title: The c-myc x E2F-1/p21 interactive gene expression index augments cytomorphologic diagnosis of lung cancer in fine-needle aspirate specimens.
abstract: Morphological analysis of cytologic samples obtained by fine-needle aspirate (FNA) or bronchoscopy is an important method for diagnosing bronchogenic carcinoma. However, this approach has only about 65 to 80% diagnostic sensitivity. Based on previous studies, the c-myc x E2F-1/p21WAF1/CIP1 (p21 hereafter) gene expression index is highly sensitive and specific for distinguishing normal from malignant bronchial epithelial tissues. In an effort to improve sensitivity of diagnosing lung cancer in cytologic specimens, we used Standardized Reverse Transcriptase Polymerase Chain Reaction (StaRT-PCR) to measure the c-myc x E2F-1/p21 index in cDNA samples from 14 normal lung samples (6 normal lung parenchyma and 8 normal bronchial epithelial cell [NBEC] biopsies), and 16 FNA biopsies from 14 suspected tumors. Based on cytomorphologic criteria, 11 of the 14 suspected tumors were diagnosed as bronchogenic carcinoma and three specimens were non-diagnostic. Subsequent biopsy samples confirmed that the three non-diagnostic samples were derived from lung carcinomas. The index value for each bronchogenic carcinoma was above a cut-off value of 7000 and the index value of all but one normal sample was below 7000. Thus the c-myc x E2F-1/p21 index may augment cytomorphologic diagnosis of bronchogenic carcinoma biopsy samples, particularly those considered non-diagnostic by cytomorphologic criteria.
authors.affiliation: Department of Medicine, Medical College of Ohio, Toledo, Ohio, USA.
authors.forename: Kristy A
authors.initials: KA
authors.lastname: Warner
authors.forename: Erin L
authors.initials: EL
authors.lastname: Crawford
authors.forename: Aiman
authors.initials: A
authors.lastname: Zaher
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Coombs
authors.forename: Haitham
authors.initials: H
authors.lastname: Elsamaloty
authors.forename: Stacie L
authors.initials: SL
authors.lastname: Roshong-Denk
authors.forename: Imran
authors.initials: I
authors.lastname: Sharief
authors.forename: Guillermo V
authors.initials: GV
authors.lastname: Amurao
authors.forename: Yongsook
authors.initials: Y
authors.lastname: Yoon
authors.forename: Amro Y
authors.initials: AY
authors.lastname: Al-Astal
authors.forename: Ragheb A
authors.initials: RA
authors.lastname: Assaly
authors.forename: Dawn-Alita R
authors.initials: DA
authors.lastname: Hernandez
authors.forename: Timothy G
authors.initials: TG
authors.lastname: Graves
authors.forename: Charles R
authors.initials: CR
authors.lastname: Knight
authors.forename: Michael W
authors.initials: MW
authors.lastname: Harr
authors.forename: Todd B
authors.initials: TB
authors.lastname: Sheridan
authors.forename: Jeffrey P
authors.initials: JP
authors.lastname: DeMuth
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Zahorchak
authors.forename: Jeffrey R
authors.initials: JR
authors.lastname: Hammersley
authors.forename: Dan E
authors.initials: DE
authors.lastname: Olson
authors.forename: Samuel J
authors.initials: SJ
authors.lastname: Durham
authors.forename: James C
authors.initials: JC
authors.lastname: Willey
mesh_terms: D000368:Aged; D001707:Biopsy, Needle; D018797:Cell Cycle Proteins; D050759:Cyclin-Dependent Kinase Inhibitor p21; D016213:Cyclins / Q000235:genetics*; D004268:DNA-Binding Proteins; D050684:E2F Transcription Factors; D050687:E2F1 Transcription Factor; D005260:Female; D015870:Gene Expression; D016259:Genes, myc; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000235:genetics / Q000473:pathology; D008297:Male; D008875:Middle Aged; D020133:Reverse Transcriptase Polymerase Chain Reaction; D012680:Sensitivity and Specificity; D014157:Transcription Factors / Q000235:genetics*
chemical_list: C493956:CDKN1A protein, human; D018797:Cell Cycle Proteins; D050759:Cyclin-Dependent Kinase Inhibitor p21; D016213:Cyclins; D004268:DNA-Binding Proteins; D050684:E2F Transcription Factors; D050687:E2F1 Transcription Factor; C493753:E2F1 protein, human; D014157:Transcription Factors