Pleural fluid carcinoembryonic antigen as a biomarker for the discrimination of tumor‐related pleural effusion

Li, Huiling; Huang, Liyan; Tang, Hailing; Zhong, Nanshan; He, Jianhang

doi:10.1111/crj.12431

Cited by 12 publications

(9 citation statements)

References 19 publications

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“…The manifestation of EPE is clinically common in pleura of patients with various respiratory disorders, and its diagnosis mainly depends on PE-based examinations, including routine, biochemical, enzymological, tumor marker and pathological cytology analysis (11,12). However, the sensitivity and specificity of these tests are less than satisfactory.…”

Section: Discussionmentioning

confidence: 99%

Combined analysis of C-reactive protein in pleural fluid and serum is effective in the differential diagnosis of exudative pleural effusions

Zhang

et al. 2021

Ann Transl Med

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Background: Exudative pleural effusion (EPE) is one of the common pleural manifestations of various diseases. Differential diagnosis of EPE is imperative clinically as it identifies different causes of EPE, thereby, enabling effective treatments. Thoracoscopy is a useful tool for differential diagnosis of EPE; however, some patients refuse thoracoscopic examination due to its invasive nature. In addition, the specificity and sensitivity of existing routine tests of EPE are unsatisfactory. Therefore, there is a great need to establish an effective method for the differential diagnosis of EPE.Methods: This study was a single-institution retrospective analysis of diagnostic efficiency of C-reactive protein (CRP) and procalcitonin (PCT) between March 2018 and September 2018. A total of 87 patients diagnosed with EPE were enrolled. All participants underwent diagnostic thoracentesis. The EPE was examined using biochemical, routine, microbiological, and cytological methods. Pathological cytology detection was necessary for those suspected of malignant PE. Benign PE originates in patients with pneumonia, empyema, and tuberculosis. The levels of CRP and PCT in EPE and serum were measured before treatment.Correlation analysis and receiver-operating characteristic (ROC) curve analysis were conducted to determine the underlying relationship between levels of CRP and PCT, and for differential diagnosis. Results:The ROC analysis showed that the sensitivity and specificity for the analysis of pleural fluid CRP (p-CRP) were higher (cut-off: 17.55 pg/mL; sensitivity: 75.00%, specificity: 83.90%) than that of serum CRP (s-CRP, cut-off: 23.90 pg/mL; sensitivity: 71.00%, specificity: 80.4%) in the differential diagnosis for EPE. However, the analysis of pleural fluid PCT (p-PCT) and serum PCT (s-PCT) did not demonstrate correlations with EPE. Combined analysis of p-CRP (cut-off: 17.55 mg/dL) with s-CRP (cut-off: 23.9 pg/mL) showed the highest diagnostic accuracy (88.4%) in diagnosing infectious EPE. Conclusions:The data support the close relationship between combined analysis of p-CRP with s-CRP and effective and accurate differential diagnosis of EPE, due to its higher sensitivity and specificity. However, as a highly sensitive marker for diagnosing bacterial infections, neither s-PCT nor p-PCT, showed correlations with the differential diagnosis of EPE.

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Section: Discussionmentioning

confidence: 99%

Combined analysis of C-reactive protein in pleural fluid and serum is effective in the differential diagnosis of exudative pleural effusions

Zhang

et al. 2021

Ann Transl Med

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“…CEA was the antibody to be tumor‐cell specific. CEA was widely recognized as a TM with high sensitivity and specificity for lung cancer, especially lung adenocarcinoma . CEA also has a good performance in the identification of benign and malignant PE .…”

Section: Discussionmentioning

confidence: 99%

“…CEA was widely recognized as a TM with high sensitivity and specificity for lung cancer, [24][25][26] especially lung adenocarcinoma. 21,[27][28][29] CEA also has a good performance in the identification of benign and malignant PE. 30,31 PE CA125 of carcinomatous pleuritis was produced by not only carcinoma cells but also activated mesothelial cells.…”

Section: Discussionmentioning

confidence: 99%

Analysis of tumor markers in pleural effusion and serum to verify the correlations between serum tumor markers and tumor size, TNM stage of lung adenocarcinoma

