title: SHOX2 DNA methylation is a tumour marker in pleural effusions.
abstract: BACKGROUND
  The published sensitivity of cytological examination for malignant pleural effusions (MPE) ranges between 50% and 71%. The Epi proLung® BL Reflex Assay (Epigenomics AG, Berlin, Germany) has been reported as being highly sensitive and specific for lung cancer using bronchial aspirates. We hypothesize the assay to be of use in the detection of MPE.
  
  
  METHODS
  To test our hypothesis, we performed a retrospective cohort study on pleural effusion specimens of 1,270 patients (472 cases and 798 controls). The assay is based on quantification of methylated Short Stature Homeobox gene two (SHOX2) DNA in the specimen measured via multiplex real-time Polymerase Chain Reaction (PCR) on bisulfite-converted DNA.
  
  
  RESULTS
  Surprisingly, the assay detects metastases of lung cancer, as well as metastases of other malignant tumours. With a re-defined cut-off criterion, the test achieved a sensitivity of 39.5% with a specificity of 96.2%.
  
  
  CONCLUSIONS
  This assay is able to detect MPE while not limited to the detection of lung cancer.
authors.affiliation: Institut für Pathologie, Schwerpunkt Cytopathologie, Heinrich-Heine-Universität, Moorenstr.5, 40225 Düsseldorf, Germany. Stefan.Biesterfeld@med.uni-duesseldorf.de.
authors.forename: Peter
authors.initials: P
authors.lastname: Ilse
authors.forename: Stefan
authors.initials: S
authors.lastname: Biesterfeld
authors.forename: Natalia
authors.initials: N
authors.lastname: Pomjanski
authors.forename: Christian
authors.initials: C
authors.lastname: Fink
authors.forename: Martin
authors.initials: M
authors.lastname: Schramm
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000235:genetics* / Q000378:metabolism; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D019175:DNA Methylation; D004273:DNA, Neoplasm / Q000235:genetics* / Q000378:metabolism; D005260:Female; D018398:Homeodomain Proteins / Q000235:genetics* / Q000378:metabolism; D006801:Humans; D008297:Male; D008875:Middle Aged; D010996:Pleural Effusion / Q000235:genetics*; D060888:Real-Time Polymerase Chain Reaction; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D014408:Biomarkers, Tumor; D004273:DNA, Neoplasm; D018398:Homeodomain Proteins; C484664:SHOX2 protein, human
keywords: Cytology; DNA methylation; SHOX2; biomarker; breast cancer; lung cancer; malignant tumour; pleural effusion; quantitative methylation-specific PCR