在疑似肺癌病变的经皮穿刺针吸活检组织样本中分析黑色素瘤抗原 (MAGE) 基因的效用。

Usefulness of melanoma antigen (MAGE) gene analysis in tissue samples from percutaneous needle aspiration biopsy of suspected lung cancer lesions.

机构信息

Department of Radiology, Research Institute of Radiological Science, Yonsei University Health System, Republic of Korea.

出版信息

Lung Cancer. 2010 Sep;69(3):284-8. doi: 10.1016/j.lungcan.2009.12.003. Epub 2010 Jan 12.

DOI:10.1016/j.lungcan.2009.12.003

PMID:20064673

Abstract

BACKGROUND

As mortality from lung cancer is still very high, early detection prior to metastasis is important in clinical settings. We prospectively evaluated the clinical usefulness of a reverse transcription-nested polymerase chain reaction (RT-nested PCR) using melanoma antigen (MAGE) A1-6 genes with tissue samples obtained from the percutaneous needle aspiration (PCNA) biopsies used in the diagnosis of lung cancer.

METHODS

We enrolled 53 patients with suspected lung cancer based on CT scan (M:F, 39:14; mean age 61 years). A PCNA biopsy was performed twice and lung cancer was diagnosed by a pathological examination. The MAGE genes were analyzed using RT-nested PCR from tissue samples obtained from the PCNA biopsy of the lesion. We compared the results from the RT-nested PCR and the pathologic diagnosis. We also analyzed the sensitivity, specificity, accuracy, positive predictive value (PPV) and negative predictive value (NPV).

RESULTS

Of the 53 patients, 39 were diagnosed with lung cancer. Six patients had tuberculosis and 8 were confirmed with chronic inflammation or benign lesion. Based on the RT-nested PCR examination, 41 of 53 patients were positive for the MAGE gene: 34 of 39 patients had lung cancer; 5 of 6 patients had tuberculosis; and 2 of 8 patients had chronic inflammation or benign lesion. The sensitivity, specificity, accuracy, PPV and NPV were 83%, 58%, 77%, 87% and 55%, respectively.

CONCLUSION

MAGE gene analysis by RT-nested PCR may be a useful method for the diagnosis of lung cancer, but it is still limited in patients with tuberculosis.

摘要

背景

由于肺癌的死亡率仍然很高，因此在转移之前进行早期检测在临床环境中非常重要。我们前瞻性地评估了使用黑色素瘤抗原（MAGE）A1-6 基因的逆转录-嵌套聚合酶链反应（RT-nested PCR）在经皮针吸活检（PCNA）活检中获得的组织样本检测肺癌的临床用途。

方法

我们根据 CT 扫描纳入了 53 例疑似肺癌患者（M：F，39：14；平均年龄 61 岁）。进行了两次 PCNA 活检，并通过病理检查诊断为肺癌。使用 RT-nested PCR 分析来自病变 PCNA 活检的组织样本中的 MAGE 基因。我们比较了 RT-nested PCR 和病理诊断的结果。我们还分析了敏感性、特异性、准确性、阳性预测值（PPV）和阴性预测值（NPV）。

结果

53 例患者中，39 例被诊断为肺癌。6 例患有肺结核，8 例被证实为慢性炎症或良性病变。根据 RT-nested PCR 检查，53 例患者中有 41 例 MAGE 基因阳性：39 例患者中有 34 例患有肺癌；6 例肺结核患者中有 5 例；8 例慢性炎症或良性病变患者中有 2 例。敏感性、特异性、准确性、PPV 和 NPV 分别为 83%、58%、77%、87%和 55%。