Division of Pneumology, San Bartolomeo Hospital, Sarzana (La Spezia) - Italy.
Int J Biol Markers. 2012 Jul 19;27(2):e99-104. doi: 10.5301/JBM.2012.9305.
human mammaglobin (hMAM) expression has been reported in pleural effusions (PE). The aim of this study was to assess the clinical relevance of hMAM mRNA in PE from patients who underwent thoracoscopy.
A total of 288 patients with PE were studied, 155 of which were diagnosed with malignant and 133 with non-malignant diseases by thoracoscopy. Cells from PE were analyzed by nested hMAM RT-PCR. Statistical analyses were performed to evaluate the diagnostic performance parameters (DPP), the association between hMAM expression and benign or malignant status and the relative risk of cancer for patients with negative thoracoscopy showing hMAM positivity.
hMAM mRNA was found in 68/288 (23.6%) PE samples of which 51 were from the 155 patients diagnosed with malignant diseases and 17 were from the 133 patients diagnosed with non-malignant diseases. A significant correlation between hMAM expression and malignancy was found (OR=3.04) and the DPP were as follows: sensitivity=32.9%, specificity=87.2%, accuracy=58.0%, positive predictive value=75.0% and negative predictive value=52.7%. Among the patients with negative thoracoscopy (n=133), 5/17 (29.4%) hMAM-positive patients had or developed a tumor during the 18-month follow up period, as compared to 10/116 (8.6%) hMAM-negative patients (relative risk of 4.6 for developing a malignancy).
These findings suggest a possible application of hMAM RT-PCR detection in PE as to identify a false-negative thoracoscopy in non-specific pleuritis.
人乳球蛋白（hMAM）在胸腔积液（PE）中已有报道。本研究旨在评估胸腔镜检查患者胸腔积液中 hMAM mRNA 的临床相关性。
共研究了 288 例胸腔积液患者，其中 155 例经胸腔镜诊断为恶性疾病，133 例为非恶性疾病。采用巢式 hMAM RT-PCR 分析胸腔积液细胞。进行统计学分析以评估诊断性能参数（DPP）、hMAM 表达与良性或恶性状态的相关性以及胸腔镜阴性但 hMAM 阳性患者的癌症相对风险。
在 288 例胸腔积液样本中，发现 68 例（23.6%）hMAM mRNA 阳性，其中 51 例来自 155 例诊断为恶性疾病的患者，17 例来自 133 例诊断为非恶性疾病的患者。hMAM 表达与恶性肿瘤显著相关（OR=3.04），DPP 如下：敏感性=32.9%，特异性=87.2%，准确性=58.0%，阳性预测值=75.0%，阴性预测值=52.7%。在胸腔镜阴性的患者（n=133）中，17 例 hMAM 阳性患者中有 5 例（29.4%）在 18 个月的随访期间发生或发展为肿瘤，而 116 例 hMAM 阴性患者中有 10 例（8.6%）（发生恶性肿瘤的相对风险为 4.6）。
这些发现提示 hMAM RT-PCR 检测在胸腔积液中的应用可能有助于识别非特异性胸膜炎中假阴性的胸腔镜检查。
