Diagnostic Accuracy of CYFRA21-1 in the Differential Diagnosis of Pleural Effusions.

Autor:	Trapé J; Department of Laboratory Medicine, Althaia Xarxa Assistencial Universitària de Manresa, Manresa, Spain jtrape@althaia.cat.; Faculty of Medicine, University of Vic - Central University of Catalonia, Barcelona, Spain., Sant F; Faculty of Medicine, University of Vic - Central University of Catalonia, Barcelona, Spain.; Department of Pathology, Althaia Xarxa Assistencial Universitària de Manresa, Manresa, Spain., Montesinos J; Department of Oncology, Althaia Xarxa Assistencial Universitària de Manresa, Manresa, Spain., Arnau A; Clinical Research Unit, Althaia Xarxa Assistencial Universitària de Manresa, Manresa, Spain., Sala M; Department of Laboratory Medicine, Althaia Xarxa Assistencial Universitària de Manresa, Manresa, Spain., Bernadich O; Department of Pulmonary Diseases, Althaia Xarxa Assistencial Universitària de Manresa, Manresa, Spain., Martín E; Department of Pulmonary Diseases, Althaia Xarxa Assistencial Universitària de Manresa, Manresa, Spain., Perich D; Department of Pulmonary Diseases, Althaia Xarxa Assistencial Universitària de Manresa, Manresa, Spain., Lopez J; Department of Laboratory Medicine, Althaia Xarxa Assistencial Universitària de Manresa, Manresa, Spain., Ros S; Department of Pulmonary Diseases, Althaia Xarxa Assistencial Universitària de Manresa, Manresa, Spain., Esteve-Valverde E; Department Internal Medicine, Althaia Xarxa Assistencial Universitària de Manresa, Manresa, Spain., Pérez R; Department Internal Medicine, Althaia Xarxa Assistencial Universitària de Manresa, Manresa, Spain., González-Fernández C; Department of Laboratory Medicine, Althaia Xarxa Assistencial Universitària de Manresa, Manresa, Spain., Aligue J; Department Internal Medicine, Althaia Xarxa Assistencial Universitària de Manresa, Manresa, Spain., Catot S; Department of Oncology, Althaia Xarxa Assistencial Universitària de Manresa, Manresa, Spain., Domenech M; Department of Oncology, Althaia Xarxa Assistencial Universitària de Manresa, Manresa, Spain., Ruiz D; Department Internal Medicine, Althaia Xarxa Assistencial Universitària de Manresa, Manresa, Spain., Bonet M; Department Internal Medicine, Althaia Xarxa Assistencial Universitària de Manresa, Manresa, Spain., Molina R; Department of Clinical Biochemistry, Hospital Clínic, Barcelona, Spain., Ordeig J; Department Internal Medicine, Althaia Xarxa Assistencial Universitària de Manresa, Manresa, Spain.
Jazyk:	angličtina
Zdroj:	Anticancer research [Anticancer Res] 2019 Sep; Vol. 39 (9), pp. 5071-5076.
DOI:	10.21873/anticanres.13700
Abstrakt:	Background/aim: Approximately 20% of pleural effusions are associated with cancer; about 50% require invasive procedures to perform diagnosis. Determination of the concentration of soluble cytokeratin 19-fragments (CYFRA21-1) may help identify patients with malignant effusions. However, pathologies other than cancer can increase its concentration. The identification of these possible false positives with routine tests CRP, ADA, % polymorphonuclear cells (PN) may improve diagnostic accuracy. This study aimed to determine the diagnostic accuracy of CYFRA21-1 in the detection of malignant pleural effusions and the possible false positives. Materials and Methods: Analysis of CYFRA21-1, adenosine deaminase (ADA), C-reactive protein (CRP), and the percentage of polymorphonuclear leukocytes (PN%) in the fluid from 643 consecutive undiagnosed pleural effusions was performed. Results: CYFRA21-1 showed 38.7% sensitivity and 97.3% specificity at 175 ng/ml cut-off. Effusions not suspicious of a false-positive showed 39.0% sensitivity and 98.2% specificity, while effusions suspicious of false positive showed lower sensitivity (36.4%) and specificity (95.0%). Conclusion: The diagnostic accuracy of CYFRA21-1 in pleural effusions can be improved by classification according to the possibility of false positives. (Copyright© 2019, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.)
Databáze:	MEDLINE
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