Long‐term stability of pleural fluid carcinoembryonic antigen and its effect on the diagnostic accuracy for malignant pleural effusion

Yang, Danni; Niu, Yan; Wen, Jian-Xun; Wen, Xu‐Hui; Wang, Yafei; Li, Yan; Jiang, Ting-Wang; Huang, Jin-Hong; Chen, Hong; Lippi, Giuseppe; Zheng, Wen‐Qi; Hu, Zhide

doi:10.1111/1759-7714.14996

Cited by 5 publications

(3 citation statements)

References 46 publications

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“…The diagnostic accuracy of CEA for MPE has been published in our previous studies. 29 , 30 In the current investigation, we also compared the diagnostic accuracy of CEA and CA72-4. The AUC of CA72-4 in the combined cohort was lower than that of CEA ( p = 0.006, Table 2 ).…”

Section: Resultsmentioning

confidence: 99%

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Pleural fluid carbohydrate antigen 72-4 and malignant pleural effusion: a diagnostic test accuracy study

Cao,

Yan,

Jiang

et al. 2024

Ther Adv Respir Dis

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Background: The prognosis of malignant pleural effusion (MPE) is poor. A timely and accurate diagnosis is the prerequisite for managing MPE patients. Carbohydrate antigen 72-4 (CA72-4) is a diagnostic tool for MPE. Objective: We aimed to evaluate the diagnostic accuracy of pleural fluid CA72-4 for MPE. Design: A prospective, preregistered, and double-blind diagnostic test accuracy study. Methods: We prospectively enrolled participants with undiagnosed pleural effusions from two centers in China (Hohhot and Changshu). CA72-4 concentration in pleural fluid was measured by electrochemiluminescence. Its diagnostic accuracy for MPE was evaluated by a receiver operating characteristic (ROC) curve. The net benefit of CA72-4 was determined by a decision curve analysis (DCA). Results: In all, 153 participants were enrolled in the Hohhot cohort, and 58 were enrolled in the Changshu cohort. In both cohorts, MPE patients had significantly higher CA72-4 levels than benign pleural effusion (BPE) patients. At a cutoff value of 8 U/mL, pleural fluid CA72-4 had a sensitivity, specificity, and area under the ROC curve (AUC) of 0.46, 1.00, and 0.79, respectively, in the Hohhot cohort. In the Changshu cohort, CA72-4 had a sensitivity, specificity, and AUC of 0.27, 0.94, and 0.86, respectively. DCA revealed the relatively high net benefit of CA72-4 determination. In patients with negative cytology, the AUC of CA72-4 was 0.67. Conclusion: Pleural fluid CA72-4 helps differentiate MPE and BPE in patients with undiagnosed pleural effusions.

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Section: Resultsmentioning

confidence: 99%

“…Our previous studies with the same cohort supported this conclusion, which found that the AUC of CEA for MPE was 0.89. 29 , 30 Further studies are needed to investigate whether multiple marker strategies incorporating CA72-4 can improve the diagnostic yield of MPE.…”

Section: Discussionmentioning

confidence: 99%

Pleural fluid carbohydrate antigen 72-4 and malignant pleural effusion: a diagnostic test accuracy study

Cao,

Yan,

Jiang

et al. 2024

Ther Adv Respir Dis

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“…Cytology sensitivity is only between 20% and 60% [ 3 , 8 ]. Previous research discovered that cancer markers such as carbohydrate antigen 125 (CA 125), carbohydrate antigen 15-3 (CA 15-3), carbohydrate antigen 19-9 (CA 19-9), and cytokeratin fragment 21-1 (CYFRA 21-1) have low sensitivity and organ specificity for detecting malignant pleural effusion [ 4 , 9 , 10 ]. As a result, there is an urgent need for a safe, quick, and accurate diagnostic approach for distinguishing between benign and malignant pleural effusions.…”

Section: Introductionmentioning

confidence: 99%

IR808@MnO nano-near infrared fluorescent dye’s diagnostic value for malignant pleural effusion

Wang,

Yan,

Zhang

et al. 2024

Respir Res

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Background Malignant pleural effusion is mostly a complication of advanced malignant tumors. However, the cancer markers such as carbohydrate antigen 125 (CA 125), carbohydrate antigen 15-3 (CA 15-3), carbohydrate antigen 19-9 (CA 19-9), and cytokeratin fragment 21-1 (CYFRA 21-1) have low sensitivity and organ specificity for detecting malignant pleural effusion. Research question Is IR808@MnO nano-near infrared fluorescent dye worthy for the diagnosis in differentiating benign and malignant pleural effusions. Study design and methods This experiment was carried out to design and characterize the materials for in vitro validation of the new dye in malignant tumor cells in the A549 cell line and in patients with adenocarcinoma pleural effusion. The dye was verified to possess tumor- specific targeting capabilities. Subsequently, a prospective hospital-based observational study was conducted, enrolling 106 patients and excluding 28 patients with unknown diagnoses. All patients underwent histopathological analysis of thoracoscopic biopsies, exfoliative cytological analysis of pleural fluid, and analysis involving the new dye. Statistical analyses were performed using Microsoft Excel, GraphPad Prism, and the R language. Results The size of IR808@MnO was 136.8 ± 2.9 nm, with peak emission at 808 nm, and it has near-infrared fluorescence properties. Notably, there was a significant difference in fluorescence values between benign and malignant cell lines (p < 0.0001). The malignant cell lines tested comprised CL1-5, A549, MDA-MB-468, U-87MG, MKN-7, and Hela, while benign cell lines were BEAS-2B, HUVEC, HSF, and VE. The most effective duration of action was identified as 30 min at a concentration of 5 μl. This optimal duration of action and concentration were consistent in patients with lung adenocarcinoma accompanied by pleural effusion and 5 μl. Of the 106 patients examined, 28 remained undiagnosed, 39 were diagnosed with malignant pleural effusions, and the remaining 39 with benign pleural effusions. Employing the new IR808@MnO staining method, the sensitivity stood at 74.4%, specificity at 79.5%, a positive predictive value of 69.2%, and a negative predictive value of 82.1%. The area under the ROC curve was recorded as 0.762 (95% CI: 0.652–0.872). The confusion matrix revealed a positive predictive value of 75.7%, a negative predictive value of 75.6%, a false positive rate of 22.5%, and a false negative rate of 26.3%. Interpretation The IR808@MnO fluorescent probe represents an efficient, sensitive, and user-friendly diagnostic tool for detecting malignant pleural fluid, underscoring its significant potential for clinical adoption.

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Quantitative proteomics revealed protein biomarkers to distinguish malignant pleural effusion from benign pleural effusion

Dong,

Liang,

Chen

et al. 2024

Journal of Proteomics

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Long‐term stability of pleural fluid carcinoembryonic antigen and its effect on the diagnostic accuracy for malignant pleural effusion

Cited by 5 publications

References 46 publications

Pleural fluid carbohydrate antigen 72-4 and malignant pleural effusion: a diagnostic test accuracy study

Pleural fluid carbohydrate antigen 72-4 and malignant pleural effusion: a diagnostic test accuracy study

IR808@MnO nano-near infrared fluorescent dye’s diagnostic value for malignant pleural effusion

Quantitative proteomics revealed protein biomarkers to distinguish malignant pleural effusion from benign pleural effusion

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