Diagnostic value of MUC1 and EpCAM mRNA as tumor markers in differentiating benign from malignant pleural effusion

Abstract

Compared with CEA and Cyfra21-1, the performance of MUC1 and EpCAM mRNA in malignant PE diagnosis was better. MUC1 and EpCAM mRNA in combination with cytology is a highly sensitive and specific diagnostic tool for detecting malignancy in PE.

The role of liquid‐based cytology and ancillary techniques in pleural and pericardic effusions: An institutional experience

“…Although no specific guidelines for the optimal or best processing of FNAC effusions have been proposed in recent years, several authors have reported reliable data with the application of conventional cytology, which has been the cornerstone of cytologic preparations for many years . With this perspective, we have analyzed our 13‐year experience using LBC preparations, underscoring the pros and cons of this method reported in the recent literature …”

“…In fact, in 572 of 2505 pleural NM effusions that had unequivocal interpretations, we combined the morphologic evaluations of LBC slides and cell blocks obtained from stored LBC material, and the results were concordant in all of the 572 samples that were analyzed; therefore, in those samples, we did not perform any ICC. Nevertheless, we are conscious that, according to data published by Sun et al, results from an immunopanel may be useful in supporting some “critical” morphologic findings, which can overlap between reactive mesothelial cells and mesothelioma even among experienced cytopathologists . In addition, although we did not use any immunomarkers, a growing body of literature is encouraging the diagnostic value of some immunomarkers (ie, claudin‐4 or mucin‐1) with high sensitivity and specificity for discriminating between reactive mesothelial cells and metastatic adenocarcinomas …”

“…The first critical role of FNAC in effusions is to discriminate between benign and malignant disease and to rule out a diagnosis of benign reactive mesothelial cells versus adenocarcinoma and epithelial mesothelioma . Indeed, as highlighted by Ylagan et al, the overlapping cytologic features in some samples may prevent a more definitive diagnosis, and a panel of immunomarkers is strongly suggested when a cytopathologist faces this issue …”

“…Overall, some original and review articles have pointed to the application of ICC as well as fluorence in situ hybridization, comparative genomic hybridization, and other molecular techniques mainly for 2 clinical scenarios: searching for metastatic cells and characterizing mesothelioma . Although the application for ancillary techniques represented a valid aid even in our study, we assessed the central role of morphology in FNAC for drawing attention to the performance of a specific useful panel unless we were testing unknown malignancies.…”

“…In addition, a strong diagnostic aid in assessing cytologic morphology is the increasing and accurate application of ancillary techniques (both molecular testing and immunocytochemistry [ICC]) to cytology, including malignant effusions, with diagnostic and predictive intent . Several groups have attempted to define the best combination of immunomarkers for diagnosing effusions, which has resulted in a lucky application of these techniques for diagnostic, therapeutic, and prognostic purposes, especially when LBC is adopted …”