Evaluation of predictive value of pleural CEA in patients with pleural effusions and histological findings: A prospective study and literature review
| Autor: | Franco Lumachi, Paolo Metus, Stefano M.M. Basso, Federica D'Aurizio, Renato Tozzoli |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
medicine.medical_specialty
Pleural effusion medicine.medical_treatment Clinical Biochemistry Thoracentesis 03 medical and health sciences 0302 clinical medicine Breast cancer Carcinoembryonic antigen Predictive Value of Tests Biopsy medicine Malignant pleural effusion Humans Mesothelioma Lung cancer neoplasms biology medicine.diagnostic_test business.industry General Medicine respiratory system medicine.disease digestive system diseases respiratory tract diseases Carcinoembryonic Antigen Pleural Effusion 030228 respiratory system 030220 oncology & carcinogenesis biology.protein Pleura Radiology business Biomarkers |
| Zdroj: | Clinical biochemistry. 49(16-17) |
| ISSN: | 1873-2933 |
| Popis: | Objectives Pleural effusion recognizes heterogeneous etiology and pathogenesis and requires invasive diagnostic procedures. Usually, after pleural fluid analysis, 30–50% of patients with malignant pleural effusion exhibit negative pleural cytology, and the sensitivity of image-guided pleural needle-aspiration biopsy ranges between 60% and 70%. With the aim of differentiating between benign (BPE) and malignant (MPE) pleural effusions, several tumor markers have been assayed in the pleural fluid and the majority of studies focus on pleural carcinoembryonic antigen (p-CEA). The aims of this study were to evaluate (i) the diagnostic accuracy of p-CEA of patients with pleural effusions undergoing video-assisted thoracoscopic surgery (VATS) for diagnostic purpose, (ii) the relationship between p-CEA and serum CEA (s-CEA), and (iii) the usefulness of the p-CEA/s-CEA ratio in the diagnosis of malignant pleural effusions (MPE). Design & methods We prospectively enrolled in the study 134 consecutive patients with pleural effusions, scheduled for having VATS and biopsy. The final diagnosis, based on histopathology of the VATS-guided specimens, was available for all patients. p-CEA and s-CEA was assayed with a chemiluminescence immunoassay method (CLIA), applied on the Maglumi 2000 Plus automated platform (SNIBE, Shenzen, China). Results The sensitivity and accuracy of p-CEA was significantly higher than that of pleural cytology at the same specificity comparing BPE with MPE and BPE with non-small lung cancer. The sensitivity of p-CEA and PC together reached 100% (BPE vs. NSCLC) and 91.5% (BPE vs. MPE excluding mesothelioma), respectively. Conclusions The p-CEA measurement in patients with pleural effusion of uncertain etiology is a safe and cost-effective procedure, everywhere easily available, which may help clinicians in selecting patients for further evaluations. An elevated p-CEA level in a patient with pleural effusion and negative pleural cytology suggests the need of more invasive procedure (e.g. VATS-guided biopsies), whilst low p-CEA may support a follow-up. |
| Databáze: | OpenAIRE |
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