cancers, serum levels of the antigen were determined in 334 patients with malignancies and 196 patients with benign diseases. The results indicated that positivity of the antigen in sera from malignant patients was highest in pancreatic cancer (58%) and biliary tract cancer (56%). False positive incidence of SLX in sera from benign diseases was as low as 6%, revealing low false positivity. Comparison with other tumor markers such as CA19-9, CA-50, CEA and ST-439 showed that positivity of SLX was as high as that of CEA, whereas it was lower than that of CA19-9 or CA-50. On the other hand, false positivity of SLX as well as ST-439 was lowest, and accuracy of SLX was no less high than that of CA19-9 or CA-50. In sera of pancreatic and biliary tract cancer, positive incidences of CA19-9, CEA and ST-439 were 80%, 64% and 53%, respectively, and the diagnostic efficiency increased by combined assay of SLX with CA19-9 (88%), CEA (81%) and ST-439 (71%). SLX appears to be no less useful than the other recently developed carbohydrate antigens or CEA as serum tumor marker for pancreatico-biliary cancer.     

Expression of Tumor-Associated Antigens on Gastric Biopsy Materials

Abstract: We investigated the expressions of SLX, ST-439 and PLAP, which are regarded as having high specificity for cancer, in borderline lesions of the stomach to ascertain the significance of these potential markers in distinguishing between benign and malignant lesions. SLX, ST-439 and PLAP expressions in gastric biopsy specimens, from 73 patients with gastric lesions, were visualized using avidin-biotin-peroxidase. Although the prevalence of SLX in Group V was 90%. it was also high in intestinal metaplasia (40%) and adenoma (75%). The prevalences of ST-439 in intestinal metaplasia and adenoma grades l and 2 were 5, 23, and 17%. respectively. On the other hand, the prevalence of ST-439 was about 60% in adenoma grade 3 and in Groups IV and V. The prevalence and immunostaining range of ST-439 increased concomitantly with increasing grades of cytological and architectural atypia. The prevalence of PLAP in gastric biopsy materials was 30% overall, but was higher among the differentiated types. Moreover, PLAP was highly specific for cancer because of the negative immunostaining observed in benign lesions such as intestinal metaplasia and adenoma. These results suggest the following: 1) SLX is relatively non-specific for cancer and thus not useful in the pathological diagnosis of gastric lesions, and 2) borderline lesions with positive ST-439 mandate careful follow-up. Moreover, lesions with apparently extensive and intense ST-439 immunostaining may be gastric cancer and require urgent attention. Furthermore, 3) PLAP may provide additional diagnostic information useful for distinguishing between well-differentiated adenocarcinoma and borderline lesions including adenoma.     

Clinical evaluation of combination assay of tumor markers in primary lung cancer patients

Recently, the measurement of tumor markers, particularly for combined measurement, have been reported to be useful for the early diagnosis of cancer. In this study, the authors measured the serum levels of SLX, CA19-9, CA153, CA125, NCC-ST-439, CEA, SCC, NSE, TPA and IAP in 155 patients with primary lung cancer before treatment (76 adenocarcinomas, 40 squamous cell carcinomas, 36 small cell cancers, 3 large cell cancers). Seventy three benign lung disease cases were also studied as controls. The serum levels of CA19-9, CA153, CA125, NCC-ST-439, CEA, NSE and TPA were significantly higher in lung cancer patients than in benign lung disease patients. CA125 and CEA levels in adenocarcinoma, SCC levels in squamous cell carcinoma, NSE levels in small cell cancer and NCC-ST-439 in non-small cell cancer were significantly higher than those of other histological types of cancer. The level of each marker became higher, and was related with advance in stage. The probability of lung cancer was 90% when three markers were positive except for IAP, which was frequently false positive in benign lung disease. In conclusion, the simultaneous, combined measurement of at least three markers, including CEA and/or TPA was considered to be useful for the diagnosis of lung cancer.     

Expression of various sialylated carbohydrate antigens in malignant and nonmalignant pancreatic tissues.

