Chest
Clinical InvestigationsPLEURAUse of a Panel of Tumor Markers (Carcinoembryonic Antigen, Cancer Antigen 125, Carbohydrate Antigen 15–3, and Cytokeratin 19 Fragments) in Pleural Fluid for the Differential Diagnosis of Benign and Malignant Effusions
Section snippets
Subjects
We studied 374 patients with PEs attending the Arnau de Vilanova University Hospital (Lleida, Spain) from 1996 to 2002, in whom at least one diagnostic thoracentesis with measurement of CEA, CA 125, CA 15–3, or CYFRA 21–1 in pleural fluid was performed. This series was completed by 42 additional patients recruited from the Virgen del Rocío University Hospital (Sevilla, Spain), who had negative pleural fluid cytology findings but confirmation of pleural malignancy by thoracoscopic biopsy. The
Etiology of PEs
Of the 416 patients who entered the study, 166 patients (86 men and 80 women, with a median age of 67 years) had a malignant PE, 77 patients (41 men and 36 women, with a median age of 69 years) had a probable malignant PE, and 173 patients (109 men and 64 women, with a median age of 67 years) had a benign PE. The specific etiologies and the histologic subtypes of tumors are presented in Table 1. Among the former group, there were 118 patients with positive pleural fluid cytology findings, and
Discussion
A large number of studies on the potential diagnostic usefulness of pleural tumor markers have been published, which report either encouraging1119 or disappointing71215 results. The disagreement in results can be attributed to different factors, including the heterogeneity of tumor types, the inappropriate inclusion of paramalignant PEs to calculate test performances, the sometimes underpowered series, or the use of different methodologies and cutoff values in tumor marker assays, among others.
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This study was sponsored in part by grants from FIS 00/0699, Ministerio de Sanidad y Consumo, Spain, and from Comité Etico de Investigación Clinica, Arnau de Vilanova University Hospital, Lleida, Spain.