Diagnostic value of CEA, CA 15-3, CA 19-9, CYFRA 21-1, NSE and TSA assay in pleural effusions

The aim of this study was to evaluate the individual and combined diagnosti c utility of six tumor markers in patients with pleural effusion. Pleural a nd serum levels of carcinoembryonic antigen (CEA), carbohydrate antigen 15- 3 (CA 15-3), carbohydrate antigen 19-9 (CA 19-9), cytokeratin Fragment 19 ( CYFRA 21-1), neuron-specific enolase (NSE) and total sialic acid (TSA) were assayed in 74 patients with pleural effusions (44 malignant and 30 benign) . All tumor markers except TSA and NSE were increased in both serum and ple ural fluid of patients with malignant diseases. Using the cut-off values 3 ng/ml. 14 U/ml, 5 U/ml, 8 ng/ml and 70 mg/dl for pleural fluid CEA, CA 15-3 , CA 19-9, CYFRA 21-1 and TSA, respectively, the sensitivity (%) and specif icity (%) Of these tumor markers were as follows: CEA, 52/77, CA 15-3; 80/9 3, CA 19-9; 36/83, CYFRA 21-1; 91/90, TSA, 80/67, for differentiating malig nant effusions from benign. When CA 15-3 and CYFRA 21-1 combined, the sensi tivity and specificity were increased (100 and 83%, respectively). Classify ing the malignant effusions as bronchial carcinoma and malignant pleural me sothelioma, CEA was shown to have the highest sensitivity and specificity ( 88 and 90%, respectively) while the combination of CEA with other tumor mar kers increased sensitivity but decreased specificity. According to our resu lts, tumor markers are not suitable for the differential diagnosis of malig nancy. (C) 2001 Elsevier Science Ireland Ltd. All rights reserved.