The expression of six sialylated carbohydrate antigens (CA19-9, CA-50, SLEX, SLX, DU-PAN-2, ST-439) was examined in malignant and nonmalignant pancreatic tissues using an immunohistochemical method to elucidate the characteristics of these carbohydrate antigens as tumor markers. All carbohydrate antigens except for sialyl SSEA-1 (SLX, 52.4%) were expressed in more than 80% of the pancreatic cancer. CA19-9 and CA-50, belonging to type I blood group antigens, and DU-PAN-2 and ST-439 were localized predominantly in the cytoplasm of cancer cells, while sialyl Lex (SLEX) and SLX, belonging to type II blood group antigens, were stained mainly on the apical membranes of malignant glands. Although type I antigens were expressed in most nonmalignant pancreatic tissues, the type II antigens and ST-439 were absent in almost all of the normal tissues and faintly expressed in few chronic pancreatitis tissues, suggesting the high tumor specificity of these antigens. Each antigen was expressed on the apical surface of ducts in normal pancreas. However, in about 30% of chronic pancreatitis cases, type I antigens and DU-PAN-2 were observed in the cytoplasm of ductal cells. All patients showing stromal stain, possibly caused by loss of antigen polar expression and shedding into the surrounding stroma adjacent to malignant glands, revealed high levels of serum antigen. This finding suggests that the stromal appearance of antigens is a significant factor in the elevation of serum antigen levels.     

A statistical analysis of serum sialyl Lewis X-1 (SLX), CEA, SCC and NSE levels in patients with lung cancer]

Serum SLX, CEA, SCC and NSE levels were serially measured in 266 patients with lung cancer and compared with those in 345 patients with benign respiratory disorders (BRD). The positive rate for CEA in lung cancer (44.4%) and the false-positive rate in BRD (15.3%) were the highest among the 4 markers. The positive rate for SLX in lung cancer (32.0%) was lower than that of CEA, while the false-positive rate for SLX in BRD (7.2%) was lower than that of CEA. The positive rate for SLX was highest in adenocarcinoma and correlated better with the clinical stages than did CEA. SCC and NSE were specifically elevated in squamous cell carcinoma and small cell carcinoma, respectively. Using these 4 markers, only 70.2% of patients were correctly diagnosed as having lung cancer or BRD. In monitoring treatment effect, only SLX showed a statistically significant correlation with regression and progression in adenocarcinoma, while NSE and SLX showed such a correlation in small cell carcinoma. Serum tumor markers seem to be less sensitive for the diagnosis of lung cancer than chest X-ray and sputum cytology, indicating that a search for more specific markers is still required. However, in monitoring treatment effect, SLX appeared to be suitable for adenocarcinoma, while NSE and SLX seemed to be useful in small cell carcinoma.     

Sialyl Lewis X-i (SLX) in the bronchoalveolar lavage fluid from patients with lung cancer]

The measurement of serum SLX is thought to be a useful aid in the diagnosis of malignant diseases, particularly adenocarcinoma of the lung. In the present investigation, we measured and compared SLX values in BALF from affected and normal bronchi, obtained from 83 patients. They consisted of 64 males and 19 females, with mean age of 60 years, consisting of 8 normal controls, 19 cases of benign lung disease, and 56 cases of primary lung cancer. SLX value in BALF from normal bronchi was significantly higher in patients with lung cancer than in normal controls, but there was no significant difference in SLX value between lung cancer and benign lung disease. On the other hand, SLX value from affected bronchi was significantly higher in patients with lung cancer than in normal controls and patients with benign lung disease. The rate of elevated SLX in BALF from affected bronchi was significantly higher in patients with lung cancer than in those with benign lung disease. These results suggest that measurement of SLX levels in BALF from affected bronchi may be a useful method for differential diagnosis of primary lung cancer.     

Serological and immunohistochemical studies on sialylated carbohydrate antigens in colorectal carcinoma.

Sialylated carbohydrate antigens, such as CA19-9 (sialyl Lea), CA-50 (sialyl Le4), CSLEX1 (sialyl Lex) and SLX (sialyl Lex-i), were assayed in the same preoperative serum samples of 63 patients with colorectal cancer, and compared with CEA. In addition immunohistochemical expressions of sialyl Lea, sialyl lex and sialyl Lex-i antigens were studied in 62 colorectal carcinomas and 42 normal mucosal sites remote from the malignant lesion using monoclonal antibodies CSLEA1, CSLEX1 and FH-6, respectively, in order to elucidate their tumor-specificity and clinical usefulness as a tumor-associated antigen. Serologically, the percent positive rates of CA19-9, CA-50, CSLEX1, SLX and CEA were 30.2%, 17.7%, 23.8%, 16.1% and 44.4%, respectively. In dukes' A and B, these sialylated carbohydrate antigens, especially CSLEX1 and SLX, showed low positive rates, but the percent positive rates of CSLEX1 and SLX correlated with operative radicality. The positive spectrum of CSLEX1 differed from that of CA19-9 in sera, and CEA had no correlation with these two antigens. The immunohistochemical expression rates of sialyl Lea, sialyl Lex and sialyl Lex-i were 88.1%, 17.0% and 9.5% in normal mucosa, but were 77.8%, 90.5% and 71.4% in carcinoma, respectively. These data suggested that the type 2 chain antigens CSLEX1 and SLX, which have high tumor-specificity compared with CA19-9, may be useful in preoperative diagnosis for extension of carcinoma and operative radicality, although early diagnosis using these sialylated carbohydrate antigens may be difficult, while the combined use of CA19-9, CSLEX1 and CEA should make it possible to detect a wide range of colorectal cancer patients.     

