title: Diagnostic accuracy of human telomerase reverse transcriptase mRNA in malignant pleural effusions: A preliminary report for in situ hybridization detection.
abstract: BACKGROUND
  Detection of human telomerase reverse transcriptase (hTERT) mRNA by in situ hybridization (ISH) may be valuable in the diagnosis of cancer. We assessed the diagnostic performance of hTERT mRNA in cells from pleural fluid in malignant pleural effusions (PEs).
  
  
  METHODS
  We used a 2-step ISH with digoxin-labelled oligonucleotide probes to detect hTERT mRNA in a blinded prospective study of cells from 103 unselected pleural fluid specimens. The reference standard for malignant PEs was clinical evaluation and pleural fluid cytology, combined with pleural biopsy, other examination and follow-up as needed.
  
  
  RESULTS
  According to the final diagnoses, there were 41 malignant PEs, 55 benign PEs and 7 cases with uncertain etiology. When the 7 cryptogenic cases were excluded, the sensitivity and specificity of detectable hTERT mRNA for malignancy were 80% and 95%, respectively. When detection of hTERT mRNA was combined with clinical repeated pleural fluid cytology, the sensitivity and specificity were 90% and 95%, respectively.
  
  
  CONCLUSIONS
  Detection of hTERT mRNA in cells from pleural fluid by ISH could potentially be used in diagnosing malignant PEs as an aid. Further investigations with stricter controls and cross-validation tests will be warranted.
authors.affiliation: Division of Respiratory Medicine, Department of Geriatrics, First Affiliated Hospital of Anhui Medical University, Hefei, Anhui 230022, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Shu
authors.forename: Geng-Yun
authors.initials: GY
authors.lastname: Sun
authors.forename: Ai-Ping
authors.initials: AP
authors.lastname: Liu
authors.forename: Jing
authors.initials: J
authors.lastname: Liu
mesh_terms: D015415:Biomarkers; D001706:Biopsy; D006801:Humans; D017403:In Situ Hybridization; D015345:Oligonucleotide Probes; D010994:Pleura / Q000473:pathology; D016066:Pleural Effusion, Malignant / Q000175:diagnosis* / Q000201:enzymology* / Q000473:pathology; D011446:Prospective Studies; D012333:RNA, Messenger / Q000032:analysis* / Q000096:biosynthesis; D019098:Telomerase / Q000096:biosynthesis* / Q000235:genetics
chemical_list: D015415:Biomarkers; D015345:Oligonucleotide Probes; D012333:RNA, Messenger; D019098:Telomerase