Shu Jun, Sun Geng-Yun, Liu Ai-Ping, Liu Jing
Division of Respiratory Medicine, Department of Geriatrics, First Affiliated Hospital of Anhui Medical University, Hefei, Anhui 230022, China.
Clin Chim Acta. 2007 Jun;381(2):131-5. doi: 10.1016/j.cca.2007.02.040. Epub 2007 Mar 3.
Detection of human telomerase reverse transcriptase (hTERT) mRNA by in situ hybridization (ISH) may be valuable in the diagnosis of cancer. We assessed the diagnostic performance of hTERT mRNA in cells from pleural fluid in malignant pleural effusions (PEs).
We used a 2-step ISH with digoxin-labelled oligonucleotide probes to detect hTERT mRNA in a blinded prospective study of cells from 103 unselected pleural fluid specimens. The reference standard for malignant PEs was clinical evaluation and pleural fluid cytology, combined with pleural biopsy, other examination and follow-up as needed.
According to the final diagnoses, there were 41 malignant PEs, 55 benign PEs and 7 cases with uncertain etiology. When the 7 cryptogenic cases were excluded, the sensitivity and specificity of detectable hTERT mRNA for malignancy were 80% and 95%, respectively. When detection of hTERT mRNA was combined with clinical repeated pleural fluid cytology, the sensitivity and specificity were 90% and 95%, respectively.
Detection of hTERT mRNA in cells from pleural fluid by ISH could potentially be used in diagnosing malignant PEs as an aid. Further investigations with stricter controls and cross-validation tests will be warranted.
通过原位杂交（ISH）检测人端粒酶逆转录酶（hTERT）mRNA在癌症诊断中可能具有重要价值。我们评估了hTERT mRNA在恶性胸腔积液（PE）患者胸液细胞中的诊断效能。
在一项对103份未经选择的胸液标本细胞进行的前瞻性盲法研究中，我们使用地高辛标记的寡核苷酸探针进行两步ISH检测hTERT mRNA。恶性PE的参考标准是临床评估、胸液细胞学检查，并根据需要结合胸膜活检、其他检查及随访结果。
根据最终诊断，有41例恶性PE、55例良性PE和7例病因不明的病例。排除7例隐源性病例后，可检测到的hTERT mRNA对恶性肿瘤的敏感性和特异性分别为80%和95%。当hTERT mRNA检测与临床重复胸液细胞学检查相结合时，敏感性和特异性分别为90%和95%。
通过ISH检测胸液细胞中的hTERT mRNA可能有助于诊断恶性PE。有必要进行更严格对照和交叉验证试验的进一步研究。
