9%, 100%, and 90.7%, respectively. The sensitivities of detecting Lunx mRNA, cast-off cells, and CEA were 84.9%, 64.2%, and

68.9%, respectively. The area under the ROC curve for Lunx mRNA, cast-off cells, and CEA detection were 0.922, 0.821, and 0.798 (Figure 2). The optimal threshold for Lunx mRNA detection according to the ROC analysis was 985 copies, and it was similar to our positive threshold. Figure 2 ROC curve of Lunx mRNA, cast-off cells, and CEA. The specificities for detecting Lunx mRNA, cast-off cells, and CEA are 95.9%, 100%, and 90.7%, respectively. The sensitivities for detecting Lunx mRNA, cast-off cells, and CEA are 84.9%, 64.2%, and 68.9%, respectively. The area under the ROC curves for detecting Lunx mRNA, cast-off cells, and CEA are 0.922, 0.821, and 0.798, respectively. Blue: Lunx mRNA; Green: cast-off cells; Brown: CEA. The relationship between the levels of Lunx mRNA and

the degree of tumor cell differentiation in pulmonary Selleckchem LY294002 carcinoma According to the National Comprehensive Cancer Network (NCCN) Clinical Practice Guidelines in Oncology [16], most pleural effusions associated with lung cancer should appear in stage IV. The effusion is not related to the tumor in only a few patients who have had multiple cytopathologic pleural effusion examinations selleck that are negative for tumor cells, and when the effusion is nonbloody and not an exudate. Pleural effusion unrelated to the tumor should be excluded as a stage element. In this study, the numbers of cases in stage I, II, and III were small, so the statistical power was insufficient when comparing the relationship between gene expression TCL and TNM stage. Furthermore, we examined the relationships between the levels of Lunx mRNA and PH, LDH, glucose, albumin in the pleural effusion, histopathological category, and the degree of tumor cell differentiation, which referred to the degree of tumor cell differentiation close to normal cells. There was no association between the levels of Lunx mRNA and PH,

LDH, glucose, and albumin in the pleural effusion (data not shown). Also, no difference was found in Lunx expression in the different histopathological categories (data not shown). The levels of Lunx mRNA expression were higher in poorly differentiated than in moderately differentiated and well differentiated tumors (P = 0.044, P < 0.001, respectively, Figure 3). There was no statistical difference in Lunx mRNA expression between moderately and well differentiated tumors (P = 0.066, Figure 3). Figure 3 Lunx mRNA expression according to tumor differentiation. Lunx mRNA was detected by real-time RT-PCR. Levels of Lunx mRNA in poorly, moderately, and well differentiated groups. The horizontal line indicates 103 copies/ml of Lunx mRNA. Copy numbers less than 103 copies/ml were considered negative. When the copy number of Lunx mRNA was not detectable, the results were shown as number undetected.