Tumor markers in pleural effusions.
OBJECTIVE
The aim of this study was to determine the diagnostic capabilities of tumor markers in pleural effusion and their importance for assessment of the etiology of pleural effusions.


METHODS
In pleural effusions from 166 patients hospitalized during the period 2003-2005 at the Department of Oncology and Radiotherapy, Faculty Hospital in Pilsen, the following tumor markers were determined: thymidine kinase (TK), neuron-specific enolase (NSE), cytokeratins [tissue polypeptide antigen (TPA), tissue polypeptide-specific antigen (TPS) and cytokeratin fragment 19 (CYFRA 21-1)], carcinoembryonic antigen (CEA) and mucinous markers (CA 15-3, CA 19-9, CA 125). The inflammatory marker procalcitonin-PCT was also assessed.


RESULTS
Tumor markers CA 125, TPA, TPS were significantly elevated in exudates, irrespective of the etiology, as a non-specific reaction in mesothelial cells. TK had a sensitivity of over 80% for all the types of cancer examined, while CA 15-3 had a sensitivity of over 90%.


CONCLUSIONS
Significant positivity of PCT and CA 15-3 in pleural effusions indicate a suspicion of inflammatory disease. Positivity of TK and CA 15-3 indicate a strong suspicion of malignant exudates.
Topolcan
O
O
Department of Nuclear Medicine, Charles University, Medical School and Teaching Hospital Plzen, Czech Republic. topolcan@fnplzen.cz
Holubec
L
L
Polivkova
V
V
Svobodova
S
S
Pesek
M
M
Treska
V
V
Safranek
J
J
Hajek
T
T
Bartunek
L
L
Rousarova
M
M
Finek
J
J
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000951:Antigens, Neoplasm / Q000032:analysis; D014408:Biomarkers, Tumor / Q000032:analysis*; D018394:CA-125 Antigen / Q000032:analysis; D018395:CA-19-9 Antigen / Q000032:analysis; D002116:Calcitonin / Q000032:analysis; D015740:Calcitonin Gene-Related Peptide; D002272:Carcinoembryonic Antigen / Q000032:analysis; D005260:Female; D006801:Humans; D053539:Keratin-19; D007633:Keratins / Q000032:analysis; D008297:Male; D008875:Middle Aged; D018396:Mucin-1 / Q000032:analysis; D009369:Neoplasms / Q000175:diagnosis*; D010455:Peptides / Q000032:analysis; D010751:Phosphopyruvate Hydratase / Q000032:analysis; D010996:Pleural Effusion / Q000737:chemistry* / Q000175:diagnosis*; D011498:Protein Precursors / Q000032:analysis; D012680:Sensitivity and Specificity; D013937:Thymidine Kinase / Q000032:analysis; D019396:Tissue Polypeptide Antigen / Q000032:analysis
D000951:Antigens, Neoplasm; D014408:Biomarkers, Tumor; D018394:CA-125 Antigen; D018395:CA-19-9 Antigen; C000606589:CALCA protein, human; D002272:Carcinoembryonic Antigen; D053539:Keratin-19; D018396:Mucin-1; D010455:Peptides; D011498:Protein Precursors; D019396:Tissue Polypeptide Antigen; C102012:antigen CYFRA21.1; C089984:tissue polypeptide specific antigen; D007633:Keratins; D002116:Calcitonin; D013937:Thymidine Kinase; D010751:Phosphopyruvate Hydratase; D015740:Calcitonin Gene-Related Peptide