Comparative analysis of serum levels of CA-50, CA-125, CA-19.9, enolase and CEA in bronchopulmonary cancer

A serum assay of CA-50, CA-125, CA-19.9, ENOLASE (NSE) and CEA was performed in 65 patients with primary lung cancer, 63% of whom had visceral metastases, with the following histological distribution: squamous carcinoma (40), adenocarcinoma (9), large cell carcinoma (4), oat cell carcinoma (12). A raised CEA level was detected in 37% of cases, compared with 40.6% for CA-50, 44.6% for CA-19.9 and 40.6% for CA-125 and only 26.6% for NSE. Overall, at least one marker was positive in 83% of cases. Statistical analysis of the different markers (correlation analysis and principal component analysis) demonstrated the existence of a strict correlation between the levels of CA-50, CEA and CA-19.9 (p less than 0.01). ENOLASE was more frequently elevated in oat cell carcinomas (42%) than in non-oat cell carcinomas (30%), but the difference was not significant. In contrast, CA-125 appears to be a good marker for non-oat cell carcinomas (51%) (p less than 0.05). The authors also found a correlation between the presence of a raised level of CA-50 (p less than 0.05), CA-125 (p less than 0.02) and especially CEA (p less than 0.001) and the presence of visceral metastases. The initial survey of disseminated lung cancers should include the assay of at least 4 of these markers in order to obtain a reliable serum tracer in more than 2/3 of cases.     

Biomarkers in the lung cancer diagnosis: a clinical perspective

The propensity for tumor biomarkers to be detected in serum at an early disease stage has become an area of interest for clinicians. This study aimed to evaluate the efficiency of 7 tumor biomarkers, namely, carcinoembryonic antigen (CEA), neuron-specific enolase (NSE), cytokeratin 19 (CYFRA-21-1), alpha-fetoprotein, carbohydrate antigen-125 (CA-125), carbohydrate antigen-19.9 (CA-19.9), and ferritin, independently or in combination for the diagnosis of lung cancer. Electrochemiluminescence immunization was used to determine biomarker levels expressed in 530 patients with pulmonary disease and 229 healthy subjects. The observed levels of CEA, NSE, CYFRA-21-1, CA-125, and CA-19.9 in patients with pathologically confirmed lung cancer were significantly higher than those in patients with benign pulmonary disease or control subjects. Adenocarcinoma, squamous cell carcinoma, and small cell carcinoma of the lung were associated with the highest observed levels of CA-125, CYFRA-21-1, and NSE, respectively. Combining biomarkers successfully led to the diagnosis of lung cancer. CEA + NSE + CA-125 showed the highest sensitivity for small cell carcinoma, at 83.33%, whereas CEA + NSE + CYFRA-21-1 + CA-125 showed 94.11% sensitivity for squamous cell carcinoma. The combination of 6 biomarkers, namely, CEA + NSE + CYFRA-21-1 + CA-125 + ferritin + CA-19.9, showed 80.49% sensitivity for adenocarcinoma. Combining biomarkers significantly aided in the diagnosis of lung cancer. However, this increased sensitivity on combination was accompanied by a decreased specificity for lung cancer subtypes. Combining biomarkers appropriately increases their sensitivity and helps with the diagnosis of lung cancer.     

