CA-15.3 assay in effusions: comparison with carcinoembryonic antigen and CA-125 assay and cytologic diagnosis.
OBJECTIVE
To compare the sensitivity of CA-15.3 with cytologic diagnosis and carcinoembryonic antigen (CEA) and CA-125 content and to determine if elevated CA-15.3 suggests a breast primary.


METHODS
A retrospective study of 111 consecutive effusions. CEA was measured by enzyme immunoassay (cutoff > 5 ng/mL), CA-125 by radioimmunoassay (cutoff > 5,000 micron/mL) and CA-15.3 by radioimmunoassay (cutoff > 15 micron/mL). Results were correlated with cytologic diagnosis, histology (when available), clinical and radiologic data, and follow-up.


RESULTS
The results were: benign, 39; malignant, 72; sensitivities and specificities: cytology, 76%/100%; CEA, 80%/97%; CA-125 22%/100%; and CA-15.3, 69%/89%. The sensitivity of CEA and cytology was 97% and of CA-15.3 and cytology, 87%. Neither mean (293.4 micron/mL) nor range of CA-15.3 predicted a breast primary. Falsely elevated CEA and CA-15.3 were noted in ascites with fecal contents from colonic perforation. High CA-125 and low CEA predicted an ovarian/endometrial primary.


CONCLUSIONS
CA-15.3 assay in effusions is not recommended since it neither enhances the sensitivity of cytologic diagnosis nor predicts a breast primary.
Pinto
M M
MM
Department of Pathology and Laboratory Medicine, Bridgeport Hospital, Connecticut 06620, USA.
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor; D001943:Breast Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000473:pathology; D018394:CA-125 Antigen / Q000032:analysis*; D002272:Carcinoembryonic Antigen / Q000032:analysis*; D016889:Endometrial Neoplasms / Q000150:complications / Q000175:diagnosis / Q000473:pathology; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000150:complications / Q000175:diagnosis / Q000473:pathology; D006801:Humans; D008175:Lung Neoplasms / Q000150:complications / Q000175:diagnosis / Q000473:pathology; D008297:Male; D008875:Middle Aged; D018396:Mucin-1 / Q000032:analysis*; D010051:Ovarian Neoplasms / Q000150:complications / Q000175:diagnosis / Q000473:pathology; D010996:Pleural Effusion / Q000737:chemistry* / Q000209:etiology / Q000473:pathology; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012680:Sensitivity and Specificity
D014408:Biomarkers, Tumor; D018394:CA-125 Antigen; D002272:Carcinoembryonic Antigen; D018396:Mucin-1