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Am. J. Respir. Crit. Care Med., Volume 164, Number 7, October 2001, 1312-1318

Application of Mucin Quantitative Competitive Reverse Transcription Polymerase Chain Reaction in Assisting the Diagnosis of Malignant Pleural Effusion

CHONG-JEN YU, JIN-YUH SHEW, YUANG-SHUANG LIAW, SOW-HSONG KUO, KWEN-TAY LUH, and PAN-CHYR YANG

Departments of Internal Medicine and Laboratory Medicine, National Taiwan University Hospital; and Department of Biochemistry, National Taiwan University, College of Medicine, Taipei, Taiwan

Aberrant expression of mucin genes occurs frequently in advanced cancer. Using quantitative competitive reverse transcriptase/polymerase chain reaction (QC RT-PCR), the expression of three mucin genes-MUC1 (widely expressed in epithelial cells), MUC2 (mainly expressed in intestinal epithelial cells), and MUC5AC (mainly from airway and gastric epithelial cells)-was evaluated in 112 patients with pleural effusions (including 54 cytologically positive malignant pleural effusions, 35 benign exudative pleural fluids, and 23 cytologically negative pleural effusions from cancer patients). The expression ratios of MUC1 and MUC5AC, but not MUC2 gene, were significantly higher in malignant than benign pleural fluids (p < 0.000). The cutoff value, sensitivity, and specificity of MUC1 expression ratio were: 0.126, 64.6%, and 95.7%; and were 0.028, 72.3%, and 95.7%, respectively, for MUC5AC. In combined evaluation with both MUC1 and MUC5AC, the sensitivity was 86.1% and specificity was 91.5%. The positive and negative predictive values were 93.3%, and 82.7%, respectively. We considered mucin QC RT-PCR to be a useful tool in assisting the diagnosis of malignant pleural effusion.




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