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Assessment of a panel of tumor markers for the differential diagnosis of benign and malignant effusions by well-based reverse phase protein array.

Braunschweig T, Chung JY, Choi CH, Cho H, Chen QR, Xie R, Perry C, Khan J, Hewitt SM - Diagn Pathol (2015)

Bottom Line: For predicting malignancy, EMA presented the best areas under the curve of 0.728 followed by MUC1 of 0.701.The sensitivity of 52.0% for MUC1 and 48.0% for EMA were not better than cytology.However, sensitivity, negative predictive value, and accuracy of the tumor marker panel were better than cytology by 14.7%, 7.5%, and 6.1%, respectively.

View Article: PubMed Central - PubMed

Affiliation: Laboratory of Pathology, National Cancer Institute, National Institutes of Health, Bethesda, MD, 20892, USA. till.braunschweig@web.de.

ABSTRACT

Background: The differential diagnosis of benign and malignant effusion is often hampered by low cell content or insufficiently preserved tumor cells. In this study, we evaluated the combined diagnostic value of six tumor markers measured by well-based reverse-phase protein array (RPPA) for diagnosis of malignant effusion.

Methods: A total of 114 patients (46 with malignant effusions, 32 with probable malignant effusions, and 36 with benign effusions) were enrolled. Expressional levels of MUC1, EMA, Pan-CK, HSP90, TGF-β and CA125 were determined by well-based RPPA.

Results: Median relative expression of MUC1, Pan-CK and EMA were significantly higher in malignant effusion than those in probable malignant or benign (p < 0.001, p = 0.003, p < 0.001, respectively), whereas the level of TGF-β in malignant effusions were significantly lower than that in the other groups (p = 0.005). For predicting malignancy, EMA presented the best areas under the curve of 0.728 followed by MUC1 of 0.701. The sensitivity of 52.0% for MUC1 and 48.0% for EMA were not better than cytology. However, sensitivity, negative predictive value, and accuracy of the tumor marker panel were better than cytology by 14.7%, 7.5%, and 6.1%, respectively.

Conclusions: Tumor marker panel measured by well-based RPPA showed values in the differential diagnosis between benign and malignant effusions. Further large scale studies need to be performed to evaluate the utility of this panel of markers.

Virtual slides: The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1433424467160224.

No MeSH data available.


Related in: MedlinePlus

Box plots of protein concentration among benign, probable malignant and malignant cases. The protein concentrations are displayed by samples origin (a) and disease category (b). The protein concentrations of cytological positive specimens are higher than negative cases. Furthermore, the protein concentration of malignant case is higher than benign (p < 0.001) or probable malignant cases (p = 0.032). *, p < 0.05; **, p < 0.01; ***, p < 0.001
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Fig1: Box plots of protein concentration among benign, probable malignant and malignant cases. The protein concentrations are displayed by samples origin (a) and disease category (b). The protein concentrations of cytological positive specimens are higher than negative cases. Furthermore, the protein concentration of malignant case is higher than benign (p < 0.001) or probable malignant cases (p = 0.032). *, p < 0.05; **, p < 0.01; ***, p < 0.001

Mentions: As expected, the protein concentrations were 1.63-fold higher in effusion specimens positive for malignancy by cytological examination compared to those negative by cytology (mean 81.0 vs 49.8, respectively, p < 0.001). This pattern was observed in both ascites and pleural effusions (p < 0.023) but ascites did not reach statistical significance due to small size of specimen number (Fig. 1a). By diagnosis criteria, the protein concentration in malignant effusion and probable malignant effusion were higher than that in benign effusion (mean 98.3 vs 46.4, p < 0.001 and 77.7 vs. 46.4, p = 0.015, respectively) (Fig. 1b).Fig. 1


Assessment of a panel of tumor markers for the differential diagnosis of benign and malignant effusions by well-based reverse phase protein array.

Braunschweig T, Chung JY, Choi CH, Cho H, Chen QR, Xie R, Perry C, Khan J, Hewitt SM - Diagn Pathol (2015)

Box plots of protein concentration among benign, probable malignant and malignant cases. The protein concentrations are displayed by samples origin (a) and disease category (b). The protein concentrations of cytological positive specimens are higher than negative cases. Furthermore, the protein concentration of malignant case is higher than benign (p < 0.001) or probable malignant cases (p = 0.032). *, p < 0.05; **, p < 0.01; ***, p < 0.001
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4447024&req=5

Fig1: Box plots of protein concentration among benign, probable malignant and malignant cases. The protein concentrations are displayed by samples origin (a) and disease category (b). The protein concentrations of cytological positive specimens are higher than negative cases. Furthermore, the protein concentration of malignant case is higher than benign (p < 0.001) or probable malignant cases (p = 0.032). *, p < 0.05; **, p < 0.01; ***, p < 0.001
Mentions: As expected, the protein concentrations were 1.63-fold higher in effusion specimens positive for malignancy by cytological examination compared to those negative by cytology (mean 81.0 vs 49.8, respectively, p < 0.001). This pattern was observed in both ascites and pleural effusions (p < 0.023) but ascites did not reach statistical significance due to small size of specimen number (Fig. 1a). By diagnosis criteria, the protein concentration in malignant effusion and probable malignant effusion were higher than that in benign effusion (mean 98.3 vs 46.4, p < 0.001 and 77.7 vs. 46.4, p = 0.015, respectively) (Fig. 1b).Fig. 1

Bottom Line: For predicting malignancy, EMA presented the best areas under the curve of 0.728 followed by MUC1 of 0.701.The sensitivity of 52.0% for MUC1 and 48.0% for EMA were not better than cytology.However, sensitivity, negative predictive value, and accuracy of the tumor marker panel were better than cytology by 14.7%, 7.5%, and 6.1%, respectively.

View Article: PubMed Central - PubMed

Affiliation: Laboratory of Pathology, National Cancer Institute, National Institutes of Health, Bethesda, MD, 20892, USA. till.braunschweig@web.de.

ABSTRACT

Background: The differential diagnosis of benign and malignant effusion is often hampered by low cell content or insufficiently preserved tumor cells. In this study, we evaluated the combined diagnostic value of six tumor markers measured by well-based reverse-phase protein array (RPPA) for diagnosis of malignant effusion.

Methods: A total of 114 patients (46 with malignant effusions, 32 with probable malignant effusions, and 36 with benign effusions) were enrolled. Expressional levels of MUC1, EMA, Pan-CK, HSP90, TGF-β and CA125 were determined by well-based RPPA.

Results: Median relative expression of MUC1, Pan-CK and EMA were significantly higher in malignant effusion than those in probable malignant or benign (p < 0.001, p = 0.003, p < 0.001, respectively), whereas the level of TGF-β in malignant effusions were significantly lower than that in the other groups (p = 0.005). For predicting malignancy, EMA presented the best areas under the curve of 0.728 followed by MUC1 of 0.701. The sensitivity of 52.0% for MUC1 and 48.0% for EMA were not better than cytology. However, sensitivity, negative predictive value, and accuracy of the tumor marker panel were better than cytology by 14.7%, 7.5%, and 6.1%, respectively.

Conclusions: Tumor marker panel measured by well-based RPPA showed values in the differential diagnosis between benign and malignant effusions. Further large scale studies need to be performed to evaluate the utility of this panel of markers.

Virtual slides: The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1433424467160224.

No MeSH data available.


Related in: MedlinePlus