Performance of CEA and CA19-9 in identifying pleural effusions caused by specific malignancies
Performance of CEA and CA19-9 in identifying pleural effusions caused by specific malignancies
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DOI：
10.1016/j.clinbiochem.2010.05.016
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发表时间：
2010-09-01
影响因子：
2.8
通讯作者：
Algeciras-Schimnich, Alicia
中科院分区：
文献类型：
--
作者：
Hackbarth, Jennifer S.;Murata, Kazunori;Algeciras-Schimnich, Alicia
目的：肿瘤标志物分析已被提议作为一种侵入性较小的替代方法，用于对恶性和非恶性胸腔积液进行分类。本研究建立了胸腔积液中 CEA 和 CA19-9 的诊断临界值，以区分胸腔积液的病因。设计和方法：对 198 名患者（100 例恶性，98 例非恶性）获得的胸腔积液进行 CEA 和 CA19-9 分析。进行 ROC 曲线分析以确定分析物截止值，并检查不同恶性肿瘤亚型中的截止性能。结果：与非恶性胸腔积液相比，恶性胸腔积液中的 CEA 和 CA19-9 浓度显着较高，特别是由肺癌和与 CEA 和/或 CA19-9 血清浓度升高相关的其他癌症引起的胸腔积液。与血清肿瘤标志物升高无关的癌症引起的积液中浓度没有升高。结论：胸腔积液中 CEA 和 CA19-9 的测量补充了细胞学和其他分类测试。在已知分泌 CEA 或 CA19-9 的恶性肿瘤引起的积液中，其性能特别增强，并且应针对疑似患有这些恶性肿瘤的患者进行定制。因此，不建议对所有胸腔积液对这些标志物进行常规分析。此外，阴性结果应与血清水平相关，以协助临床解释。 (C) 2010 年加拿大临床化学家协会。由爱思唯尔公司出版。保留所有权利。
Objectives: Tumor markers analysis has been proposed as a less invasive alternative for categorizing malignant and non-malignant pleural effusions. This study establishes diagnostic cutoffs for CEA and CA19-9 in pleural fluid to differentiate etiologies of effusions.Design and methods: Pleural effusions obtained from 198 patients (100 malignant, 98 non-malignant) were analyzed for CEA and CA19-9. ROC curve analysis was performed to determine analyte cutoffs, and cutoff performance was examined in various subsets of malignancies.Results: CEA and CA19-9 concentrations were significantly higher in malignant effusions compared to non-malignant effusions, particularly in effusions caused by lung cancer and other cancers associated with elevated CEA and/or CA19-9 serum concentrations. Concentrations were not elevated in effusions caused by cancers not associated with serum tumor marker elevations.Conclusions: Measurement of CEA and CA19-9 in pleural fluid complements cytology and other classifying tests. Performance is specifically enhanced in effusions caused by malignancies known to secrete CEA or CA19-9, and their use should be tailored to patients suspected of having those malignancies. Routine analysis of these markers is therefore not recommended in all pleural effusions. Moreover, negative results should be correlated with serum levels to assist in the clinical interpretation. (C) 2010 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.