Usefulness of melanoma antigen (MAGE) gene analysis in tissue samples from percutaneous needle aspiration biopsy of suspected lung cancer lesions

Abstract

BACKGROUND: As mortality from lung cancer is still very high, early detection prior to metastasis is important in clinical settings. We prospectively evaluated the clinical usefulness of a reverse transcription-nested polymerase chain reaction (RT-nested PCR) using melanoma antigen (MAGE) A1-6 genes with tissue samples obtained from the percutaneous needle aspiration (PCNA) biopsies used in the diagnosis of lung cancer.

METHODS: We enrolled 53 patients with suspected lung cancer based on CT scan (M:F, 39:14; mean age 61 years). A PCNA biopsy was performed twice and lung cancer was diagnosed by a pathological examination. The MAGE genes were analyzed using RT-nested PCR from tissue samples obtained from the PCNA biopsy of the lesion. We compared the results from the RT-nested PCR and the pathologic diagnosis. We also analyzed the sensitivity, specificity, accuracy, positive predictive value (PPV) and negative predictive value (NPV).

RESULTS: Of the 53 patients, 39 were diagnosed with lung cancer. Six patients had tuberculosis and 8 were confirmed with chronic inflammation or benign lesion. Based on the RT-nested PCR examination, 41 of 53 patients were positive for the MAGE gene: 34 of 39 patients had lung cancer; 5 of 6 patients had tuberculosis; and 2 of 8 patients had chronic inflammation or benign lesion. The sensitivity, specificity, accuracy, PPV and NPV were 83%, 58%, 77%, 87% and 55%, respectively.

CONCLUSION: MAGE gene analysis by RT-nested PCR may be a useful method for the diagnosis of lung cancer, but it is still limited in patients with tuberculosis.