title: Malignant pleural effusion supernatants are substitutes for metastatic pleural tumor tissues in EGFR mutation test in patients with advanced lung adenocarcinoma.
abstract: BACKGROUND
  Though the possibility of using malignant pleural effusions (MPEs) as alternatives for metastatic pleural tumor tissues (MPTTs) in epidermal growth factor receptor (EGFR) mutation test has been examined, due to the lack of studies comparing the results in matching MPEs and MPTTs, the clinical value of MPEs for advanced adenocarcinoma patients with pleural effusions is not confirmed.
  
  
  METHODS
  EGFR mutation statuses in matching MPTTs, MPE supernatants and cell blocks, of 41 patients with advanced lung adenocarcinoma as diagnosed by thoracoscopy were analyzed using amplification refractory mutation system (ARMS).
  
  
  RESULTS
  EGFR mutations were detected in 46.3% (19/41) of MPTTs, 43.9% (18/41) of MPE supernatants and 56.3% (18/32) of MPE cell blocks by ARMS analysis. Generally, the same EGFR statuses were identified in both MPTTs and matching MPE cell blocks of 81.3% patients (26/32), whereas MPTTs and matching MPE supernatants of 87.8% (36/41) patients shared the same EGFR status. Compared with EGFR mutation detection in MPTTs, the sensitivity of EGFR mutation detection in MPE-cell blocks was 87.5% (14/16), specificity was 75.0% (12/16), while the sensitivity of EGFR mutation detection in MPE-supernatants was 84.2% (16/19), specificity was 90.9% (20/22).
  
  
  CONCLUSIONS
  The high concordance of EGFR mutation statuses between MPEs and MPTTs in lung adenocarcinoma patients with pleural metastasis as determined by ARMS analysis suggests that MPEs, particularly MPE supernatants, may be substitutes for MPTTs in EGFR mutation test.
authors.affiliation: Department of Respiratory Medicine, Changhai Hospital, The Second Military Medical University, Shanghai, China.
authors.forename: Dan
authors.initials: D
authors.lastname: Liu
authors.affiliation: Innovation Center China, AstraZeneca Global R&D, Shanghai, China.
authors.forename: Yachao
authors.initials: Y
authors.lastname: Lu
authors.affiliation: Department of Respiratory Medicine, Changhai Hospital, The Second Military Medical University, Shanghai, China.
authors.forename: Zhenli
authors.initials: Z
authors.lastname: Hu
authors.affiliation: Department of Respiratory Medicine, Changhai Hospital, The Second Military Medical University, Shanghai, China.
authors.forename: Ning
authors.initials: N
authors.lastname: Wu
authors.affiliation: Department of Respiratory Medicine, Changhai Hospital, The Second Military Medical University, Shanghai, China.
authors.forename: Xiaomeng
authors.initials: X
authors.lastname: Nie
authors.affiliation: Department of Respiratory Medicine, Changhai Hospital, The Second Military Medical University, Shanghai, China.
authors.forename: Yang
authors.initials: Y
authors.lastname: Xia
authors.affiliation: Department of Respiratory Medicine, Changhai Hospital, The Second Military Medical University, Shanghai, China.
authors.forename: Yiping
authors.initials: Y
authors.lastname: Han
authors.affiliation: Department of Respiratory Medicine, Changhai Hospital, The Second Military Medical University, Shanghai, China.
authors.forename: Qiang
authors.initials: Q
authors.lastname: Li
authors.affiliation: Innovation Center China, AstraZeneca Global R&D, Shanghai, China.
authors.forename: Guanshan
authors.initials: G
authors.lastname: Zhu
authors.affiliation: Department of Respiratory Medicine, Changhai Hospital, The Second Military Medical University, Shanghai, China.
authors.forename: Chong
authors.initials: C
authors.lastname: Bai
mesh_terms: D000230:Adenocarcinoma / Q000235:genetics*; D000077192:Adenocarcinoma of Lung; D000328:Adult; D000368:Aged; D066246:ErbB Receptors / Q000235:genetics*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000235:genetics*; D008297:Male; D008875:Middle Aged; D009154:Mutation / Q000235:genetics; D016066:Pleural Effusion, Malignant / Q000235:genetics*
chemical_list: D066246:ErbB Receptors