Tumor markers in pleural effusion of patients with lung cancer and patients with tuberculous pleurisy]

Carcinoembryonic antigen (CEA), cancer antigen 125 (CA 125), NCC-ST-439, carbohydrate antigen 19-9 (CA 19-9), cytokeratin 19 fragment (CYFRA 21-1), sialyl Lewis X-i antigen (SLX), progastrin-releasing peptide (ProGRP), squamous cell carcinoma antigen (SCC) and neuron specific enolase (NSE) were evaluated in the pleural effusion of 39 patients with lung cancer (29 adenocarcinomas, seven small-cell carcinomas, three squamous cell carcinomas) and 43 patients with tuberculous pleurisy. The levels of the tumor markers other than SCC and NSE were significantly higher in lung cancer than in tuberculosis. High levels of CYFRA 21-1 and SCC were observed in squamous cell carcinoma and high levels of ProGRP and NSE were observed in small-cell carcinoma. According to the validity score, sensitivity (%) + specificity (%) - 100, the optimal cut-off levels of pleural effusion were 8.1 ng/ml for CEA, 660 U/ml for CA 125, 2.6 U/ml for NCC-ST-439, 10 U/ml for CA 19-9, 65 ng/ml for CYFRA 21-1, 140 U/ml for SLX, 23.2 pg/ml for ProGRP, 0.6 ng/ml for SCC and 5 ng/ml for NSE. By comparison of validity scores for each optimal cut-off level and of receiver operating characteristic (ROC) curves, we suggest that a CEA assay is the most useful for pleural effusion. The combined assay of CEA + ProGRP and CEA + ProGRP + CYFRA 21-1 were considered to be useful.     

Comparison of carbohydrate antigens--sialylated Lewisx and sialylated SSEA-1 in the sera from patients with primary lung cancer

Serum levels of sialylated Lewisx (SLEX) and sialylated SSEA-1 (S-Xi) in 136 cases of diagnosed lung cancer (63 adenocarcinoma, 45 squamous cell carcinoma, 20 small cell carcinoma and 8 large cell carcinoma) and 111 cases of benign pulmonary disease were measured. The positive rate of these markers in the primary lung cancer group was significantly higher than those in benign pulmonary diseases. The positive rates of serum SLEX and S-Xi in all lung cancer cases were 27.2% and 27.9%, respectively. The antigen levels in the sera were higher in adenocarcinoma as compared to other histologic types, and increased as the stage advanced. It was concluded that SLEX and S-Xi are very useful markers of lung cancer for diagnosis and monitoring the clinical status.     

联合检测血清CYFRA21-1、CA-125、NSE诊断肺癌的价值

目的　探讨联合检测血清中细胞角蛋白 19血清片段 2 1- 1(CYFRA2 1- 1)、糖链抗原 - 12 5 (CA - 12 5 )、神经元特异性烯醇化酶 (NSE)表达水平对肺癌的诊断价值。方法　应用 EL ISA和化学发光法分别检测 74例肺癌患者 (肺癌组 )和 34例肺良性疾病患者 (肺良性疾病组 )及 5 2例正常人 (正常对照组 )血清 CYFRA 2 1- 1、CA- 12 5、NSE水平。结果　肺癌组血清 CYFRA2 1- 1、CA- 12 5、NSE浓度显著高于正常对照组和肺良性疾病组 (P <0 .0 0 1) ,CYFRA2 1- 1在肺鳞癌中表达水平最高 ,CA- 12 5在肺腺癌中表达水平最高 ,NSE在肺小细胞癌中表达水平最高。血清 CYFRA2 1- 1+CA- 12 5 +NSE联合检测肺癌的敏感性为 90 .4 % ,特异性为 81.3%。结论　联合检测血清 CYFRA2 1- 1、CA- 12 5、NSE水平对肺癌的诊断有重要的临床参考价值。     

Evaluation of Cancer-Associated Carbohydrate Antigen (NCC-ST-439) Measurement in Pure Pancreatic Juice Collected by Endoscopic Aspiration

Abstract: This study was undertaken to elucidate the diagnostic significance of the measurement of a cancer-associated carbohydrate antigen, NCC-ST-439 (ST-439), in pure pancreatic juice collected by endoscopic cannulation, chiefly from patients with pancreatic diseases. The mean concentrations of ST-439 in each of the 4 fractions collected were significantly higher in patients with pancreatic cancer than in controls, but patients with chronic pancreatitis or cholecystolithiasis did not have higher levels. Similarly, a significant increase in the mean output of ST-439 was observed only in patients with pancreatic cancer. When the cut-of value was set at the mean concentration+ 2 X the standard deviations of the controls, significant concentrations of ST-439 were found, in the first fraction (washout phase) in 56% of the pancreatic cancer cases, 31% of the chronic pancreatitis cases and 0% of the cholecystolithiasis cases; in the third fraction (secretory phase) results were 50%, 7% and 0%, respectively. Furthermore, when the cut-of value was set at the highest concentration found among patients with chronic pancreatitis (to enhance the specificity for pancreatic cancer), the prevalence of significant ST-339 levels among Pancreatic cancer patients was 50% in the first fraction and 44% in the third fraction. These results indicate that the measurement of ST-439 in pancreatic juice is useful as a specific marker for pancreatic cancer, although its sensitivity is less than was initially hoped,     

