Use of cholesterol and soluble tumour markers CEA and syndecan-2 in pleural effusions in cases of inconclusive cytology
| Autor: | János Fillinger, Miklos Z. Molnar, Andras D. Kaposi, Miklos Gulyas |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
0301 basic medicine
Male Cell- och molekylärbiologi Gastroenterology chemistry.chemical_compound 0302 clinical medicine Carcinoembryonic antigen tumour markers Cytology Medicine Aged 80 and over Cholesterol Measurement biology Clinical Laboratory Medicine General Medicine Middle Aged Immunohistochemistry Klinisk laboratoriemedicin Cholesterol Effusion pleura 030220 oncology & carcinogenesis Original Article Female Adult medicine.medical_specialty Cytodiagnosis Pathology and Forensic Medicine Diagnosis Differential 03 medical and health sciences Young Adult cytopathology Predictive Value of Tests Internal medicine Carcinoma Biomarkers Tumor Humans cancer Aged business.industry Cancer Reproducibility of Results medicine.disease Carcinoembryonic Antigen Pleural Effusion Malignant 030104 developmental biology chemistry Cytopathology biology.protein Syndecan-2 business Cell and Molecular Biology |
| Zdroj: | Journal of Clinical Pathology |
| Popis: | AimsIn order to improve diagnostics in pleural effusions, additional value of effusion cholesterol, carcinoembryonic antigen (CEA) and syndecan-2 assays to cytology was studied.MethodsBiomarkers were measured in effusion supernatants from 247 patients, of whom 126 had malignant pleural involvement, and their additional diagnostic efficacy to cytology was assessed.ResultsSyndecan-2 measurement, although gave detectable concentrations in all effusions with highest median value in mesotheliomas, was non-discriminative between different pathological conditions. CEA concentrations exceeding 5 ng/mL cut-off point indicated carcinomas, regardless of pleural involvement, which gave a sensitivity of 62% and specificity of 100% for carcinoma. Cholesterol concentration over 1.21 mmol/L cut-off value indicated neoplastic pleural involvement with 99% sensitivity and ‘merely’ 69% specificity, the latter mainly due to raised levels being associated also with benign inflammatory effusions. Combined CEA and cholesterol determinations increased the sensitivity for diagnosing carcinomatosis from 70% with cytology alone to 84% and established the correct diagnosis in 16 of 31 carcinomatosis cases with inconclusive cytology. Cholesterol measurement alone, with elevated level, in combination with absence of substantial number of inflammatory cells in effusion sediment proved to be a magnificent marker for neoplastic pleural involvement with 99% efficacy, and recognised all 36 such cases with inconclusive cytology.ConclusionsSimultaneous measurement of CEA and cholesterol concentrations in effusion, or at least cholesterol alone, in combination with non-inflammatory fluid cytology, provides additional specific information about neoplastic pleural involvement, and can therefore be used as an adjunct to cytology, above all, in inconclusive cases. |
| Databáze: | OpenAIRE |
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