Performance of CEA and CA19-9 in identifying pleural effusions caused by specific malignancies

Background: The role of combinations of tumor markers such as carcinoembryonic antigen (CEA), carbohydrate antigens (CA) 125, 15-3, and 19-9, and CYFRA 21-1 (a fragment of cytokeratin 19) in diagnosing malignant pleural effusion (MPE) has not been clearly established. Objectives: This meta-analysis was performed to establish the overall diagnostic accuracies of combinations of these pleural fluid tumor markers for MPE. Methods: The PubMed, Ovid, Embase, Web of Science, and Cochrane bibliographic databases were searched. Sensitivity, specificity, and other measures of the accuracy of combinations of pleural CEA, CA 125, CA 15-3, CA 19-9, and CYFRA 21-1 in the diagnosis of MPE were pooled after a systematic review of English-language studies. Results: Twenty studies met the inclusion criteria. For pleural fluid tumor marker combinations including more than 3 studies, the summary estimates of the sensitivity/specificity for diagnosing MPE were as follows: CEA + CA 125, 0.65/0.98; CEA + CA 15-3, 0.64/0.98; CEA + CA 19-9, 0.58/0.98; CEA + CYFRA 21-1, 0.82/0.92; and CA 15-3 + CYFRA 21-1, 0.88/0.94. Conclusions: In patients with undiagnosed pleural effusion, the combinations of positive pleural CEA + CA 15-3 and CEA + CA 19-9 are highly suspicious for pleural malignancy, but the sensitivity of these tests is poor. Therefore, their routine role in the diagnostic algorithm of these patients is questionable, and management decisions should depend on positive cytological or biopsy results from the pleura.

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“…1 ) [13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32] . Eleven were from the 2008 article by Liang et al [6] .…”

Section: Study Characteristics and Quality Of Reportingmentioning

confidence: 99%

Diagnostic Accuracy of Combinations of Tumor Markers for Malignant Pleural Effusion: An Updated Meta-Analysis

Yang

Liu

Shi³

2017

Respiration

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“…Pleural effusion is a common complication of many disorders (12). The first step in evaluating pleural fluids is determining the transudate and exudate features.…”

Section: Discussionmentioning

confidence: 99%

Neural stem cells and their role in the pathology and classification of central nervous system tumors

Tihan

Pekmezci

Karnezis

2011

TJPATH

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Objective: Cytological examination of pleural fluids is a fast, efficient and non-invasive diagnostic method. identification of malignant effusions bears critical importance in treatment and prognosis. The aim of this study was to investigate the distribution of cytopathologic diagnoses in pleural effusions and the cyto-histopathologic correlation rates.Material and Method: a total of 298 pleural fluid cases diagnosed from 2008 to 2009 in our laboratory were retrospectively identified as the study group. Evaluation results were classified in 5 groups as inconclusive, benign, atypical, suspicious and malignant, and compared with the biopsy results.Results: of the total 298 pleural fluid cases, 114 (38.3%) were females and 184 (61.7%) were males. The age range was between 15 and 89 with a mean value of 58.4±17.8. of the cases, 3 (1%) were diagnosed as inadequate, 246 (82.6%) benign, 8 atypical, 10 suspicious, and 31 malignant by cytology. among the cases who were diagnosed as malignant, 24 (8.1%) were reported as metastatic carcinoma and 7 (2.3%) as malignant mesothelioma. of the 8 cases reported as atypical, biopsy results of 2 showed malignant mesothelioma, and of the 10 cases reported as suspicious, 1 case whose biopsy result was obtained was diagnosed as epidermoid carcinoma metastasis. Conclusion:Cytological examination is the most valuable diagnostic method for pleural effusions which may have various etiological causes. The most common cause of pleural effusions in our region is metastatic carcinomas including those from the lung, breast and ovarian tumors, followed by malignant mesothelioma.

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“…Secreting malignancies were defined as cancers that were associated with serum elevations of the tumor marker. CEA secreting carcinomas include: gastrointestinal (gastric, cholangiocarcinoma, colorectal), pancreatic, gynecological (ovarian, endometrial, fallopian), lung, peritoneal carcinomatosis, bladder/renal and breast; CA 19-9: include all those for CEA in addition to mesothelioma and hepatocellular carcinoma; AFP: hepatocellular carcinoma only [6][7][8][9][10][11][12].…”

Section: Patientsmentioning

confidence: 99%

“…An improvement on these studies lies in subtype analysis by correlating tumor marker values with malignancies known to have elevations of these antigens in serum. This has shown to improve sensitivity in tumor marker analysis in pleural fluid [6]. The aim of this study was to correlate cytological findings with tumor marker analysis as a way to improve the differentiation of malignancy-associated ascites from non-malignant ascites.…”

Section: Introductionmentioning

confidence: 99%

CEA, AFP and CA 19-9 analysis in peritoneal fluid to differentiate causes of ascites formation

Kaleta

Tolan

Ness

et al. 2013

Clinical Biochemistry

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Performance of CEA and CA19-9 in identifying pleural effusions caused by specific malignancies

Cited by 35 publications

References 27 publications

Diagnostic Accuracy of Combinations of Tumor Markers for Malignant Pleural Effusion: An Updated Meta-Analysis

Diagnostic Accuracy of Combinations of Tumor Markers for Malignant Pleural Effusion: An Updated Meta-Analysis

Neural stem cells and their role in the pathology and classification of central nervous system tumors

CEA, AFP and CA 19-9 analysis in peritoneal fluid to differentiate causes of ascites formation

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