Soluble oncoprotein 185HER-2 in pleural fluid has limited usefulness for the diagnostic evaluation of malignant effusions.
OBJECTIVE
To investigate whether pleural levels of the soluble oncoprotein 185 HER-2 (sp185(HER-2)), individually or in combination with CEA and CA 15-3, were useful for the diagnosis of malignant effusions.


METHODS
Levels of CEA, CA 15-3, and sp185(HER-2) were measured in the pleural fluid from 135 malignant and 103 benign effusions. Thresholds of these tumor markers were chosen for a diagnostic specificity of >or=99%.


RESULTS
Pleural sp185(HER-2) levels greater than 25 ng/mL were observed in 20% of breast and 10% of lung adenocarcinomas, and predicted a malignant effusion with a sensitivity of 7% and a likelihood ratio of 7.6. Combination of CEA and CA 15-3 resulted in 50% sensitivity, while adding sp185(HER-2) to this panel nonsignificantly increased sensitivity by 5% (P = 0.45). Only 1 patient with breast adenocarcinoma among 45 cytology-negative malignant effusions had sp185(HER-2) above the diagnostic cutoff point.


CONCLUSIONS
Measurement of pleural fluid sp185(HER-2) has poor diagnostic performance in patients with malignant effusions.
Porcel
José Manuel
JM
Department of Internal Medicine, Arnau de Vilanova University Hospital, Alcalde Rovira Roure 80, 25198 Lleida, Spain. jporcelp@yahoo.es
Salud
Antonieta
A
Vives
Manuel
M
Esquerda
Aureli
A
Rodríguez-Panadero
Francisco
F
D000230:Adenocarcinoma / Q000175:diagnosis; D000368:Aged; D014408:Biomarkers, Tumor / Q000032:analysis*; D001943:Breast Neoplasms / Q000175:diagnosis; D002272:Carcinoembryonic Antigen / Q000032:analysis; D005188:False Negative Reactions; D006801:Humans; D016013:Likelihood Functions; D008175:Lung Neoplasms / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D018396:Mucin-1 / Q000032:analysis; D010996:Pleural Effusion / Q000737:chemistry / Q000175:diagnosis; D016066:Pleural Effusion, Malignant / Q000737:chemistry / Q000175:diagnosis*; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000032:analysis*; D012680:Sensitivity and Specificity
D014408:Biomarkers, Tumor; D002272:Carcinoembryonic Antigen; D018396:Mucin-1; D018719:Erb-b2 Receptor Tyrosine Kinases