2019

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Background The study of tumor markers (TM) in pleural effusion (PE) was not extensive. Methods TM in PE and serum were analyzed to determine whether TM was expressed in intrathoracic and extrathoracic tissues. To further verify the correlations between serum TM and tumor size, TNM stage of lung adenocarcinoma. Results Serum AFP was not correlated with tumor size, T stage, N stage, and M stage (P > .05). Serum CEA, serum CA125, serum CA15‐3 were positively correlated with tumor size, T stage, N stage, M stage (P < .05). Serum CA19‐9 was not significantly correlated with tumor size and T stage (P > .05), but was positively correlated with N stage and M stage (P < .05). The levels of PE CEA, PE CA125, PE CA15‐3 were higher than those of serum CEA, serum CA125, serum CA15‐3 (all P < .05). The level of PE AFP was lower than that of serum AFP (P < .05). The level of PE CA19‐9 was not significantly different from that of serum CA19‐9 (P > .05). The positive rates of PE CEA and PE CA125 were higher than those of serum CEA and serum CA125 (P < .05). The positive rates of PE AFP, PE CA15‐3, PE CA19‐9 were not significantly different from those of serum AFP, serum CA15‐3, serum CA19‐9 (P > .05).PE CEA, PE CA125, PE CA15‐3 were moderately positively correlated with serum CEA, serum CA125, serum CA15‐3, respectively (r = 0.597; r = 0.46; r = 0.583, all P < .05). However, PE AFP and PE CA19‐9 were very strongly positively correlated with serum AFP and serum CA19‐9, respectively (r = 0.888; r = 0.874, all P < .05). Conclusion The expression characteristics of TM in PE and serum supported the correlations between serum TM and tumor size, TNM stage of lung adenocarcinoma.

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“…The conventional cytology method is deficient for diagnosis of the types of PE, especially for distinguishing malignant PE from benign PE ( 2 , 24 – 26 ). In recent years, research has been done to find an effective diagnosis method.…”

Section: Discussionmentioning

confidence: 99%

Combination of procalcitonin, C‑reaction protein and carcinoembryonic antigens for discriminating between benign and malignant pleural effusions

Zhu

Dong

et al. 2018

Oncol Lett

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Pleural effusion (PE) is a common manifestation associated with certain chest diseases. However, there is no effective diagnostic marker with high sensitivity and specificity. The aim of the present study was to evaluate the diagnostic performance of several biomarkers in the use of detecting malignant pleural disorder. One hundred and fifty patients with a specific diagnosis of exudative PE were enrolled in this study and were divided into the benign PE group (n=93) and the malignant PE group (n=57). Thoracoscopy was conducted to identify the reasons for the PE. Biomarkers in pleural fluid and in sera were determined either by microparticle enzyme immunoassay [carcinoembryonic antigen (CEA)], fluorescence immunoassay [procalcitonin (PCT)] or light-scattering turbidimetric immunoassay [C-reaction protein (CRP)]. Then, correlation analysis and receiver-operating characteristic (ROC) curve analysis individually or in combination were performed. The CRP and PCT levels were higher in benign PE than they were in malignant PE (PCT: P=0.017, P=0.032; CRP: P=0.001, P<0.001, respectively), while CEA levels were lower in benign PE than in malignant PE (CEA: P=0.001, P=0.001, respectively). During the ROC curve analysis, an optimal discrimination was identified by combining pleural CRP, pleural CEA and serum (s)PCT with an area under the curve of 0.973 (sensitivity, 98.9%; specificity, 89.5%). In the diagnosis of PE, there was no single biomarker that appeared to be adequately accurate. The combination of pleural CRP, pleural CEA and sPCT may represent an efficient diagnostic procedure for guiding the patient towards follow-up clinical treatment.

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Pleural fluid carcinoembryonic antigen as a biomarker for the discrimination of tumor‐related pleural effusion

Cited by 12 publications

References 19 publications

Combined analysis of C-reactive protein in pleural fluid and serum is effective in the differential diagnosis of exudative pleural effusions

Combined analysis of C-reactive protein in pleural fluid and serum is effective in the differential diagnosis of exudative pleural effusions

Analysis of tumor markers in pleural effusion and serum to verify the correlations between serum tumor markers and tumor size, TNM stage of lung adenocarcinoma

Combination of procalcitonin, C‑reaction protein and carcinoembryonic antigens for discriminating between benign and malignant pleural effusions

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