[Value of tumor markers series of hydrothorax in differential diagnosis of pleural effusion].
OBJECTIVE
To investigate the clinical value of pleural effusion lung ProGRP, neuron specific enolase (NSE), cytokeratin fragment 19 (CYFRA21-1), carcino-embryonic antigen (CEA), carbohydrate antigen 153 (CA153), carbohydrate antigen 19 - 9 (CA19-9) in differential diagnosis and histological typing of malignant pleural effusion caused by lung cancer.


METHODS
All the 171 patients with malignant hydrothorax caused by lung cancer were from coal-mine area of Kailuan. They were divided into the small cell lung cancer (SCLC) group (n = 39), the adenocarcinoma group (n = 99) and the squamous cell carcinoma group (n = 37). The patients with benign pleural effusion served as the controls (n = 30). The diagnostic value of pleural effusion ProGRP, NSE, CYFRA21-1, CEA, CA153 and CA19-9 was compared for each group.


RESULTS
Youden index and the accurate rate of pleural effusion ProGRP + NSE (sequence test) were the highest in the diagnosis of malignant hydrothorax caused by SCLC. CEA + CA153 + CA19-9 (sequence test) was the highest in the diagnosis of malignant hydrothorax caused by adenocarcinoma. CYFRA21-1 + CEA + CA153 (on parallel test) were the highest in the diagnosis of malignant hydrothorax caused by squamous cell carcinoma. The Yonden index and the accurate rate were the highest by the single detection of CYFRA21 (0.5514 and 0.6878), and by the combined detection of ProGRP + CYFRA21-1 + CEA (on parallel test) (0.7029 and 0.8878).


CONCLUSIONS
The first pleural effusion tumor markers of malignant hydrothorax caused by the SCLC, adenocarcinoma of lung, and lung squamous cell carcinoma are ProGRP, CEA and CYFRA21-1, respectively. The best combinations of pleural effusion tumor marker in diagnosis of malignant hydrothorax caused by the SCLC, adenocarcinoma of lung, lung squamous cell carcinoma and lung cancer are the combined detection of ProGRP + NSE (sequence test), combined detection of CEA + CA153 + CA19-9 (sequence test), the combined detection of CYFRA21-1 + CEA + CA153 (on parallel test) and ProGRP + CYFRA21-1 + CEA (on parallel test), respectively.
Liu
Yun-qiu
YQ
The Affiliated Kailuan Hospital of Huabei Coal Medical School, Tangshan 063000, Hebei, China.
Zhang
Hui-li
HL
Gao
Wen-jing
WJ
Lan
Xuan
X
Yuan
Bao-jun
BJ
Zou
Ji-min
JM
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000951:Antigens, Neoplasm / Q000032:analysis*; D014408:Biomarkers, Tumor / Q000032:analysis*; D018395:CA-19-9 Antigen / Q000032:analysis; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D053539:Keratin-19 / Q000032:analysis; D008175:Lung Neoplasms / Q000150:complications / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D010446:Peptide Fragments / Q000032:analysis; D016066:Pleural Effusion, Malignant / Q000175:diagnosis* / Q000209:etiology; D011994:Recombinant Proteins / Q000032:analysis
D000951:Antigens, Neoplasm; D014408:Biomarkers, Tumor; D018395:CA-19-9 Antigen; C000621856:CA153 protein, human; D053539:Keratin-19; D010446:Peptide Fragments; D011994:Recombinant Proteins; C102012:antigen CYFRA21.1; C087079:pro-gastrin-releasing peptide (31-98)