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. 2014 Feb 28;9(2):e89946.
doi: 10.1371/journal.pone.0089946. eCollection 2014.

Malignant pleural effusion supernatants are substitutes for metastatic pleural tumor tissues in EGFR mutation test in patients with advanced lung adenocarcinoma

Dan Liu  1 , Yachao Lu  2 , Zhenli Hu  1 , Ning Wu  1 , Xiaomeng Nie  1 , Yang Xia  1 , Yiping Han  1 , Qiang Li  1 , Guanshan Zhu  2 , Chong Bai  1
Affiliations

Malignant pleural effusion supernatants are substitutes for metastatic pleural tumor tissues in EGFR mutation test in patients with advanced lung adenocarcinoma

Dan Liu et al. PLoS One. .

Abstract

Background: Though the possibility of using malignant pleural effusions (MPEs) as alternatives for metastatic pleural tumor tissues (MPTTs) in epidermal growth factor receptor (EGFR) mutation test has been examined, due to the lack of studies comparing the results in matching MPEs and MPTTs, the clinical value of MPEs for advanced adenocarcinoma patients with pleural effusions is not confirmed.

Methods: EGFR mutation statuses in matching MPTTs, MPE supernatants and cell blocks, of 41 patients with advanced lung adenocarcinoma as diagnosed by thoracoscopy were analyzed using amplification refractory mutation system (ARMS).

Results: EGFR mutations were detected in 46.3% (19/41) of MPTTs, 43.9% (18/41) of MPE supernatants and 56.3% (18/32) of MPE cell blocks by ARMS analysis. Generally, the same EGFR statuses were identified in both MPTTs and matching MPE cell blocks of 81.3% patients (26/32), whereas MPTTs and matching MPE supernatants of 87.8% (36/41) patients shared the same EGFR status. Compared with EGFR mutation detection in MPTTs, the sensitivity of EGFR mutation detection in MPE-cell blocks was 87.5% (14/16), specificity was 75.0% (12/16), while the sensitivity of EGFR mutation detection in MPE-supernatants was 84.2% (16/19), specificity was 90.9% (20/22).

Conclusions: The high concordance of EGFR mutation statuses between MPEs and MPTTs in lung adenocarcinoma patients with pleural metastasis as determined by ARMS analysis suggests that MPEs, particularly MPE supernatants, may be substitutes for MPTTs in EGFR mutation test.

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Conflict of interest statement

Competing Interests: Chong Bai was supported by Wu Jie-Ping Research Fund, Guanshan Zhu and Yachao Lu received honoraria from AstraZeneca. The authors in the list who are affiliated to AstraZeneca did important work on implementing experiments and polishing the English of drafts. This does not alter the authors' adherence to all the PLOS ONE policies on sharing data and materials.

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