Detection of telomerase activity in bronchial lavage as an adjunct to cytological diagnosis in lung cancer

• Published in: European journal of cardio-thoracic surgery Vol. 23; no. 2; pp. 194 - 199
• Main Authors: Dikmen, Erkan, Kara, Murat, Dikmen, Günnur, Çakmak, Hüseyin, Dogan, Pakize
• Format: Journal Article
• Language: English
• Published: Germany Elsevier Science B.V 01.02.2003
• Subjects: Adult; Aged; Biomarkers, Tumor - analysis; Bronchial lavage; Bronchoalveolar Lavage Fluid - chemistry; Carcinoma, Small Cell - diagnosis; Carcinoma, Squamous Cell - diagnosis; Diagnosis, Differential; Female; Humans; Lung Abscess - diagnosis; Lung cancer; Lung Neoplasms - diagnosis; Male; Middle Aged; Polymerase Chain Reaction - methods; Predictive Value of Tests; Sensitivity and Specificity; Telomerase; Telomerase - analysis; Telomerase; Lung cancer; Bronchial lavage
• ISSN: 1010-7940; 1873-734X
• DOI: 10.1016/S1010-7940(02)00741-8

Objective: Definitive diagnosis of lung cancer with conventional methods may sometimes be difficult in clinical practice. Telomerase is a ribonucleoprotein DNA polymerase that maintains the telomeric region of chromosomes during successive rounds of cell division. Telomerase activity in body cavity fluids has been advocated to be a potential diagnostic marker for malignancy. We investigated the diagnostic value of telomerase activity in bronchial lavage samples of patients undergoing diagnosis of lung cancer. Methods: A total of 29 bronchial lavage samples were collected from patients in whom the diagnosis was confirmed with cytological and/or histological examinations. Patients were classified as lung cancer patients (Group 1, n=22) and patients with benign disease (Group 2, n=7). Telomerase activity was determined with polymerase chain reaction-based TRAP (The telomeric repeat amplification protocol) assay. Results: Cytological examination was diagnostic in 12 (54.5%) of 22 patients in Group 1, and in all seven patients of Group 2 (P=0.063). Telomerase activity was positive in 16 (72.7%) of Group 1 patients, while it was positive in only 1 (14.3%) sample of a lung abscess in Group 2 (P=0.011). The sensitivity rate of cytological examination when combined with telomerase activity (81.8%) was significantly greater than that of cytological examination alone (54.5%) (P=0.031). The sensitivity and specificity of telomerase activity were 72.7 and 85.7%, respectively. Telomerase activity had a positive predictive value as 0.94 and negative predictive value as 0.50. Diagnostic accuracy of telomerase activity was 75.8%. Conclusion: Telomerase activity in bronchial lavage is a highly sensitive diagnostic biomarker for malignancy and a potential complementary diagnostic technique to cytological examination in the diagnosis of lung cancer.