CEA and CA 15-3 in Pleural Effusion of Advanced Breast Cancer Patients: Clinical Relevance and Diagnostic Value

Abstract

Serum and pleural effusion fluid were tested for CEA concentration in 83 advanced breast cancer patients, in 43 of whom CA 15-3 was also determined. All pleural effusions were clinically malignant. The sensitivity of the CEA test for the presence of pleural metastases was closer to that of the CA 15-3 test in effusion (0.59 and 0.79, respectively) than the sensitivity of CEA compared to CA 15-3 in serum (0.43 vs. 0.79). The use of two markers combined with cytology increased the diagnostic rate from 48% (cytologically positive) to 88% (cytologically positive and/or with one or both markers increased in effusion). A high diagnostic rate in cytologically negative effusions (65%), and in effusions presented as the sole metastatic involvement (100%), points to the clinical value of these two markers. Our results show that markers produced by pleural metastases may be secreted either into the effusion fluid or into serum, or both. This finding, as well as some other observations, are discussed in the present paper.

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 …”