Carcinoembryonic antigen in pleural effusions: A diagnostic and prognostic indicator

Evaluation of seven tumour markers in pleural fluid for the diagnosis of malignant effusions

“…Since a high diagnostic specificity is essential for the clinical use of tumour markers, we first defined highly specific thresholds for each marker. Empyemas were excluded from our series since, in agreement with several reports (Klockars et al, 1980;Garcia-Pachon et al, 1997;Villena et al, 1998) we previously observed high false-positive rates for CEA, but also for CYFRA (Salama et al, 1998) in these fluids. This exclusion is not prejudicial because cytological and bacteriological analyses of pleural fluid easily identify these effusions and overall, malignancy is very rarely associated with this clinical presentation (Sahn, 1988).…”

“…Indeed, at the same level of specificity, pleural and serum thresholds are different, as shown for CEA (Rittgers et al, 1978, Romero et al, 1996 and also for CYFRA (Toumbis et al, 1996). In patients with malignant effusions, pleural values of markers are higher than serum values and the greater sensitivity of the pleural assay for the diagnosis of malignancy was demonstrated for several markers such as CEA (Rittgers et al, 1978;Klockars et al, 1980;Asseo and Tracopoulos, 1982;Rapellino et al, 1990;Romero et al, 1996), CA 15-3 (Rapellino et al, 1990) or neuron-specific enolase (NSE) (Menard et al, 1993).…”

Diagnostic value of carcinoembryonic antigen in malignant pleural effusion: A meta‐analysis

“…After independent review, 75 publications on the role of pleural CEA concentrations in the diagnosis of MPE were considered to be eligible for inclusion in the analysis 21–95 . Of these publications, two were excluded because they recruited less than 10 patients in one of study groups, 69,70 four were excluded because the CEA concentration was determined only in patients with MPE, 71–74 16 were excluded because they included MPE and malignant peritoneal effusions as a single group, 75–90 two were excluded because they did not allow the calculation of sensitivity or specificity, 91,92 and three were excluded because the same authors published several reports on the same patients, and only the best‐quality study was considered 93–95 …”

“…The remaining 45 articles, 21–65 based on 2834 patients with MPE and 3251 patients without MPE, were available for the meta‐analysis and the diagnostic characteristics of these studies, along with STARD and QUADAS scores, are outlined in Table 1. Eight of these 45 publications also assessed the value of pleural CEA measurement in the differential diagnosis of malignant pleural mesothelioma and metastatic pleural malignancy due to lung cancer 29,35,37,52,54,55,59,60 .…”

Diagnostischer Wert der Tumormarker TPA-M, CYFRA 21-1 und CEA bei Pleuraergüssen - Prospektiver Vergleich bei thorakoskopisch untersuchten Patienten mit Pleuaerguß -

“…Bislang am häufigsten wurde die diagnostische Wertigkeit von CEA im Pleuraerguß untersucht [8,9,12,13,26,27]. Die Angaben zur Sensitivität (34 -59 %) und Spezifität (92 -100 %) schwanken in Abhängigkeit von der Zusammensetzung des Patientenkollektivs, der Bestimmungsmethode sowie des gewählten Grenzwertes (cut-off).…”