Chest
Clinical Investigations: TumorsDiagnostic Value of CYFRA 21–1 Tumor Marker and CEA in Pleural Effusion Due to Mesothelioma
Section snippets
Patients
We measured CEA and CYFRA 21––1 in the serum and PE of 106 consecutive patients admitted for diagnosis to the Department of Respiratory Disease of San Martino Hospital and to the Thoracic Endoscopy Service of the National Institute for Cancer Research of Genoa from 1995 to 1997. Informed consent was obtained from all the subjects.
Thirty-four patients had benign PE, and 72 patients had malignant PE. Of these latter patients, 32 malignant PEs were from mesothelioma (Table 1). All the PEs were
Results
The median concentration and range of CEA and CYFRA 21––1 in the serum and PE of patients with malignant and benign disease are reported in Table 2. The PE CYFRA 21––1 concentration was significantly higher in patients with mesothelioma than in those with benign pleurisy (p < 0.001) and with carcinoma (p = 0.02). In serum, a significant difference was observed between patients with mesotheliomas and benign diseases (p < 0.0001), but not those with carcinomas. The CEA values both in the serum
Discussion
The differential diagnosis between benign and malignant effusions represents a critical clinical problem. Cytologic analysis is the method usually adopted to identify malignant cells in a PE, but it seems not to be sensitive enough (40 to 60%).3 In the case of uncertainty, blind or thoracoscopic-guided biopsy should be used. This procedure is highly sensitive, but, unfortunately, it is also invasive and limited to specialized centers.
The results of previous studies have suggested that a pool of
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Cited by (81)
Simultaneous presence of lung adenocarcinoma and malignant pleural mesothelioma: A case report
2019, Respiratory Medicine Case ReportsCitation Excerpt :Pettersson et al. reported that using a cut-off level of 100 mg/L, the concentration of HA in the pleural fluid showed sensitivity of 73% and specificity of 90% for MPM [18]. Moreover, CYFRA and TPA are useful as positive markers for MPM, whereas CEA is useful as a negative marker [19,20]. In the present case, the patient had high levels of HA (>80,000 ng/mL), CYFRA (466.9 ng/mL) and TPA (7636 U/L), and normal CEA levels in the pleural fluid.
Evaluation of predictive value of pleural CEA in patients with pleural effusions and histological findings: A prospective study and literature review
2016, Clinical BiochemistryCitation Excerpt :Moreover, blind needle aspiration biopsy adds little value, reporting often false-negative results requiring more invasive procedures such as VATS [17]. A number of several TMs other than CEA have been assayed in PF of patients with PE, including cytokeratin fragment 21-1 (CYFRA 21-1) [5,7,11,18–51], carbohydrate antigen (CA) 15-3 [5,11,24,28,30–34,41–44,49], CA 19-9 [5,24,30,34,42,43,46,49,51], CA 125 [5,11,32,35,39,44–46,49], CA 724 [5,30,34,41,42,45], CA 549 [40,41], and neuron-specific enolase (NSE) [15,32,34,35,44], especially in patients with MPE from lung cancer or pulmonary metastases. CEA, which is a glycoprotein involved in cell adhesion normally produced during fetal life, is one of the most studied TM available for clinical use [52,53].
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