Pleural CEA, CA-15-3, CYFRA 21-1, CA-19-9, CA-125 discriminating malignant from benign pleural effusions: Diagnostic cancer biomarkers.

IF 2.3 4区 医学 Q3 BIOTECHNOLOGY & APPLIED MICROBIOLOGY
Farzaneh Fazli Khalaf, Mehrnaz Asadi Gharabaghi, Maryam Balibegloo, Hamidreza Davari, Samaneh Afshar, Behnaz Jahanbin
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引用次数: 0

Abstract

Introduction: There is a need for a rapid, accurate, less-invasive approach to distinguishing malignant from benign pleural effusions. We investigated the diagnostic value of five pleural tumor markers in exudative pleural effusions.

Methods: By immunochemiluminescence assay, we measured pleural concentrations of tumor markers. We used the receiver operating characteristic curve analysis to assess their diagnostic values.

Results: A total of 281 patients were enrolled. All tumor markers were significantly higher in malignant pleural effusions than benign ones. The area under the curve of carcinoembryonic antigen (CEA), carbohydrate antigen (CA) 15-3, cytokeratin fragment 19 (CYFRA) 21-1, CA-19-9, and CA-125 were 0.81, 0.78, 0.75, 0.65, and 0.65, respectively. Combined markers of CEA + CA-15-3 and CEA + CA-15-3 + CYFRA 21-1 had a sensitivity of 87% and 94%, and specificity of 75% and 58%, respectively. We designed a diagnostic algorithm by combining pleural cytology with pleural tumor marker assay. CEA + CYFRA 21-1 + CA-19-9 + CA-15-3 was the best tumor markers panel detecting 96% of cytologically negative malignant pleural effusions, with a negative predictive value of 98%.

Conclusions: Although cytology is specific enough, it has less sensitivity in identifying malignant pleural fluids. As a result, the main gap is detecting malignant pleural effusions with negative cytology. CEA was the best single marker, followed by CA-15-3 and CYFRA 21-1. Through both cytology and suggested panels of tumor markers, malignant and benign pleural effusions could be truly diagnosed with an accuracy of about 98% without the need for more invasive procedures, except for the cohort with negative cytology and a positive tumor markers panel, which require more investigations.

胸膜CEA、CA-15-3、CYFRA 21-1、CA-19-9、CA-125鉴别良性和恶性胸腔积液:诊断癌症的生物标志物。
简介:需要一种快速、准确、微创的方法来区分良性和恶性胸腔积液。探讨五种胸膜肿瘤标志物在胸腔渗出性积液中的诊断价值。方法:采用免疫化学发光法测定胸膜肿瘤标志物浓度。我们使用受试者工作特征曲线分析来评估其诊断价值。结果:共纳入281例患者。恶性胸腔积液的各项肿瘤指标均高于良性胸腔积液。癌胚抗原(CEA)、糖类抗原(CA) 15-3、细胞角蛋白片段19 (CYFRA) 21-1、CA-19-9、CA-125的曲线下面积分别为0.81、0.78、0.75、0.65、0.65。CEA + CA-15-3和CEA + CA-15-3 + CYFRA 21-1联合标记的敏感性分别为87%和94%,特异性分别为75%和58%。我们设计了一种结合胸膜细胞学和胸膜肿瘤标志物测定的诊断算法。CEA + CYFRA 21-1 + CA-19-9 + CA-15-3是检测96%细胞学阴性恶性胸腔积液的最佳肿瘤标志物,阴性预测值为98%。结论:虽然细胞学检查具有足够的特异性,但在鉴别恶性胸腔积液时敏感性较低。因此,主要的空白是发现阴性细胞学的恶性胸腔积液。CEA为最佳单标记,CA-15-3次之,CYFRA 21-1次之。除了细胞学阴性和肿瘤标志物阳性的队列需要更多的检查外,通过细胞学和建议的肿瘤标志物组,可以真正诊断出恶性和良性胸腔积液,准确率约为98%,而不需要更多的侵入性手术。
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来源期刊
International Journal of Biological Markers
International Journal of Biological Markers 医学-生物工程与应用微生物
CiteScore
4.10
自引率
0.00%
发文量
43
期刊介绍: IJBM is an international, online only, peer-reviewed Journal, which publishes original research and critical reviews primarily focused on cancer biomarkers. IJBM targets advanced topics regarding the application of biomarkers in oncology and is dedicated to solid tumors in adult subjects. The clinical scenarios of interests are screening and early diagnosis of cancer, prognostic assessment, prediction of the response to and monitoring of treatment.
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