Diagnostic utility of MOC-31, HBME-1 and MOC-31 mRNA in distinguishing between carcinoma cells and reactive mesothelial cells in pleural effusions.

OBJECTIVE

To evaluate the individual and combined diagnostic utility of MOC-31, HBME-1 and MOC-31mRNA in the differentiation of adenocarcinoma cells from reactive mesothelial cells in pleural effusions.

STUDY DESIGN

To subject the cells from 293 pleural effusions to immunocytochemical staining for MOC-31 and HBME-1 and reverse transcriptase polymerase chain reaction for the expression of MOC-31.

RESULTS

MOC-31 and MOC-31mRNA expression were significantly higher in the cancer cell group and in 3 subgrouped as adenocarcinoma, squamous cell carcinoma and small cell lung carcinoma than in the mesothelial cell group, whereas HBME-1 expression was obviously lower in those (p < 0.01). In single use, MOC-31mRNA had the highest sensitivity (90.8%) and accuracy (91.5%), whereas MOC-31 had the highest specificity (100%). When combinations of markers were evaluated together, MOC-31mRNA and HBME-1 gave a high diagnostic performance: sensitivity of 96.7% and accuracy of 95.2%, respectively.

CONCLUSION

The detection of MOC-31, HBME-1 and MOC-31-mRNA is helpful in distinguishing between cancer and reactive mesothelial cells in pleural effusions. MOC-31mRNA could be useful to the diagnosis of pleural micrometastasis.