Pleural fluid analysis of lung cancer vs benign inflammatory disease patients.
BACKGROUND
Correct diagnosis of pleural effusion (PE) as either benign or malignant is crucial, although conventional cytological evaluation is of limited diagnostic accuracy, with relatively low sensitivity rates.


METHODS
We identified biological markers accurately detected in a simple PE examination. We analysed data from 19 patients diagnosed with lung cancer (nine adeno-Ca, five non-small-cell Ca (not specified), four squamous-cell Ca, one large-cell Ca) and 22 patients with benign inflammatory pathologies: secondary to trauma, pneumonia or TB.


RESULTS
Pleural effusion concentrations of seven analysed biological markers were significantly lower in lung cancer patients than in benign inflammatory patients, especially in matrix metalloproteinase (MMP)-9, MMP-3 and CycD1 (lower by 65% (P<0.000003), 40% (P<0.0007) and 34% (P<0.0001), respectively), and in Ki67, ImAnOx, carbonyls and p27. High rates of sensitivity and specificity values were found for MMP-9, MMP-3 and CycD1: 80 and 100%; 87 and 73%; and 87 and 82%, respectively.


CONCLUSIONS
Although our results are of significant merit in both the clinical and pathogenetic aspects of lung cancer, further research aimed at defining the best combination for marker analysis is warranted. The relative simplicity in analysing these markers in any routine hospital laboratory may result in its acceptance as a new diagnostic tool.
Kremer
R
R
Department of General Thoracic Surgery, Rambam Health Care Campus, Haifa, Israel.
Best
L A
LA
Savulescu
D
D
Gavish
M
M
Nagler
R M
RM
D000230:Adenocarcinoma / Q000378:metabolism; D000368:Aged; D015415:Biomarkers / Q000378:metabolism; D018287:Carcinoma, Large Cell / Q000175:diagnosis / Q000378:metabolism; D002289:Carcinoma, Non-Small-Cell Lung / Q000175:diagnosis / Q000378:metabolism; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis / Q000378:metabolism; D019938:Cyclin D1 / Q000378:metabolism; D005260:Female; D006801:Humans; D019394:Ki-67 Antigen / Q000378:metabolism; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000378:metabolism; D008297:Male; D019278:Matrix Metalloproteinase 3 / Q000378:metabolism; D020780:Matrix Metalloproteinase 9 / Q000378:metabolism; D008875:Middle Aged; D010996:Pleural Effusion / Q000175:diagnosis* / Q000378:metabolism; D011014:Pneumonia / Q000175:diagnosis / Q000378:metabolism
D015415:Biomarkers; D019394:Ki-67 Antigen; D019938:Cyclin D1; D019278:Matrix Metalloproteinase 3; D020780:Matrix Metalloproteinase 9