title: Assessment of a panel of tumor markers for the differential diagnosis of benign and malignant effusions by well-based reverse phase protein array.
abstract: BACKGROUND
  The differential diagnosis of benign and malignant effusion is often hampered by low cell content or insufficiently preserved tumor cells. In this study, we evaluated the combined diagnostic value of six tumor markers measured by well-based reverse-phase protein array (RPPA) for diagnosis of malignant effusion.
  
  
  METHODS
  A total of 114 patients (46 with malignant effusions, 32 with probable malignant effusions, and 36 with benign effusions) were enrolled. Expressional levels of MUC1, EMA, Pan-CK, HSP90, TGF-β and CA125 were determined by well-based RPPA.
  
  
  RESULTS
  Median relative expression of MUC1, Pan-CK and EMA were significantly higher in malignant effusion than those in probable malignant or benign (p < 0.001, p = 0.003, p < 0.001, respectively), whereas the level of TGF-β in malignant effusions were significantly lower than that in the other groups (p = 0.005). For predicting malignancy, EMA presented the best areas under the curve of 0.728 followed by MUC1 of 0.701. The sensitivity of 52.0% for MUC1 and 48.0% for EMA were not better than cytology. However, sensitivity, negative predictive value, and accuracy of the tumor marker panel were better than cytology by 14.7%, 7.5%, and 6.1%, respectively.
  
  
  CONCLUSIONS
  Tumor marker panel measured by well-based RPPA showed values in the differential diagnosis between benign and malignant effusions. Further large scale studies need to be performed to evaluate the utility of this panel of markers.
  The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1433424467160224.
authors.affiliation: Laboratory of Pathology, National Cancer Institute, National Institutes of Health, Bethesda, MD, 20892, USA. till.braunschweig@web.de.|Institute of Pathology, RWTH Aachen University, Aachen, 52074, Germany. till.braunschweig@web.de.
authors.forename: Till
authors.initials: T
authors.lastname: Braunschweig
authors.affiliation: Laboratory of Pathology, National Cancer Institute, National Institutes of Health, Bethesda, MD, 20892, USA. chungjo@mail.nih.gov.
authors.forename: Joon-Yong
authors.initials: JY
authors.lastname: Chung
authors.affiliation: Laboratory of Pathology, National Cancer Institute, National Institutes of Health, Bethesda, MD, 20892, USA. chelhun.choi@nih.gov.|Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, 135-710, Republic of Korea. chelhun.choi@nih.gov.
authors.forename: Chel Hun
authors.initials: CH
authors.lastname: Choi
authors.affiliation: Laboratory of Pathology, National Cancer Institute, National Institutes of Health, Bethesda, MD, 20892, USA. hanbyoul@yuhs.ac.|Department of Obstetrics and Gynecology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, 135-720, Republic of Korea. hanbyoul@yuhs.ac.
authors.forename: Hanbyoul
authors.initials: H
authors.lastname: Cho
authors.affiliation: Oncogenomics Section, Pediatric Oncology Branch, National Cancer Insititute, National Institutes of Health, Bethesda, MD, 20892, USA. chenqi@mail.nih.gov.|Present affiliation: Center for Biomedical Informatics and Information Technology, National Cancer Institute, National Institutes of Health, Bethesda, MD, 20892, USA. chenqi@mail.nih.gov.
authors.forename: Qing-Rong
authors.initials: QR
authors.lastname: Chen
authors.affiliation: Laboratory of Pathology, National Cancer Institute, National Institutes of Health, Bethesda, MD, 20892, USA. xie_ran@yahoo.com.
authors.forename: Ran
authors.initials: R
authors.lastname: Xie
authors.affiliation: Laboratory of Pathology, National Cancer Institute, National Institutes of Health, Bethesda, MD, 20892, USA. perrycd@mail.nih.gov.|Antibody Characterization Laboratory, Advanced Technology Program, Leidos Biomedical Research, Inc., Frederick, MD, USA. perrycd@mail.nih.gov.
authors.forename: Candice
authors.initials: C
authors.lastname: Perry
authors.affiliation: Oncogenomics Section, Pediatric Oncology Branch, National Cancer Insititute, National Institutes of Health, Bethesda, MD, 20892, USA. khanjav@mail.nih.gov.
authors.forename: Javed
authors.initials: J
authors.lastname: Khan
authors.affiliation: Laboratory of Pathology, National Cancer Institute, National Institutes of Health, Bethesda, MD, 20892, USA. genejock@helix.nih.gov.
authors.forename: Stephen M
authors.initials: SM
authors.lastname: Hewitt
mesh_terms: D019540:Area Under Curve; D014408:Biomarkers, Tumor / Q000032:analysis*; D016000:Cluster Analysis; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008297:Male; D010996:Pleural Effusion / Q000175:diagnosis* / Q000209:etiology / Q000378:metabolism*; D016066:Pleural Effusion, Malignant / Q000737:chemistry* / Q000175:diagnosis* / Q000209:etiology; D011237:Predictive Value of Tests; D040081:Protein Array Analysis; D012372:ROC Curve
chemical_list: D014408:Biomarkers, Tumor