title: Diagnostic value of metabolic phenotypes in malignant pleural effusions: expression of GLUT1 and CAIX by immunocytochemistry.
abstract: BACKGROUND
  The sensitivity of conventional cytology for the detection of malignant cells in pleural effusion is insufficient. GLUT1 and CAIX are the hallmarks of metabolic change in cancer cells. The aim of this study was to evaluate the usefulness of GLUT1 and CAIX expression to the detection of cancer cells in pleural effusions.
  
  
  METHODS
  A total of 150 pleural effusions were subjected to immunocytochemical staining for GLUT1 and CAIX expression. According to their cytological diagnosis and etiology, these included 58 benign effusions, 38 probable malignant effusions, 7 atypical effusions, and 47 malignant effusions,.
  
  
  RESULTS
  None of the benign effusions showed GLUT1 or CAIX expression, but probable malignant effusions and malignant effusions significantly expressed GLUT1 and CAIX with a positive result in 74.5% and 63.8% of the malignant effusions, respectively, with 100% specificity. When the combination of both markers was evaluated, GLUT1 and CAIX displayed a higher diagnostic performance, ie, a sensitivity of 76.6%, specificity of 100%, and accuracy of 89.5%. A statistically significant positive correlation between GLUT1 and CAIX expression was observed. In addition, 18% of cases with cells resembling mesothelial cell hyperplasia in probable malignant effusions and 71.4% of cases with atypical cells of uncertain significance in atypical effusions were highlighted on GLUT1 or/and CAIX immunocytochemical stains.
  
  
  CONCLUSIONS
  Immunocytochemical staining for GLUT1 and CAIX may be a complementary tool for the detection of malignant pleural effusions and is helpful in distinguishing cancer cells from reactive mesothelial cells. A combination of GLUT1 and CAIX immunocytochemical staining can give a higher diagnostic performance.
authors: Department of Cytopathology, Chi Mei Medical Center, Tainan, Taiwan.
authors: Nai-Ding
authors: ND
authors: Liao
authors: Jiunn-Min
authors: JM
authors: Shieh
authors: Wen-Ying
authors: WY
authors: Lee
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000951:Antigens, Neoplasm / Q000096:biosynthesis*; D014408:Biomarkers, Tumor / Q000096:biosynthesis; D000071231:Carbonic Anhydrase IX; D002256:Carbonic Anhydrases / Q000096:biosynthesis*; D005260:Female; D051272:Glucose Transporter Type 1 / Q000096:biosynthesis*; D006801:Humans; D007150:Immunohistochemistry / Q000379:methods; D008297:Male; D008875:Middle Aged; D016066:Pleural Effusion, Malignant / Q000175:diagnosis* / Q000378:metabolism*; D011446:Prospective Studies; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
chemical_list: D000951:Antigens, Neoplasm; D014408:Biomarkers, Tumor; D051272:Glucose Transporter Type 1; C495677:SLC2A1 protein, human; C089226:CA9 protein, human; D000071231:Carbonic Anhydrase IX; D002256:Carbonic Anhydrases