CEA, AFP, CA125, CA153 and CA199 in Malignant Pleural Effusions Predict the Cause

Wang, Xinfeng; Wu, Yanhua; Wang, Mao‐Shui; Wang, Yunshan

doi:10.7314/apjcp.2014.15.1.363

Cited by 47 publications

(41 citation statements)

References 27 publications

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“…The golden standard for diagnosing MPE is histopathologic diagnosis of primary neoplasm combined with finding malignant cells in pleural fluid or pleural biopsy; however, only about 60 % cases can be diagnosed by pleural aspiration or thoracentesis. In recent years, several tumor markers have been investigated in patients with pleural effusion for their ability to discriminate malignant causes from benign diseases; however, few of them have gained consensus as a highly efficient marker because of varied test accuracies [7,8]. A more efficient marker, either in pleural fluid or in serum, is therefore required.…”

Section: Discussionmentioning

confidence: 99%

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Diagnostic value of soluble receptor-binding cancer antigen expressed on SiSo cells and carcinoembryonic antigen in differentiating malignant from benign pleural effusion

2015

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Diagnosis of malignant pleural effusion (MPE) remains a major clinical challenge. The aim of this study was to evaluate the diagnostic value of combined detection of receptor-binding cancer antigen expressed on SiSo cells (RCAS1) and carcinoembryonic antigen (CEA) in patients with MPE and benign pleural effusion (BPE). The serum and pleural fluid samples were collected from 53 patients diagnosed with MPE and 49 patients with BPE. Enzyme-linked immunosorbent assay was used to detect the concentration of RCAS1 in serum and pleural effusion. The clinical data and laboratory information, including CEA levels, were gathered from these cases. The concentration of RCAS1 in MPE was significantly higher than that of BPE (P < 0.001). There was no significant difference between the two serum groups. The diagnostic sensitivity and specificity of pleural fluid RCAS1 were 67.92 and 81.63 %, respectively, at the optimized cutoff value of 7.326 U/mL; meanwhile, the sensitivity and specificity of pleural fluid CEA were 83.02 and 91.84 % at the cutoff value of 3.93 ng/mL. The specificity could be elevated to 98.50 % in serial detection, while the sensitivity may be improved to 94.55 % in parallel detection. Serum RCAS1 concentration was only detected in 53 serum samples out of the 102 samples, indicating that serum RCAS1 may not be a better option in differential diagnosis of malignancies compared with serum CEA, of which the diagnostic sensitivity and specificity were 64.15 and 83.67 % at the cutoff value of 3.90 ng/mL. No significant differences were found in pleural fluid RCAS1 concentration in MPE patients with different ages, gender, and pathological types of lung cancers. The detection of RCAS1 concentration in pleural fluid is informative for the diagnosis of MPE. Joint detection of RCAS1 and CEA can improve the diagnostic sensitivity and specificity. However, the diagnostic value of RCAS1 is not higher than that of CEA.

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Section: Discussionmentioning

confidence: 99%

“…Carcinoembryonic antigen (CEA) is a commonly used biomarker of MPE, and it is recommended as a useful biomarker in postoperative monitoring and curative effect observation [7][8][9][10][11]. However, it is known that CEA has some limitations [7,10,12].…”

Section: Introductionmentioning

confidence: 99%

Diagnostic value of soluble receptor-binding cancer antigen expressed on SiSo cells and carcinoembryonic antigen in differentiating malignant from benign pleural effusion

2015

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“…Hence various ancillary techniques like immunocytochemistry, tumor markers, image morphometry, flow cytometry and others are being evaluated (Murugan et al, 2009;Krishan et al, 2010;Bunjhoo et al, 2012;Cheng et al, 2012;Kundu et al, 2012;Liu et al, 2013;Yildirim et al, 2013;Wang et al, 2013;2014). Computerised image analysis can estimate various parameters of the cells.…”

Section: 6919 Utility Of Nuclear Morphometry With Imagej In Effusionmentioning

confidence: 99%

“…Cytological diagnosis of effusion fluids is an important investigation to determine the appropriate treatment.The distinction of reactive mesothelial cells from carcinoma cells can sometimes prove to be a diagnostic challenge even for the experienced cytopathologist. Hence there is an increasing need to develop cost-effective ancillary methods to enhance the accuracy of cytologic diagnosis (Murugan et al, 2009;Bunjhoo et al, 2012;Cheng et al, 2012;Liu et al, 2013;Yildirim et al, 2013;Wang et al, 2013;2014). Image morphometry is one such ancillary technique and often requires expensive software and hardware for image acquisition and analysis.…”

Section: Introductionmentioning

confidence: 99%

Utility of Nuclear Morphometry in Effusion Cytology

Ambroise

Jothilingam²,

Ramdas³

2014

Asian Pacific Journal of Cancer Prevention

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Background: The cytological analysis of serous effusions is a common investigation and yields important diagnostic information. However, the distinction of reactive mesothelial cells from malignant cells can sometimes be difficult for the cytopathologist. Hence cost-effective ancillary methods are essential to enhance the accuracy of cytological diagnosis. The aim of this study was to examine the utility of nuclear morphometry in differentiating reactive mesothelial cells from malignant cells in effusion smears. Materials and Methods: Sixty effusion smears consisting of 30 effusions cytologically classified as malignant (adenocarcinomas) and 30 benign effusions showing reactive mesothelial cells were included in the study. ImageJ was used to measure the nuclear area, perimeter, maximal feret diameter, minimal feret diameter and the circularity. A total of ten representative cells were studied in each case. Results: Significant differences were found between benign and malignant effusions for the nuclear area, perimeter, maximal feret diameter and minimal feret diameter. No significant difference was found for circularity, a shape descriptor. Receiver operating characteristic (ROC) curve analysis revealed that nuclear area, perimeter, maximal feret diameter, and minimal feret diameter are helpful in discriminating benign and malignant effusions. Conclusions: Computerised nuclear morphometry is a helpful ancillary technique to distinguish benign and malignant effusions. ImageJ is an excellent cost effective tool with potential diagnostic utility in effusion cytology.

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“…Significantly higher levels of CA15-3 (138.6 U/mL vs 21.3 U/mL) and CA19-9 (516.6 U/mL vs 181.5 U/mL) were found in 128 lung adenocarcinoma cases than in 18 mesotheliomas. 17 Kallikreins are a subgroup of serine proteases which have been implicated in carcinogenesis. Tissue expression of kallikreins has been demonstrated in pleural mesothelioma, 18 yet explanations for their levels and significance in malignant pleural fluids is lacking.…”

Section: Discussionmentioning

confidence: 99%