Tumor markers in the diagnosis of malignant serous effusions

Am J Clin Oncol. 1997 Jun;20(3):247-50. doi: 10.1097/00000421-199706000-00007.


To assess the possibility of increasing the detection rates of cytological examination in malignant effusions by the selection of specific tumor markers for a given type of tumor, we measured CEA, CA 19.9, CA 15.3, MCA, PSA, and AFP in malignant effusions from 89 patients with the following primary malignancies: colon, stomach, breast, liver, prostate, lung, and kidney. Cytological examination was positive in only 35 of 89 patients (40%), while the tumor markers were positive in 72 of 89 cases (80%). However, apart from small cell lung and kidney cancers, where the lack of a specific tumor marker resulted in no advantage, in the other types of tumors, the specific marker for each tumor identified correctly malignant effusions in 72 of 74 cases (97%). In fact, CEA was positive in 11 of 11 effusions induced by colorectal cancer; CA 19.9 in 28 of 30 gastric cancer effusions, while MCA and CA 15.3 were positive in breast cancer effusions (16/22 and 20/22). Finally, elevated AFP and PSA indicated hepatocellular and prostate cancer, respectively. In conclusion, in cancer patients with elevated effusion levels of specific tumor markers, the effusions could be considered of a malignant nature even without cytologically demonstrable tumor cells.

MeSH terms

  • Adult
  • Aged
  • Antigens, Neoplasm / analysis
  • Antigens, Tumor-Associated, Carbohydrate*
  • Ascitic Fluid / chemistry*
  • Ascitic Fluid / etiology
  • Biomarkers, Tumor / analysis*
  • CA-19-9 Antigen / analysis
  • Carcinoembryonic Antigen / analysis
  • Female
  • Humans
  • Male
  • Middle Aged
  • Mucin-1 / analysis
  • Neoplasms / complications*
  • Pericardial Effusion / chemistry*
  • Pericardial Effusion / etiology
  • Pleural Effusion, Malignant / chemistry*
  • Pleural Effusion, Malignant / etiology
  • Prostate-Specific Antigen / analysis
  • Sensitivity and Specificity
  • alpha-Fetoproteins / analysis


  • Antigens, Neoplasm
  • Antigens, Tumor-Associated, Carbohydrate
  • Biomarkers, Tumor
  • CA-19-9 Antigen
  • Carcinoembryonic Antigen
  • Mucin-1
  • alpha-Fetoproteins
  • mucinous carcinoma-associated antigen
  • Prostate-Specific Antigen