P3.03-022 Serum CEA, VEGF and MMP-7 in Patients with Malignant Pleural Effusion. A Prospective Study with Logistic Regression Analysis of Accuracy: Topic: Mesothelioma Transitional

Abstract

Several tumor markers have been proposed in differentiating between benign and malignant pleural effusions (PE). The aim of this prospective study was to evaluate the usefulness of serum carcinoembryonic antigen (CEA), vascular endothelial growth factor (VEGF), and matrix metalloproteinase-7 (MMP-7) assay in patients with PE of uncertain origin. A series of 36 consecutive patients with suspicious PE requiring VATS-guided biopsy underwent serum CEA, VEGF, MMP-7 measurement before PC and biopsy. There were 20 (55.6%) males and 16 (44.4%) females, with an overall median age of 67 (range 40-82 years). According to the receiver operating characteristic (ROC) curve, the optimum cutoff levels were 5 ng/mL, 7.5 ng/mL, and 250 pg/mL for CEA, VEGF and MMP-7, respectively. Final pathology showed 10 (27.8%) patients with NSCLC, 13 (36.1%) with LMs, and 13 (36.1%) with benign PE. The age did not differ between groups (p=0.59). The sensitivity, specificity and accuracy of PC were 56.5%, 92.3%, and 69.4%, respectively. The results of serum markers measurement are reported in the Table (95% CI). The logistic regression excluded CEA from the model, and thus we calculated the area under the curve (AUC) of the combination VEGF+MMP-7. The AUC was 0.681 (95% CI: 0.413-0.743) and the diagnostic accuracy was 77.8%, which was superior than that of MMP-7 alone (72.2%, p=0.41). In patients with PEs, the measurement of serum VEGF and MMP-7 together reached a good accuracy with a fair AUC, and should be suggested when a noninvasive evaluation of a PE is required.