ABSTRACT
The sensitivity of conventional cytology for the detection of malignant cells in pleural effusion is insufficient. Since survivin is frequently overexpressed in lung cancer, it might play a role in oncogenesis and progression of the tumor. To evaluate diagnostic value of survivin mRNA expression in lung cancer with pleural effusion. Sixty-five pleural fluid specimens were collected from lung cancer patients [group I]. Twenty benign pleural fluid specimens were also collected [group II], considered to be control group, and this group was classified into transudate and exudate according to Light's criteria. Real time Polymerase chain reaction [RT-PCR] was performed to detect the survivin mRNA expression in the pleural fluid specimens. The sensitivity, specificity and accuracy were calculated by using receiver operating characteristic [ROC] analysis. Sixty-five pleural fluid specimens from lung cancer patients were tested by RT-PCR, only 30/65 [46%] had positive cytology. The positive rate of survivin mRNA expression in maligant pleural effusion [63/65; 95.38%] was much higher than that in the pleural effusion with benign disease [4/20; 20%, P < 0.01]. Twenty-seven cancer patients were negative for cytology and 24/27 were positive for survivin mRNA expression. The sensitivity, specificity and accuracy of survivin were 89.5%, 50%, 73.1% for diagnosing malignant pleural effusion. The detection of survivin by RT-PCR seems to be a promising assay to diagnose malignant pleural effusions, using the appropriate cut-off point, survivin mRNA has a significant role in differentiating benign from malignant pleural effusion