title: Evaluation of seven tumour markers in pleural fluid for the diagnosis of malignant effusions.
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.
authors.affiliation: Department of Biology and Pathology of the Cell, INSERM CJF 96-02/IFR30, Toulouse Purpan School of Medicine, University of Toulouse III, France.
authors.forename: M
authors.initials: M
authors.lastname: Miédougé
authors.forename: P
authors.initials: P
authors.lastname: Rouzaud
authors.forename: G
authors.initials: G
authors.lastname: Salama
authors.forename: M C
authors.initials: MC
authors.lastname: Pujazon
authors.forename: C
authors.initials: C
authors.lastname: Vincent
authors.forename: M A
authors.initials: MA
authors.lastname: Mauduyt
authors.forename: J
authors.initials: J
authors.lastname: Reyre
authors.forename: P
authors.initials: P
authors.lastname: Carles
authors.forename: G
authors.initials: G
authors.lastname: Serre
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis / Q000473:pathology; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000032:analysis*; D002277:Carcinoma / Q000175:diagnosis / Q000473:pathology; D018288:Carcinoma, Small Cell / Q000175:diagnosis / Q000473:pathology; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis / Q000473:pathology; D002648:Child; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis / Q000473:pathology; D008297:Male; D008875:Middle Aged; D016066:Pleural Effusion, Malignant / Q000175:diagnosis* / Q000473:pathology; D012189:Retrospective Studies; D012680:Sensitivity and Specificity
chemical_list: D014408:Biomarkers, Tumor