Tuberc Respir Dis.  2004 Feb;56(2):159-168. 10.4046/trd.2004.56.2.159.

Diagnostic Utility of MAGE Expression in Exudative Pleural Effusion

Affiliations
  • 1Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Korea. jeon425@dsmc.or.kr
  • 2Department of Immunology, Keimyung University School of Medicine, Daegu, Korea.
  • 3Department of Laboratory Medicine, School of Medicine, Catholic University of Daegu, Daegu, Korea.

Abstract

BACKGROUND: In recent years, numerous human tumor specific antigens such as melanoma antigen gene(MAGE) that is recognized by autologous cytotoxic T lymphocytes have been identified. MAGE is expressed in many human malignancies in various organs, such as lung, breast, stomach, esophagus and leukemia. Therefore MAGE has been studied widely for tumor diagnosis and immunotherapy. But, so far there were no clinical studies evaluating the role of MAGE in pleural effusion. We investigated the expression of MAGE in the patients with exudative pleural effusion for it's diagnostic utility and the RESULTS: were compared with those of cytologic examinations.
METHODS
Diagnostic thoracentesis was performed in 44 consecutive patients with exudative pleural effusion during 6 months. We examined the expression of MAGE and cytology with the obtained pleural effusion. Expression of MAGE was interpreted by means of a commercial kit using RT-PCR method. Enrolled patients were divided into two groups such as malignant and benign and we analyzed its' sensitivity and specificity.
RESULTS
There were no significant differences between two groups in age, sex, white blood cell counts in pleural fluid, pleural fluid/serum protein ratio and pleural fluid/serum LDH ratio. The sensitivity and specificity of MAGE were 72.2% and 96.2% respectively and the positive predictive value and negative predictive value of MAGE were also 92.9% and 83.3% respectively. The sensitivity and negative predictive value of cytologic examinations were 66.7% and 81.3% respectively. There were no significant differences between sensitivities of MAGE and cytologic examinations but false positive result of MAGE was found in 1 case of tuberculous pleurisy.
CONCLUSION
MAGE is a sensitive and specific marker for the differential diagnosis between benign and malignant effusion in patients with exudative pleural effusion. And MAGE would provide the equal sensitivity compared with that of cytologic examination in patients with malignant pleural effusion if 5mL of the pleural fluid is examined.

Keyword

MAGE; Cytology; Pleural effusion; Sensitivity; Specificity

MeSH Terms

Breast
Diagnosis
Diagnosis, Differential
Esophagus
Humans
Immunotherapy
Leukemia
Leukocyte Count
Lung
Melanoma
Pleural Effusion*
Pleural Effusion, Malignant
Sensitivity and Specificity
Stomach
T-Lymphocytes, Cytotoxic
Tuberculosis, Pleural
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