title: Nonenriched PCR Versus Mutant-Enriched PCR in Detecting Selected Epidermal Growth Factor Receptor Gene Mutations Among Nonsmall-Cell Lung Cancer Patients.
abstract: BACKGROUND
  Biopsies obtained from lung cancers contain a mixture of cancerous and healthy tissues. The mutant-enriched polymerase chain reaction (ME-PCR) identifies low-level somatic DNA mutations within an excess wild-type sample.
  
  
  OBJECTIVE
  This study aimed at comparing nonenriched PCR (NE-PCR) versus ME-PCR for the detection of two epidermal growth factor receptor (EGFR) gene mutations among nonsmall cell lung cancer patients.
  
  
  METHODS
  Fifty lung tissue biopsies were screened for inframe TTAA deletions in exon-19 and the L858R point mutation in exon-21, using ME-PCR and NE-PCR, followed by capillary electrophoresis.
  
  
  RESULTS
  Only exon-19 deletions were detected in 22% and 18% of cases using ME-PCR and NE-PCR, respectively. Diagnostic performance of the NE-PCR versus the ME-PCR serving as a "gold standard" revealed a sensitivity of 82%, and a specificity of 100%, with positive and negative predictive values of 100% and 95%, respectively, and an overall accuracy of 96%. Despite a strong agreement shown between the two assays (K=0.875), the NE-PCR showed an 18% false-negative rate in bronchoscopically obtained biopsies compared to ME-PCR.
  
  
  CONCLUSIONS
  The false negativity encountered with NE-PCR in bronchoscopically obtained samples makes ME-PCR the technique of choice in such situations.
authors.affiliation: 1 Department of Chemical Pathology, Medical Research Institute, Alexandria University, Alexandria, Egypt .
authors.forename: Moyassar Ahmad
authors.initials: MA
authors.lastname: Zaki
authors.affiliation: 1 Department of Chemical Pathology, Medical Research Institute, Alexandria University, Alexandria, Egypt .
authors.forename: Ragaa Abd El Kader
authors.initials: RA
authors.lastname: Ramadan
authors.affiliation: 2 Department of Chest Diseases, Faculty of Medicine, Alexandria University , Alexandria, Egypt .
authors.forename: Mahmoud Ibrahim
authors.initials: MI
authors.lastname: Mahmoud
authors.affiliation: 3 Department of Clinical Pathology, Faculty of Medicine, Alexandria University , Alexandria, Egypt .
authors.forename: Dalal Mohammed
authors.initials: DM
authors.lastname: El-Kaffash
authors.affiliation: 1 Department of Chemical Pathology, Medical Research Institute, Alexandria University, Alexandria, Egypt .
authors.forename: Rami Samir
authors.initials: RS
authors.lastname: Assaad
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000175:diagnosis / Q000235:genetics*; D066246:ErbB Receptors / Q000235:genetics*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis / Q000235:genetics*; D008297:Male; D008875:Middle Aged; D017354:Point Mutation; D016133:Polymerase Chain Reaction / Q000379:methods*; D020641:Polymorphism, Single Nucleotide; D015203:Reproducibility of Results; D017384:Sequence Deletion
chemical_list: C512478:EGFR protein, human; D066246:ErbB Receptors