EVALUATION OF CYFRA-21-1 IN MALIGNANT AND BENIGN PLEURAL EFFUSIONS

CYFRA 21-1 was evaluated in 115 untreated patients with malignant pleu ral effusions (96 with primary lung cancer and 19 with non lung cancer ) and 99 patients with benign pleural effusions. The levels of pleural fluid CYFRA 21-1 were from 1 to 385 times higher than those in serum, in all the examined patients. The mean level of pleural fluid CYFRA 2 1-1 was significantly higher in cancer patients than in patients with benign pleural effusion (96.1 ng/ml vs 26.2 ng/ml, p < 0.001). At 92% specificity for benign pleural effusion (> 50 ng/ml) the overall sensi tivity of CYFRA 21-1 in malignant pleural effusions wa 69.6%. When the histology was considered the highest sensitivity was found in squamou s cell lung cancer (90%), followed by adenocarcinoma cell lung cancer (74%), non lung cancer (54%) and small cell lung cancer (25%). These r esults indicate that CYFRA 21-1 could be a useful pleural fluid marker in discriminating benign from malignant pleural effusion and particul arly from those due to squamous and adenocarcinoma cell lung cancer.