Abstract

The Aim Evaluation of usefulness of telomerase activity assay in transthoracic fine-needle biopsy [TFNB] aspirates collected from peripheral tumours of the lung in predicting of the malignant aetiology of lung infiltrations.

Material and Methods: The study group consisted of one hundred patients with a peripheral infiltration of the lung. All of them had TFNB of the focal lesion performed. The aspirates were subjected to the standard cytological evaluation. Telomerase activity in the specimens was determined with the PCR-ELISA PLUS method. The sensitivity, specificity, accuracy and predictive value of TFNB were calculated for the cytological examination of aspirates alone and the cytological examination with additional telomerase activity assessment.

Results: Lung cancer was newly diagnosed in 84 subjects, and benign peripheral lesions were found in 16 subjects. During the first TFNB lung cancer was recognized in 56 [66.7%] cancer cases, while increased telomerase activity was found in 61 [72.6%] cancer aspirates. Nobody with a benign infiltration had a false positive result of the cytological examination, but in 1 case [6.25%] increased telomerase activity was observed. The diagnostic sensitivity, accuracy and positive predictive value of the combination of cytological examination and telomerase activity assay in TFNB specimens were significantly higher than those of the cytological examination alone [89.3% vs. 66.7%, p=0.0004; 90% vs. 72.%, p=0.001; 62.5% vs. 36.4%, p=0.039], however performance of both examinations was associated with a lower specificity of TFNB [96.9% vs. 100%, p=0.002].

Conclusion: Detection of telomerase activity in aspirates taken during TFNB of a peripheral lung infiltration should be considered as a warning of the risk of malignancy in case of false-negative results of cytology.