Epithelial cell adhesion molecule (EpCAM) from pleural fluid cell lysates is a highly accurate diagnostic biomarker of adenocarcinomatous effusions
Por:
Porcel, JM, Esquerda, A, Bielsa, S, Novell, A, Sorolla, MA, Gatius, S, Zamora, C, Vidal, S, Salud, A
Publicada:
1 ago 2019
Resumen:
Background and objective The discovery of highly accurate pleural fluid (PF) biomarkers of malignancy remains elusive. We assessed the operating characteristics of the PF epithelial cell adhesion molecule (EpCAM), claudin 4 (CL4) and human epididymis protein 4 (HE4) as potential markers of epithelial malignancies. Methods The three markers were quantified by immunoassays in the supernatants (s) and cell lysates (cl) of 175 PF samples. The cut-off values with 100% specificity were selected for malignant-benign discrimination. An immunocytochemical staining index score for each marker was also evaluated on PF cell blocks. The resulting best biomarker was further validated in two independent populations of 73 and 48 patients with pleural effusions (PE). Results An EpCAM(cl) >98 pg/g total lysate protein yielded 75% sensitivity, 100% specificity, negative likelihood ratio of 0.25 and area under the curve of 0.94 for labelling adenocarcinomatous effusions. Sensitivity reached 88% if EpCAM(cl) was combined with EpCAM immunostaining. One-third or more of the malignant effusions exhibiting a false-negative cytological fluid examination were correctly classified by EpCAM(cl) concentrations. Immunoassays for CL4 and HE4 were diagnostically useless. Conclusion EpCAM(cl) is a new biomarker of adenocarcinomatous PE with meaningful discriminating properties.
Filiaciones:
Porcel, JM:
Arnau de Vilanova Univ Hosp, Dept Internal Med, Pleural Med Unit, Ave Alcalde Rovira Roure 80, Lleida 25198, Spain
IRBLleida, Res Grp Canc Biomarkers, Lleida, Spain
Esquerda, A:
IRBLleida, Res Grp Canc Biomarkers, Lleida, Spain
Arnau de Vilanova Univ Hosp, Dept Lab Med, Lleida, Spain
Bielsa, S:
Arnau de Vilanova Univ Hosp, Dept Internal Med, Pleural Med Unit, Ave Alcalde Rovira Roure 80, Lleida 25198, Spain
IRBLleida, Res Grp Canc Biomarkers, Lleida, Spain
Novell, A:
IRBLleida, Res Grp Canc Biomarkers, Lleida, Spain
Sorolla, MA:
IRBLleida, Res Grp Canc Biomarkers, Lleida, Spain
Gatius, S:
Arnau de Vilanova Univ Hosp, Dept Pathol, Lleida, Spain
Zamora, C:
Hosp Santa Creu & Sant Pau, Inst Recerca, Dept Immunol, Barcelona, Spain
Vidal, S:
Hosp Santa Creu & Sant Pau, Inst Recerca, Dept Immunol, Barcelona, Spain
Salud, A:
IRBLleida, Res Grp Canc Biomarkers, Lleida, Spain
Arnau de Vilanova Univ Hosp, Dept Med Oncol, Lleida, Spain
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