Cytologic examination and determination of tumor markers (PHI, LDH, alpha-1-glycoprotein, alpha-2-HS-glycoprotein, β2-microglobulin, feritin, sialic acid IgE, fetoprotein, CEA, βHCG and β1-SP-glycoprotein) were carried out in pleural fluid samples obtained from 70 patients with suspected neoplasia. Tumor markers were also determined in sera. The protein content of all pleural effusions was ≥ 3 g/dl. Patients were grouped according to diagnosis as follows: (a) 42 withneoplastic diseases (7 mesotheliomas and 19 lung, 4 ovarian, 3 breast and 8 miscellaneous cancers), (b) 22 with benign inflammations and (c) 6 with congestive effusions. Of the parameters examined, only CEA and α-HCG gave information that the effusionwas probably malignant. Using 6 ng/ml as cut-off for CEA and 10 mIU/ml for βHCG, the sensitivity was 57.1% and 45.2%, respectively, specificity was 92.8% for both parameters and test efficiency 0.75 and 0.69, respectively. When CEA and βHCG were considered together sensitivity increased to 73.8% and efficiency to 0.78. CEA and/or βHCG were positive in the pleural effusions of 19 of the 20 malignant pleural effusions, all with a negative cytologic examination,, which subsequently became positive in 8. Because of their high specificity, these two parameters are a useful tool and can be routinely measured to evaluate pleural effusions of dubious origin, even if CEA and βHCG cannot, in their own, define the primary malignancy.
ASJC Scopus subject areas