Tumor markers in pleural effusion diagnosis

Tamura, Shinsuke; Nishigaki, Tetsuya; Moriwaki, Yuji; Fujioka, Hikaru; Nakano, Takashi; Fujii, Junji; Yamamoto, Tetsuya; Nabeshima, K; Hada, Toshikazu; Higashino, Kazuya

doi:10.1002/1097-0142(19880115)61:2<298::aid-cncr2820610219>3.0.co;2-u

Cited by 70 publications

(30 citation statements)

References 18 publications

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“…The results of the present study again confirm CEA as the most dependable tumour marker in pleural fluid [9,10,13], where its sensitivity was 57%, a value close to that of cytology in most series, and its specificity was 99%. The CA 15-3, with an accuracy only 4% lower than that of CEA, showed a sensitivity of 48% with a specificity of 97%, making this marker useful, either alone or in combination with other diagnostic procedures.…”

Section: Discussionmentioning

confidence: 99%

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CEA, CA 15-3 and CYFRA 21-1 in serum and pleural fluid of patients with pleural effusions

Romero

Fernandez²,

Jm³

et al. 1996

Eur Respir J

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The role of tumour marker assays in differentiating malignant from benign pleural effusions is not yet clear. This study was designed to prospectively assess the individual and combined diagnostic utility of three tumour markers in patients with pleural effusion.Pleural and serum levels of carcinoembryonic antigen (CEA), carbohydrate antigen 15-3 (CA 15-3) and cytokeratin 19 fragment (CYFRA 21-1) were determined in 115 patients with pleural effusions (42 malignant and 73 benign). The diagnostic utility of each tumour marker was assessed using accuracy to determine the optimal cut-off point, whilst a logistic regression model was used to obtain the optimal combined test.In serum, every marker showed an individual high specificity (over 97%) for malignancy. The sensitivity of CEA, CA 15-3 and CYFRA 21-1 was 36, 48 and 31%, respectively. In patients without renal failure, the sensitivity of CYFRA 21-1 rose to 53%, while those of CEA and CA 15-3 remained almost unchanged. In pleural fluid, CYFRA 21-1 showed low sensitivity (32%) and specificity (82%), while CEA showed the highest sensitivity (57%). Excluding patients with renal failure, the combined determination in serum of CEA, CA 15-3 and CYFRA 21-1 has a high accuracy (88%), similar to that for CEA plus CA 15-3 in pleural fluid (87%).We conclude that CYFRA 21-1 is useless in pleural fluid and should not be used in serum for patients with renal failure. The combined determination of CEA, CA 15-3 and CYFRA 21-1 in serum may obviate its determination in pleural fluid.

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Section: Discussionmentioning

confidence: 99%

“…Previous studies have tried to find biochemical markers in pleural fluid which could be of value in the differential diagnosis of pleural effusions [6][7][8][9][10][11][12]. The role, if any, of tumour marker assays in differentiating malignant from benign pleural effusions is not yet clear.…”

mentioning

confidence: 99%

CEA, CA 15-3 and CYFRA 21-1 in serum and pleural fluid of patients with pleural effusions

Romero

Fernandez²,

Jm³

et al. 1996

Eur Respir J

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“…2- 15 We noted elevated levels of sialyl SSEA-1 in pleural fluid of patients with adenocarcinoma of the lung. The positive rate was 64% in adenocarcinoma, whereas it was 7.7% in nonadenocarcinoma and 0% in benign pulmonary disease when the cutoff level was defined as 300 unit/ml.…”

Section: Discussionmentioning

confidence: 63%

Elevation of sialyl stage-specific mouse embryonic antigen levels in pleural effusion in patients with adenocarcinoma of the lung

Iguchi

Hara²,

Miyazaki

et al. 1989

Cancer

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Sialyl stage-specific mouse embryonic antigen (SSEA-1) levels were measured in pleural effusions obtained from patients with lung cancer and benign pulmonary disease, using a solid-phase immunoradiometric sandwich assay. The mean (+/- SEM) levels (unit/ml) of pleural fluid sialyl SSEA-1 were 3620 +/- 1419 in adenocarcinoma (n = 25), 123 +/- 30 in nonadenocarcinoma (n = 13) and 95 +/- 19 in benign pulmonary disease (n = 13), respectively. The positive rate was 64% in adenocarcinoma, 7.7% in nonadenocarcinoma, and 0% in benign pulmonary disease, respectively, when a cutoff level was defined as the mean + 3 SD value (300 unit/ml) based on pleural fluid sialyl SSEA-1 levels in benign pulmonary disease. There was a significant positive correlation between pleural fluid levels of sialyl SSEA-1 and those of carcinoembryonic antigen in adenocarcinoma patients (r = 0.8246, P less than 0.01). Pleural fluid sialyl SSEA-1 levels correlated with cytologic findings in adenocarcinoma patients. These observations suggest that sialyl SSEA-1 in pleural effusion is a useful marker to discriminate malignant from nonmalignant and adenocarcinoma from nonadenocarcinoma of the lung.

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“…CEA has been utilized most widely as a tumor marker for serous effusions (Nystrom et al 1977 ; Whiteside and Dekker 1979 ; Vladutiu et al 1979Vladutiu et al , 1981Niwa et al 1985 ;Tamura et al 1988). In the present study, we demonstrated that the SLEX antigen could be the most useful tumor marker among the three carbohydrate antigens tested in patients with various types of cancer, and especially in pulmonary adenocarcinoma.…”

Section: Discussioi~mentioning

confidence: 74%

Detection of three sialylated tumor-associated antigens in malignant serous effusions.

Kadota

1990

Tohoku J. Exp. Med.

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One hundred thirty-seven fluid samples from patients with malignant diseases, including 58 with lung cancer and 36 with gastric carcinoma, were screened for three tumor-associated carbohydrate antigens. The antigens tested were sialylated LewisX (SLEX) antigen, sialylated SSEA-1 (SLX) antigen, and sialylated Lewisa (CA19-9) antigen. Thirty-four fluid samples from patients with benign diseases including 20 with tuberculous pleurisy were also tested for these three antigens as a control. SLEX antigen had the highest positivity rate among the three antigens both in the pleural effusions of patients with pulmonary adenocarcinoma and for all types of lung cancer (64.1% and 46.6%, respectively). In cancers of digestive system, the percentage of SLEX positivity was almost same as that for CA19-9, and higher than that for SLX. A combination assay using the three antigens resulted in an increased rate of detection of tumor-associated antigens (68% of 58 lung cancers including 83% of 39 adenocarcinomas, as well as 77% of 63 digestive system cancers including 84% of 36 gastric carcinomas). Gel filtration of pleural effusions or bile using sephacryl 5-1000 showed that these three antigens were eluted in the void volume, indicating a molecular weight of > 2 X 106. Thus, all 3 antigens possibly exist on carrier protein with a high molecular weight. These observations suggest the potential application of these antigens to distinguish between benign and malignant fluid, and to monitor the effects of the treatment of various types of cancer. tumor marker ; Sialylated LewisX antigen ; malignant effusion

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Tumor markers in pleural effusion diagnosis

Cited by 70 publications

References 18 publications

CEA, CA 15-3 and CYFRA 21-1 in serum and pleural fluid of patients with pleural effusions

CEA, CA 15-3 and CYFRA 21-1 in serum and pleural fluid of patients with pleural effusions

Elevation of sialyl stage-specific mouse embryonic antigen levels in pleural effusion in patients with adenocarcinoma of the lung

Detection of three sialylated tumor-associated antigens in malignant serous effusions.

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