Glycoprotein tumour markers in head and neck neoplasms —a consecutive study on CA-50, CA 19-9, and CEA

Summary Serum levels of three glycoprotein tumour antigens (carcino-embryonic antigen, CEA; cancer-associated antigen 50, CA-50; gastrointestinal cancer-associated antigen, CA 19-9) were determined on 125 consecutive patients with tumours of the head and neck region. Elevated CEA values (> 5 units/ml) were found in 13/70 squamous cell carcinomas, 3/21 benign and 4/18 malignant salivary gland neoplasms. Elevated CA-50 values (> 17 units/ml) were found in 19/70 squamous cell carcinomas, 6/18 malignant and 1/21 benign salivary neoplasms. CA 19-9 displayed higher values (> 37 units/ml) in 9/68 squamous cell carcinomas, 4/18 malignant and none of 21 benign salivary gland tumours. Combination of CEA and CA-50 analyses increased the proportion of elevated values to 30/70 in squamous cell carcinomas and 10/18 in salivary gland malignancies. In squamous cell carcinomas no correlation between staging or grading and serum levels was detected for any of the markers. Among malignant salivary gland tumours, CA-50 displayed enhanced serum values in 4/6 mucoepidermoid carcinomas. The mean values for CA-50 and CA 19-9 serum levels were significantly higher for malignant salivary gland neoplasms compared to benign tumours. There was a close correlation between CA-50 and CA 19-9 serum levels. Although, the results suggest that at present none of the tumour markers tested have a place alone in the routine examination of patients with tumours affecting the head and neck region, further studies on salivary gland neoplasms and combinations of the tumour markers are justified.This study was supported by grants from the Swedish Society for Cancer Research and Lions Research Foundation, Umeå Sweden     

非小细胞肺癌EBUS-TBNA标本中TTF-1、CK7、CK5/6和p63的表达及其意义

目的：探讨在非小细胞肺癌支气管内超声引导针吸活检(EBUS-TBNA)标本中TTF-1、CK7、CK5/6和 p63的表达及其意义。方法采用免疫组化 SP 法检测64例非小细胞肺癌患者EBUS-TBNA标本的TTF-1、CK7、CK5/6和 p63的表达情况。结果 TTF-1和 CK7在肺腺癌患者EBUS-TBNA标本中的表达阳性率分别为75.00%和100.00%,明显高于肺鳞癌(χ2值分别为16.94、32.00,P值均<0.05);CK5/6和 p63在肺鳞癌患者 EBUS-TBNA标本中的表达阳性率分别为91.67%和75.00%,明显高于肺腺癌(χ2值分别为11.45、4.80,P 值均<0.05)。结论检测非小细胞肺癌EBUS-TBNA标本的TTF-1、CK7、CK5/6和 p63对鉴别肺鳞癌和腺癌有重要意义。     

Measurement of carcinoembryonic antigen, squamous cell carcinoma related antigen and neuron-specific enolase in the bronchoalveolar lavage fluid in patients with peripheral lung cancer

Carcinoembryonic antigen (CEA), squamous cell carcinoma related antigen (SCC) and neuron-specific enolase (NSE) in bronchoalveolar lavage fluid were measured in 30 patients with peripheral lung cancer, 11 patients with benign lung disease and 19 healthy controls. The mean levels and positive rates of lavaged fluid CEA were 128.0 +/- 16.9 ng/mg and 33.3% in patients with lung cancer, 68.1 +/- 25.9 ng/mg and 9.1% in patients with benign lung disease, and 68.3 +/- 11.6 ng/mg and 5.2% in healthy controls, respectively. The mean levels and positive rates of lavaged fluid CEA in patients with lung cancer were significantly higher than those in patients with benign lung disease (p less than 0.05) and those in healthy controls (p less than 0.05). The mean levels of lavaged fluid SCC and NSE showed no significant difference between cases of lung cancer and benign lung disease or healthy controls. No lavaged tumor marker level in patients with lung cancer showed any close correlation with histologic types and serum levels. In conclusion, measurement of lavaged fluid CEA was considered to be useful in the differential diagnosis of peripheral lung cancer.     

