title: Microsatellite analysis of pleural supernatants could increase sensitivity of pleural fluid cytology.
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.
authors.affiliation: Department of Pathology, University of Regensburg, Franz-Josef-Strauss-Allee 11, D-93053 Regensburg, Germany. matthias.woenckhaus@klinik.uni-regensburg.de
authors.forename: Matthias
authors.initials: M
authors.lastname: Woenckhaus
authors.forename: Ulrike
authors.initials: U
authors.lastname: Grepmeier
authors.forename: Bernhard
authors.initials: B
authors.lastname: Werner
authors.forename: Christian
authors.initials: C
authors.lastname: Schulz
authors.forename: Felix
authors.initials: F
authors.lastname: Rockmann
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Wild
authors.forename: Georg
authors.initials: G
authors.lastname: Röckelein
authors.forename: Hagen
authors.initials: H
authors.lastname: Blaszyk
authors.forename: Marion
authors.initials: M
authors.lastname: Schuierer
authors.forename: Ferdinand
authors.initials: F
authors.lastname: Hofstaedter
authors.forename: Arndt
authors.initials: A
authors.lastname: Hartmann
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Dietmaier
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001826:Body Fluids / Q000166:cytology / Q000378:metabolism*; D003955:Diagnostic Tests, Routine / Q000379:methods*; D005260:Female; D005819:Genetic Markers / Q000235:genetics; D006801:Humans; D019656:Loss of Heterozygosity / Q000235:genetics; D008297:Male; D018895:Microsatellite Repeats / Q000235:genetics*; D008875:Middle Aged; D009369:Neoplasms / Q000175:diagnosis / Q000235:genetics / Q000473:pathology; D010994:Pleura / Q000166:cytology / Q000378:metabolism* / Q000473:pathology*; D012680:Sensitivity and Specificity
chemical_list: D005819:Genetic Markers