Diagnostic value of CA 72-4, carcinoembryonic antigen, CA 15-3, and CA 19-9 assay in pleural fluid: A study of 207 patients

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

“…Few studies on pleural fluid have integrated CA 72-4 (Ferroni et al, 1990, Villena et al, 1996 and our results confirmed the high sensitivity of CA 72-4 in all types of adenocarcinomas, but we also noted high levels in squamous cell carcinomas. Similarly, as previously described (Ferroni et al, 1990, Romero et al, 1996Villena et al, 1996), we observed high values of CA 15-3 in adenocarcinomas and not only in those of breast origin. Furthermore, compared to CEA and CA 72-4, CA 15-3 showed an atypical pattern in mesotheliomas, with a sensitivity of 45.5%, in agreement with the results of Villena et al (1996).…”

“…Malignant pleural involvement was ascertained in 215 patients (52.1% men, aged from 19 to 89 years, median 65 years), by the presence of malignant cells in pleural fluid and/or in pleural biopsy (blind needle biopsy or biopsy under thoracoscopy). These two groups were representative of the main causes of pleurisies (Serre et al, 1990;Fenton and Richardson, 1995;Villena et al, 1996;Sahn, 1988). Breast and lung cancer were the most frequent causes of malignant pleural involvement.…”

“…The diagnostic sensitivity for pleural CEA was concordant with those described in previous studies, confirming its utility in carcinomas (Rapellino et al, 1990) and its non-expression in mesotheliomas (Mezger et al, 1994). Few studies on pleural fluid have integrated CA 72-4 (Ferroni et al, 1990, Villena et al, 1996 and our results confirmed the high sensitivity of CA 72-4 in all types of adenocarcinomas, but we also noted high levels in squamous cell carcinomas. Similarly, as previously described (Ferroni et al, 1990, Romero et al, 1996Villena et al, 1996), we observed high values of CA 15-3 in adenocarcinomas and not only in those of breast origin.…”

“…Malignant effusions of unknown primary site were frequent in our recruitment (46 out of 215, i.e. 21%) in agreement with the prospective study of Villena et al (1996) (17 out of 65, i.e 26%).…”

“…Nevertheless, for a particular carcinoma the use of a single marker appeared insufficient because it is not always expressed and, in addition, no tumour marker has a spectrum wide enough to detect all types of malignancies. Thus, many studies emphasized the association of CEA with various tumour markers such as carbohydrate antigens (Ferroni et al, 1990;Villena et al, 1996). The best results were logically obtained in adenocarcinomas since serum CA 15-3 is proposed for the management of breast adenocarcinomas (Soletormos et al, 1996), CA 72-4 for gastric and ovarian adenocarcinomas (Guadagni et al, 1995) and CA 19-9 for digestive adenocarcinomas (Grem, 1997).…”