Detection of Lung Cancer using MAGE A1-6 and SSX4 RT-PCR Expression Profiles in the Bronchial Wash Fluid

Abstract

Bronchial wash fluid may be a useful for detecting lung cancer. To increase the detection rates, we performed molecular analysis with using MAGE A1-6 and SSX4 RT-PCR on bronchial wash fluid specimens. We obtained 57 lung cancer tissue specimens by bronchoscopic biopsy and 131 bronchial washes from 96 patients with lung cancer and 35 patients with benign lung diseases. The MAGE A1-6 and SSX4 gene expressions were investigated in the cancer tissue specimens and bronchial wash fluids. We evaluated the positive detection rates of these methods according to the cytology results and the clinical findings. For the cancer tissue specimens and the bronchial wash fluid, the positive detection rate of MAGE or SSX4 was 91.2% and 75.0%, respectively. Combined MAGE and SSX4 PCR and cytology tests showed an 83.3% detection rate for the bronchial wash fluid. From bronchial washes of patients with benign lung diseases, the positive rates of using MAGE or SSX4 was 11.4%. In the bronchial wash fluid of lung cancer patients, 66.7% of the peripheral cancers were detected by MAGE or SSX4, while examination with cytology did not detect any peripheral lung cancer. The application of both MAGE and SSX4 showed high sensitivity and specificity for the detection of lung cancer. Thus, MAGE and SSX4 RT-PCR may be effectively utilized as additional methods to improve detection of lung cancer with using bronchial wash fluids.