The diagnostic value of combined detection of tumor markers for malignant pleural effusions

Abstract

Objective To investigate the significance of combined detection of tumor markers in serum and pleural fluid on differential diagnosis of benign and malignant pleural effusion.Methods Three hundred and seventy six cases of pleural effusion were selected.The levels of carcinoembryonic antigen (CEA),neuronspecific enolase(NSE),cancer antigen 125 ( CA125 ),squamous cell carcinoma antigen (SCC) in serum and pleural fluid were examined and they were analyzed combined with histological or cytological evidence using statistical methods.Results There were 298 cases in malignant group and 98 cases in benign group.The levels of the four tumor markers in malignant group were significantly higher than in benign group both in pleural fluid (CEA:[279.9 ± 170.0]μg/L v.s.[ 12.6 ± 6.2 ] μg/L,t =6.29,P ＜ 0.01; NSE:[ 112.3 ± 86.8 ] μg/L v.s.[14.7 ±7.3] μg/L,t =5.13,P ＜0.01 ;SCC:[ 10.6 ± 5.4] μg/L v.s.[ 1.2 ±0.6 ] μg/L,t =2.34,P ＜0.01;CA125:[ 409.2 ± 206.7] U/ml v.s.[ 44.0 ± 20.5 ] U/ml,t =7.46,P ＜ 0.01 ) and in serum ( CEA:[ 86.7 ±42.0] μg/L v.s.[6.2±3.1]μg/L,t=3.14,P＜0.01;NSE:[31.6±18.2]μg/Lv.s.[11.2±5.0]μg/L,t=4.61,P＜0.01;SCC:[3.5±2.2]μg/Lv.s.[1.8±0.g]μg/L,t=1.70,P＜0.01;CA125:[134.0±72.6]U/ml v.s.[ 19.8 ± 9.6 ] U/m1,t =4.04,P ＜ 0.01 ).Moreover,the levels of tumor markers in pleural fluid were higher than in serum.The sensitivity were 100％ by combined detection of pleural fluid and serum tumor markers in parallel and the specificity were 100％ in sequence.Conclusion The levels of CEA,NSE,CA125,SCC in pleural effusion were more sensjtive than which in serum.Combined detection of tumor markers in pleural fluid and serum could improve the sensitivity of diagnosis for benign and malignant pleural effusion. Key words: Pleural fluid; Tumor markers; Carcinoemhryonic antigen; Neuron-specific enolase; Cancer antigen 125 ; Squamous cell carcinoma antigen