Diagnostic value of Her-2/neu, Cyfra 21-1, and carcinoembryonic antigen levels in malignant pleural effusions of lung adenocarcinoma

Huang, Wen Wei; Tsao, Shih Ming; Lai, Ching‐Huang; Su, Cheng; Tseng, Chih En

doi:10.3109/00313021003631320

Cited by 41 publications

(42 citation statements)

References 19 publications

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“…The future spells interest in sensitive technologies and techniques for imaging the pleura such as MRI, PET-CT, autofluorescence thoracoscopy and NBI as well as novel biomarkers which can translate to improved clinical diagnostic and staging accuracy. Strategies incorporating biomarkers combined with Bayesian statistics [Westfall et al 2010] or clinical characteristics [Sales et al 2009] are being developed to improve biomarker specificity in the diagnosis of malignant pleural effusions [Huang et al 2010;Li et al 2010;Pu et al 2008aPu et al , 2008b, and validation studies are eagerly awaited before recommendation for use in diagnostic algorithms of pleural diseases.…”

Section: Resultsmentioning

confidence: 99%

“…Forty-one patients with histology proven malignant pleural effusion due to lung adenocarcinoma, and 93 patients with benign pleural effusions were evaluated. Pleural fluid CEA (>6.0 mm/l) combined with cytokeratin fragment (Cyfra) 21-1 (> 60 mm/l) resulted in 97.6% sensitivity and 91.4% specificity for malignancy [Huang et al 2010]. In another study of 80 patients with malignant pleural effusions due to lung cancer, and 50 patients with benign pleural effusions, pleural fluid Cyfra 21-1 combined with telomerase yielded 90% sensitivity, 76% specificity and an overall 86.9% accuracy for malignancy [Li et al 2010].…”

Section: Advances In Pleural Biomarkersmentioning

confidence: 99%

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Advances in the diagnosis of pleural disease in lung cancer

See¹,

Lee²

2011

Ther Adv Respir Dis

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Pleural disease in lung cancer can be benign or malignant with the latter carrying a grave prognosis. In this review, we describe and discuss the advances in pleural imaging, procedures, and biomarkers for the diagnosis of pleural diseases in lung cancer. Ultrasound and computed tomography are increasingly applied in the planning of pleural procedures to enhance diagnostic accuracy and safety whilst pleuroscopy gives excellent yield in excess of 93% in the evaluation of cytology negative pleural effusions. Invasion beyond the elastic layer of the visceral pleura upstages lung cancer, and may indicate a need for adjuvant chemotherapy. Biomarkers isolated from pleural fluid or tissue may aid in diagnosis and guide treatment in the future. Magnetic resonance imaging, positron emission tomography, narrow band imaging of the pleura and autofluorescence thoracoscopy are technologies that require further evaluation to better define their respective roles in the diagnostic algorithms of pleural diseases in lung cancer.

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Section: Resultsmentioning

confidence: 99%

Section: Advances In Pleural Biomarkersmentioning

confidence: 99%

Advances in the diagnosis of pleural disease in lung cancer

See¹,

Lee²

2011

Ther Adv Respir Dis

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“…informahealthcare.com carcinoma, osteoprotegerin (OPG), TNF-related apoptosisinducing ligand, but the studies are still limited so far [30][31][32].…”

Section: Reviewmentioning

confidence: 99%

2015 update on the diagnosis and management of neoplastic pericardial disease

Lestuzzi

Berretta

Tomkowski³

2015

Expert Review of Cardiovascular Therapy

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The best approach in diagnosis and treatment of neoplastic pericardial disease has not been defined yet. The authors report the most recent literature about the new diagnostic techniques that are useful to improve the diagnosis. The literature about the therapeutic options is critically reviewed, in order to give suggestions of use to the clinical practice. Pericardial effusion may require urgent drainage; the solid component, however, becomes predominant in some cases. Neoplastic pericardial disease should be assessed following oncologic criteria evaluation of the neoplastic burden; outcome classified as complete or partial response, stable or progressive disease and - in cases with progression - event-free survival. Systemic chemotherapy may be effective in lymphomas and possibly in breast carcinomas. Intrapericardial chemotherapy with systemic chemotherapy is the treatment of choice in lung cancer. Pericardial window with systemic chemotherapy is also effective in preventing the accumulation of large amount of fluid.

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“…The majority of these studies was focused on pleural effusions (which are much more common and easily drained) but similar results have been obtained in pericardial effusions [47,48] . More recently, Her-2/neu has been added to the panel of possible markers in lung carcinoma effusions, but CEA is still the most accurate single diagnostic marker, followed by CYFRA 21-1, and the combination of a CEA > 6 ng/mL and CYFRA 21-1 > 60 ng/mL resulted in a sensitivity of 97.6% and a specificity of 91.4% in the most recent report [49] . After drainage of the pericardial fluid, samples of fluid are sent both to microbiology and pathology laboratories for culture, chemical tests and neoplastic marker dosages.…”

Section: Diagnosismentioning

confidence: 99%

Neoplastic pericardial disease: Old and current strategies for diagnosis and management

Lestuzzi¹

2010

WJC

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The prevalence of neoplastic pericardial diseases has changed over time and varies according to diagnostic methods. The diagnostic factor is usually the detection of neoplastic cells within the pericardial fluid or in specimens of pericardium, but the diagnosis may be difficult. Accurate sampling and cytopreparatory techniques, together with ancillary studies, including immunohistochemical tests and neoplastic marker dosage, are essential to obtain a reliable diagnosis. The goals of treatment may be simply to relieve symptoms (cardiac tamponade or dyspnea), to prevent recurrent effusion for a long-term symptomatic benefit, or to treat the local neoplastic disease with the aim of prolonging survival. Immediate relief of symptoms may be obtained with percutaneous drainage or with a surgical approach. For long term prevention of recurrences, various approaches have been proposed: extended drainage, pericardial window (surgical or percutaneous balloon pericardiostomy), sclerosing local therapy, local and/or systemic chemotherapy or radiation therapy (RT) (external or with intrapericardial radionuclides). The outcomes of various therapeutic approaches vary for different tumor types. Lymphoma and leukemias can be successfully treated with systemic chemotherapy; for solid tumors, percutaneous drainage and the use of systemic and/or local sclerosing and antineoplastic therapy seems to offer the best chance of success. The use of "pure" sclerosing agents has been replaced by agents with both sclerosing and antineoplastic activity (bleomycin or thiotepa), which seems to be quite effective in breast cancer, at least when associated with systemic chemotherapy. Local chemotherapy with platinum, mitoxantrone and other agents may lead to good local control of the disease, but the addition of systemic chemotherapy is probably relevant in order to prolong survival. The surgical approach (creation of a pericardial window, even with the mini-invasive method of balloon pericardiostomy) and RT may be useful in recurring effusions or in cases that are refractory to other therapeutic approaches.

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Diagnostic value of Her-2/neu, Cyfra 21-1, and carcinoembryonic antigen levels in malignant pleural effusions of lung adenocarcinoma

Cited by 41 publications

References 19 publications

Advances in the diagnosis of pleural disease in lung cancer

Advances in the diagnosis of pleural disease in lung cancer

2015 update on the diagnosis and management of neoplastic pericardial disease

Neoplastic pericardial disease: Old and current strategies for diagnosis and management

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