Diagnostic value of carcinoembryonic antigen in malignant pleural effusion: A meta-analysis

Background: Tumour markers in pleural fluid and their diagnostic value are subject to debate. Although there are several studies on this topic, standardized cut-off values do not exist. In this study we investigated the potential of a ratio of carcinoembryonic antigen (CEA) in pleural fluid and serum, serving as an individual marker for pleural cancer manifestation. Methods: A total of 201 consecutive patients with unclear pleural effusion were included in the study; 98 were diagnosed with malignant pleural effusion and 103 had an effusion due to other, benign reasons. CEA levels in pleural fluid and serum were measured. Results: By using receiver operating characteristics analysis, at the cut-off of 1.0, the CEA ratio showed a specificity of 92% and sensitivity of 85%, with a positive predictive value of 91% and a negative predictive value of 87%. These results are higher than in previous investigations on different pleural tumour markers and their combination. Conclusions: The CEA ratio is a useful tool in predicting pleural carcinosis. Elevated results in cytology-negative patients should lead to further investigations, such as repeated cytological examination or thoracoscopy.

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Diagnostic Potential of Carcinoembryonic Antigen and Ferritine in Tuberculous and Malignant Pleural Effusion

Tumori Journal ◽

10.1177/030089169508100612 ◽

1995 ◽

Vol 81 (6) ◽

pp. 440-444 ◽

Cited By ~ 2

Author(s):

Robert Loncar ◽

Ljerka Ostojic ◽

Vera Tabakovic-Loncar ◽

Ante Roguljić

Keyword(s):

Pleural Effusion ◽

Carcinoembryonic Antigen ◽

Sensitivity And Specificity ◽

Malignant Pleural Effusion ◽

Bayes Theorem ◽

Diagnostic Value ◽

Physical Status ◽

Predictive Values ◽

Diagnostic Potential ◽

Significant Difference

The aim of the study was to determine the diagnostic value of carcinoembryonic antigen (CEA) and ferritine in malignant and tuberculous non-bloody pleural effusion. The etiology of diseases was determined by cytologic, histologic and microbiologic methods. CEA concentration above 5 ng/ml and ferritine concentration above 200 ng/ml were considered to be positive. There was significant difference in the value of CEA measured in malignant and in tuberculous pleural effusion (P < 0.005) as well as in the sera (P < 0.01) of these two groups. There was no correlation between concentration of CEA and ferritine in malignant pleural effusion. Ratio between CEA and ferritine in effusions and sera was of no help in discrminating malignant from tuberculous effusions. No correlation between examined markers and physical status of patients was observed. The sensitivity and specificity of CEA assay in malignant pleural effusion was 65% and 90%, respectively, and for ferritine 67% and 80%, respectively. A high correlation was observed between the CEA concentration in malignant pleural effusion and sera patients (r = 0.95). Combined sensitivity and specificity of CEA and ferritine was 65.9% and 85%. Bayes theorem was used to calculate the positive predictive values for CEA and ferritine, which were 53% and 37%, respectively. Results obtained in the study show the relatively good diagnostic potential of CEA.

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