Original scientific paper

https://doi.org/10.11613/BM.2018.010706

Diagnostic value of tumour markers in pleural effusions

Darian Volarić orcid.org/0000-0001-5702-4749 ; Division of Pulmonology, Clinic of Internal Medicine, Clinical Hospital Centre Rijeka, Rijeka, Croatia; Department of Internal Medicine, Faculty of Medicine, University of Rijeka, Rijeka, Croatia
Veljko Flego orcid.org/0000-0002-6333-9883 ; Division of Pulmonology, Clinic of Internal Medicine, Clinical Hospital Centre Rijeka, Rijeka, Croatia; Department of Internal Medicine, Faculty of Medicine, University of Rijeka, Rijeka, Croatia
Gordana Žauhar orcid.org/0000-0002-5931-2872 ; Department of Medical Physics and Biophysics, Faculty of Medicine, University of Rijeka, Rijeka, Croatia; Department of Physics, University of Rijeka, Rijeka, Croatia
Ljiljana Bulat-Kardum ; Division of Pulmonology, Clinic of Internal Medicine, Clinical Hospital Centre Rijeka, Rijeka, Croatia; Department of Internal Medicine, Faculty of Medicine, University of Rijeka, Rijeka, Croatia

Abstract

Introduction: We investigated whether tumour markers carcinoembryonic antigen (CEA), neuron-specific enolase (NSE), cancer antigen 125 (CA-
125), and cytokeratin 19 fragment (CYFRA 21-1) in pleural effusions and serum can be used to distinguish pleural effusion aetiology.
Materials and methods: During the first thoracentesis, we measured pleural fluid and serum tumour marker concentrations and calculated the
pleural fluid/serum ratio for patients diagnosed with pleural effusion, using electrochemiluminescence immunoassays. Receiver operating characteristic
(ROC) analysis was carried out and the Hanley and McNeil method was used to test the significance of the difference between the areas under
ROC curves (AUCs). In order to detect which tumour marker best discriminates between malignant and non-malignant pleural effusions and to establish
the predictive value of those markers, discriminant function analysis (DFA) and logistic regression analysis were utilized.
Results: Serum tumour markers CYFRA 21-1 and NSE as well as pleural NSE were good predictors of pleural effusion malignancy and their combined
model was found statistically significant (Chi-square = 28.415, P < 0.001). Respective ROC analysis showed significant discrimination value of the
combination of these three markers (AUC = 0.79).
Conclusions: Serum markers showed superiority to pleural fluid markers in determining pleural fluid aetiology. Serum CYFRA 21-1 and NSE concentrations
as well as pleural fluid NSE values had the highest clinical value in differentiating between malignant and non-malignant pleural effusions.
The combination of these three markers produced a significant model to resolve pleural effusion aetiology.

Keywords

pleural effusion; CA-125 antigen; carcinoembryonic antigen; neuron-specific enolase; cytokeratin 19 fragment

Hrčak ID:

192381

URI

https://hrcak.srce.hr/192381

Publication date:

15.2.2018.

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