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Updated: May 21, 2026
Local Anesthetic Thoracoscopy for Undiagnosed Pleural Effusion
Published on: November 10, 2023
Clinical relevance of human mammaglobin mRNA in pleural effusion from patients undergoing thoracoscopy: a pilot study
Pier Aldo Canessa1, Carmen Manta, Paola Ferro
1Division of Pneumology, San Bartolomeo Hospital, Sarzana (La Spezia) - Italy.
Background:
human mammaglobin (hMAM) expression has been reported in pleural effusions (PE). The aim of this study was to assess the clinical relevance of hMAM mRNA in PE from patients who underwent thoracoscopy.
Material And Methods:
A total of 288 patients with PE were studied, 155 of which were diagnosed with malignant and 133 with non-malignant diseases by thoracoscopy. Cells from PE were analyzed by nested hMAM RT-PCR. Statistical analyses were performed to evaluate the diagnostic performance parameters (DPP), the association between hMAM expression and benign or malignant status and the relative risk of cancer for patients with negative thoracoscopy showing hMAM positivity.
Results:
hMAM mRNA was found in 68/288 (23.6%) PE samples of which 51 were from the 155 patients diagnosed with malignant diseases and 17 were from the 133 patients diagnosed with non-malignant diseases. A significant correlation between hMAM expression and malignancy was found (OR=3.04) and the DPP were as follows: sensitivity=32.9%, specificity=87.2%, accuracy=58.0%, positive predictive value=75.0% and negative predictive value=52.7%. Among the patients with negative thoracoscopy (n=133), 5/17 (29.4%) hMAM-positive patients had or developed a tumor during the 18-month follow up period, as compared to 10/116 (8.6%) hMAM-negative patients (relative risk of 4.6 for developing a malignancy).
Conclusion:
These findings suggest a possible application of hMAM RT-PCR detection in PE as to identify a false-negative thoracoscopy in non-specific pleuritis.
Insights
Human mammaglobin (hMAM) mRNA detection in pleural effusions (PE) can help identify malignancy. hMAM positivity in patients with negative thoracoscopy indicates a higher risk of developing cancer.
Area of Science:
- Oncology
- Molecular Diagnostics
- Pleural Diseases
Background:
- Human mammaglobin (hMAM) expression has been observed in pleural effusions (PE).
- The clinical significance of hMAM mRNA in PE requires further investigation, particularly in patients undergoing thoracoscopy.
Purpose of the Study:
- To evaluate the clinical relevance of detecting human mammaglobin (hMAM) mRNA in pleural effusions (PE).
- To assess the diagnostic performance of hMAM mRNA detection for malignancy in PE.
- To determine the association between hMAM expression and malignancy status in PE patients.
Main Methods:
- Nested hMAM RT-PCR was used to analyze PE cells from 288 patients.
- Patients were categorized into malignant (155) and non-malignant (133) groups based on thoracoscopy diagnosis.
- Statistical analyses were performed to calculate diagnostic performance parameters and relative cancer risk.
Main Results:
- hMAM mRNA was detected in 23.6% of PE samples, with a higher prevalence in malignant cases (51/155) compared to non-malignant cases (17/133).
- A significant correlation between hMAM expression and malignancy was observed (OR=3.04).
- hMAM-positive patients with negative thoracoscopy had a 4.6-fold increased risk of developing malignancy during follow-up.
Conclusions:
- hMAM mRNA detection in PE shows potential as a biomarker for identifying malignancy.
- This method may help identify false-negative thoracoscopy results in cases of non-specific pleuritis.
- hMAM RT-PCR could aid in the diagnosis and risk stratification of pleural effusions.
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