title: Pleural fluid carcinoembryonic antigen as a biomarker for the discrimination of tumor-related pleural effusion.
abstract: OBJECTIVE
  To assess the value of tumor biomarkers in the determination of tumor-related pleural effusion (PE). Cytological examination of the pleural fluid has a limited sensitivity in diagnosing tumor PE.
  
  
  METHODS
  Pleural fluid and serum samples were obtained from 1137 patients and PE etiology was determined by multiple diagnostic techniques. Carcinoembryonic antigen (CEA) levels were measured in both pleural fluid and serum samples. Levels of cancer antigen (CA) 125, glucose, and lactate dehydrogenase (LDH) were assessed in pleural fluid specimens.
  
  
  RESULTS
  601 PE patients were diagnosed with tumors, while 595 tested individuals were tumor-free. Among the measured biomarkers, pleural fluid CA 125, glucose, and LDH levels, and serum CEA amounts were comparable between tumor and tumor-free PE patients (P > 0.05). Only pleural fluid CEA levels were significantly different between the two groups (P < 0.05). A CEA cutoff of 2.645 ng/mL yielded sensitivity and specificity of 69.4% and 82.2%, respectively, for tumor-related PE detection. The area under the curve for CEA was 0.740 (95%CI: 0.710-0.770).
  
  
  CONCLUSIONS
  CEA levels in pleural fluid were a potential biomarker for the detection of tumor-related PE. These findings provide an easy and simple method for clinical screening and detection of PE.
authors.affiliation: Department of Respiratory, Hainan Branch of PLA Hospital, Sanya, 572000, Hainan Province, China.|Department of Cardiothoracic Surgery, Guangzhou Institute of Respiratory Disease, State Key Laboratary of Respiratory Disease, The First Hospital Affiliated to Guangzhou Medical University, Guangzhou, 510120, Guangdong Province, China.
authors.forename: Huiling
authors.initials: H
authors.lastname: Li
authors.affiliation: Department of Cardiothoracic Surgery, Guangzhou Institute of Respiratory Disease, State Key Laboratary of Respiratory Disease, The First Hospital Affiliated to Guangzhou Medical University, Guangzhou, 510120, Guangdong Province, China.
authors.forename: Liyan
authors.initials: L
authors.lastname: Huang
authors.affiliation: Department of Cardiothoracic Surgery, Guangzhou Institute of Respiratory Disease, State Key Laboratary of Respiratory Disease, The First Hospital Affiliated to Guangzhou Medical University, Guangzhou, 510120, Guangdong Province, China.
authors.forename: Hailing
authors.initials: H
authors.lastname: Tang
authors.affiliation: Department of Cardiothoracic Surgery, Guangzhou Institute of Respiratory Disease, State Key Laboratary of Respiratory Disease, The First Hospital Affiliated to Guangzhou Medical University, Guangzhou, 510120, Guangdong Province, China.
authors.forename: Nanshan
authors.initials: N
authors.lastname: Zhong
authors.affiliation: Department of Cardiothoracic Surgery, Guangzhou Institute of Respiratory Disease, State Key Laboratary of Respiratory Disease, The First Hospital Affiliated to Guangzhou Medical University, Guangzhou, 510120, Guangdong Province, China.
authors.forename: Jianhang
authors.initials: J
authors.lastname: He
mesh_terms: D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000097:blood; D018394:CA-125 Antigen / Q000378:metabolism; D002272:Carcinoembryonic Antigen / Q000378:metabolism*; D005122:Exudates and Transudates / Q000737:chemistry / Q000166:cytology / Q000378:metabolism*; D006801:Humans; D007770:L-Lactate Dehydrogenase / Q000378:metabolism; D008875:Middle Aged; D010994:Pleura / Q000473:pathology*; D010996:Pleural Effusion / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology / Q000378:metabolism*; D016066:Pleural Effusion, Malignant / Q000378:metabolism* / Q000473:pathology; D012189:Retrospective Studies
chemical_list: D014408:Biomarkers, Tumor; D018394:CA-125 Antigen; D002272:Carcinoembryonic Antigen; D007770:L-Lactate Dehydrogenase
keywords: carcinoembryonic antigen; cutoff value; diagnosis of tumor; pleural effusion; receiver operating characteristic