title: Tumor markers in the diagnosis of malignant serous effusions.
abstract: 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.
authors.affiliation: Servizio di Oncologia Medica, Ospedale di Pesaro, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Cascinu
authors.forename: E
authors.initials: E
authors.lastname: Del Ferro
authors.forename: I
authors.initials: I
authors.lastname: Barbanti
authors.forename: M
authors.initials: M
authors.lastname: Ligi
authors.forename: A
authors.initials: A
authors.lastname: Fedeli
authors.forename: G
authors.initials: G
authors.lastname: Catalano
mesh_terms: D000328:Adult; D000368:Aged; D000951:Antigens, Neoplasm / Q000032:analysis; D015295:Antigens, Tumor-Associated, Carbohydrate; D001202:Ascitic Fluid / Q000737:chemistry* / Q000209:etiology; D014408:Biomarkers, Tumor / Q000032:analysis*; D018395:CA-19-9 Antigen / Q000032:analysis; D002272:Carcinoembryonic Antigen / Q000032:analysis; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018396:Mucin-1 / Q000032:analysis; D009369:Neoplasms / Q000150:complications*; D010490:Pericardial Effusion / Q000737:chemistry* / Q000209:etiology; D016066:Pleural Effusion, Malignant / Q000737:chemistry* / Q000209:etiology; D017430:Prostate-Specific Antigen / Q000032:analysis; D012680:Sensitivity and Specificity; D000509:alpha-Fetoproteins / Q000032:analysis
chemical_list: D000951:Antigens, Neoplasm; D015295:Antigens, Tumor-Associated, Carbohydrate; D014408:Biomarkers, Tumor; D018395:CA-19-9 Antigen; D002272:Carcinoembryonic Antigen; D018396:Mucin-1; D000509:alpha-Fetoproteins; C057387:mucinous carcinoma-associated antigen; D017430:Prostate-Specific Antigen