Abstract
To assess the practical utility of pleural fluid carbonic anhydrase XII (CAXII) quantification for differential diagnosis of effusions. Fluid was collected prospectively from fifty patients presenting with lymphocytic pleural effusions for investigation and CAXII was quantified by ELISA. Pleural fluid CAXII concentrations were significantly higher in lung cancer patients (n=30) than in tuberculous controls (n=20). The sensitivity and specificity of this biomarker were 60%and 75%, respectively. CAXII measurement was not inferior to cytological examination in the diagnosis and exclusion of pleural effusions from lung cancer patients (sensitivity 60% vs. 57%; specificity 75% vs. 100%; positive predictive value 77%; negative predictive value 54%). In patients with negative cytology, it offered a sensitivity of 54%. Pleural fluid CAXII is elevated in pleural effusions from lung cancer patients. Measurement of CAXII may be used in the future as a valuable adjunct to cytology in the diagnostic assessment of patients with pleural effusions related to lung cancer, especially when cytological examination is inconclusive.
Highlights
Malignant and tuberculous pleurisy are two main causes of pleural effusion (PE) in a high tuberculosis prevalence region (Liam et al, 2000; World Health Organization, 2011)
Measurement of carbonic anhydrase XII (CAXII) may be used in the future as a valuable adjunct to cytology in the diagnostic assessment of patients with pleural effusions related to lung cancer, especially when cytological examination is inconclusive
Pleural fluid CAXII levels Quantification of CAXII was first done in specimens
Summary
Malignant and tuberculous pleurisy are two main causes of pleural effusion (PE) in a high tuberculosis prevalence region (Liam et al, 2000; World Health Organization, 2011). At present there are evidences to demonstrate that pleural fluid mesothelin, MMP-7 and MMP-10 may provide additional value over pleural fluid cytology in patients with an undiagnosed pleural effusions (Davies et al, 2009; Cheng et al, 2012). Serum CAXII levels are significantly higher in lung cancer patients than healthy controls (Kobayashi et al, 2012). Its measurement in pleural fluid (PF) offers a theoretical advantage over serum measurement and has attracted attention as a diagnostic assay. The objective of present study is to explore whether CAXII levels is detectable in pleural fluids and to evaluate its potential diagnostic usefulness and its reliability
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