Evaluation of seven tumour markers in pleural fluid for the diagnosis of malignant effusions

Br J Cancer. 1999 Nov;81(6):1059-65. doi: 10.1038/sj.bjc.6690807.

Abstract

Carcinoembryonic antigen (CEA), carbohydrate antigens 15-3, 19-9 and 72-4 (CA 15-3, CA 19-9 and CA 72-4), cytokeratin 19 fragments (CYFRA 21-1), neuron-specific enolase (NSE) and squamous cell carcinoma antigen (SCC) were evaluated in pleural fluid for the diagnosis of malignant effusions. With a specificity of 99%, determined in a series of 121 benign effusions, the best individual diagnostic sensitivities in the whole series of 215 malignant effusions or in the subgroup of adenocarcinomas were observed with CEA, CA 15-3 and CA 72-4. As expected, a high sensitivity was obtained with SCC in squamous cell carcinomas and with NSE in small-cell lung carcinomas. CYFRA and/or CA 15-3 were frequently increased in mesotheliomas. Discriminant analysis showed that the optimal combination for diagnosis of non-lymphomatous malignant effusions was CEA + CA 15-3 + CYFRA + NSE: sensitivity of 94.4% with an overall specificity of 95%. In malignant effusions with a negative cytology, 83.9% were diagnosed using this association. The association CYFRA + NSE + SCC was able to discriminate adenocarcinomas from small-cell lung cancers. Regarding their sensitivity and their complementarity, CEA, CA 15-3, CYFRA 21-1, NSE and SCC appear to be very useful to improve the diagnosis of malignant pleural effusions.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adenocarcinoma / diagnosis
  • Adenocarcinoma / pathology
  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Biomarkers, Tumor / analysis*
  • Carcinoma / diagnosis
  • Carcinoma / pathology
  • Carcinoma, Small Cell / diagnosis
  • Carcinoma, Small Cell / pathology
  • Carcinoma, Squamous Cell / diagnosis
  • Carcinoma, Squamous Cell / pathology
  • Child
  • Female
  • Humans
  • Lung Neoplasms / diagnosis
  • Lung Neoplasms / pathology
  • Male
  • Middle Aged
  • Pleural Effusion, Malignant / diagnosis*
  • Pleural Effusion, Malignant / pathology
  • Retrospective Studies
  • Sensitivity and Specificity

Substances

  • Biomarkers, Tumor