支气管肺泡灌洗液、血清中铁蛋白、CA-199、CEA对肺癌的诊断价值

目的探讨支气管肺泡灌洗液（BALF）、血清中铁蛋白（SF）、糖链抗原199（CA-199）和癌胚抗原（CEA）测定对肺癌的诊断价值。方法采用免疫放射分析法（IRMA）测定60例肺癌患者和68例肺良性疾病患者BALF和血清中SF、CA-199、CEA的水平。结果肺癌组BALF和血清中SF、CA-199、CEA明显高于肺良性疾病组，有非常显著性差异（P〈0．0001），肺癌组BALF的SF、CA-199、CEA水平高于血清，有显著性差异（P〈0．001），肺癌组3项联合检测的敏感性及准确性明显高于单项检测（P〈0．05）。结论联合检测BALF及血清中的SF、CA-199、CEA对于鉴别肺部良、恶性疾病有较好的临床价值，对肺癌的早期诊断提供良好手段。     

肺腺癌患者血清CEA和糖链抗原肿瘤标记物联合测定的临床意义

目的为了探讨85例肺腺癌患者血清CEA和糖链抗原肿瘤标记物水平联合测定的临床意义。方法化学发光免疫分析测定85例肺腺癌、35例肺鳞癌、42例小细胞肺癌和49例良性肺部疾病血清CEA和糖链抗原(CA125、CA199和CA153)水平,并进行了比较性研究。结果 162例肺癌患者中,85例肺腺癌、35例肺鳞癌、42例小细胞肺癌患者血清CEA水平较之49例良性肺部疾病明显增高(P0.001、P0.01和P0.001),以肺腺癌增高最为明显。血清糖链抗原(CA125、CA199和CA153)水平亦然,也以肺腺癌血清CA125、CA199和CA153水平增高最为显著。四项肿瘤标记物的联合测定对85例肺腺癌的敏感性为95.29%和准确性83.76%较之单项肿瘤标记物明显增高(P均0.01),而特异性为75.23%适中。结论四项肿瘤标记物血清CEA和糖链抗原(CA125、CA199和CA153)水平的联合测定,是诊断肺腺癌的有效指标,而且提高了敏感性和准确性。     

CA50、CEA、Cyfra21-1和SCC在肺癌患者中的表达及其临床意义

目的探讨血清肿瘤标志物CA50、CEA、Cyfra21-1和SCC在肺癌诊断中的价值。方法采用电化学发光法检测260例肺癌患者、65例肺良性病变患者及117例健康体检者血清CA50、CEA、Cyfra21-1和SCC的含量。结果肺癌患者CA50、CEA、Cyfra21-1和SCC在肺癌患者中的阳性率分别为46.9%、66.5%、57.7%和58.1%,显著高于肺部良性病变患者和健康对照组(P0.05)。CA50、CEA、Cyfra21-1和SCC小细胞肺癌患者较非小细胞肺癌患者表达水平低。CA50和CEA在肺腺癌高表达;而Cyfra21-1在肺鳞癌高表达。结论血清CA50、CEA、Cyfra21-1和SCC检测对于肺癌诊断敏感性和特异性强,并有助于判断病理类型。     

Expression and clinical significance of lung-specific X protein mRNA in bronchial brushing specimens from patients with or without lung cancer

BACKGROUND AND OBJECTIVE: The aim of this study was to evaluate the diagnostic utility of lung-specific X protein (LUNX) mRNA expression in bronchial brushing specimens from patients with lung cancer. METHODS: LUNX mRNA levels were assessed by performing RT-PCR on liquid-based cytology bronchial brushing specimens from patients with lung cancer (n=104) or benign lung disease (n=91). Results: LUNX mRNA expression was significantly more frequent in patients with all carcinomas, squamous cell carcinomas, adenocarcinomas, as well as patients with central, peripheral and diffuse carcinomas (P<0.01), and non-small cell lung carcinomas (P<0.05) compared with patients with benign disease. The diagnostic performance of RT-PCR analysis of LUNX mRNA was significantly better than that of cytology in terms of sensitivity (93.3±4.8% vs 64.4±9.2%), negative predictive value (91.6±6.0% vs 71.1±7.9%) and accuracy (88.7±4.4% vs 81.0±5.5%), whereas specificity (83.5±7.6%) and positive predictive value (86.6±6.3%) were lower than those of cytology (100%). Conclusions: Liquid-based cytology and RT-PCR can be performed to detect LUNX mRNA expression in bronchial brushing specimens, and this technique may be a useful adjunct to cytological diagnosis of lung cancer. The sensitivity of the technique was greater than that of cytology but its lower specificity should be taken into account.