Abstract
Background & Objective:Early detection of malignancies in the serous fluids has been remained an issue. A classic diagnostic tool for the ascites and pleural effusions is cytologic study (morphology) with approximately 98% specificity for the detection of cancer cells. This study aimed to evaluate the diagnostic value of three complementary markers in the serosal fluids of patients with malignant cytology and suspected cases.Methods:Seventy two patients with serosal effusion treated in three teaching hospitals were studied. The cases underwent a diagnostic workup to determine the pleural effusion malignancy and etiologies. Complementary markers, including CEA, CA15-3, and CA125 were measured in serosal fluids of three categories of benign, suspicious, and malignant. The study was carried out by Chemiluminescence immunoalayzer. The morphologies were re-evaluated by a consulting Cytopathologist.Results:Of 72 serosal fluid specimens, 41 (56.9%) were related to pleural effusion and 31 (43.1%) were related to ascites. The sensitivity of CEA, CA125, and CA15-3 biomarkers were 64, 84, and 68%, respectively, and the specificity of each test was 100, 86, and 96%, respectively. This was statistically achieved for the combination of the area of markers below the curve (AUC), 0.93 and 90% sensitivity and 91% specificity. Conclusion:The results suggest that complementary CA125, CA15-3, and CEA markers assayed with well-developed immunoassay method might be useful in the differentiation between malignant and benign effusions while combined with conventional cytology. CA125 yielded a significant correlation between cytomorphology and biomarkers based on the correlation coefficient analysis.
Highlights
IntroductionThe presence of serous fluid effusion, including pleural effusion and ascites, is a common and challenging diagnostic issue caused by different with etiologies varied form neoplastic such as metastatic involvement to non-neoplastic of infectious and non-infectious agents
Serosal effusion is one of the complications of a large number of diseases [1]
One of the most common diagnostic tools for the serous fluids is the detection of malignant cells using conventional cytology, which has a specificity of about 98% but a maximum sensitivity of 60% [3]
Summary
The presence of serous fluid effusion, including pleural effusion and ascites, is a common and challenging diagnostic issue caused by different with etiologies varied form neoplastic such as metastatic involvement to non-neoplastic of infectious and non-infectious agents. One of the most common diagnostic tools for the serous fluids is the detection of malignant cells using conventional cytology, which has a specificity of about 98% but a maximum sensitivity of 60% [3]. Cytology showed a clinical sensitivity of 57% and specificity of 89% for the detection of malignant cells in the effusion samples [4]. A classic diagnostic tool for the ascites and pleural effusions is cytologic study (morphology) with approximately 98% specificity for the detection of cancer cells. This study aimed to evaluate the diagnostic value of three complementary markers in the serosal fluids of patients with malignant cytology and suspected cases
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