Pathology & Oncology Research

, Volume 11, Issue 4, pp 236–241 | Cite as

Diagnostic value of tumor markers for differentiating malignant and benign pleural effusions of Iranian patients

  • Sied Mohammad Ali Ghayumi
  • Samrad Mehrabi
  • Mehrnossh Doroudchi
  • Abbas Ghaderi


In order to evaluate the diagnostic yield of tumor markers in differentiating malignant and benign pleural effusions, we carried out a prospective study in a group of Iranian people. Pleural and serum levels of carcinoembryonic antigen (CEA), carbohydrate antigen 15-3 (CA15-3), neuron-specific enolase (NSE) and cancer antigen 125 (CA 125) were assayed prospectively in patients with pleural effusion (40 malignant and 37 benign). The highest sensitivity was obtained with a combination of CA 15-3 in serum, and CA 15-3 and CEA in pleural fluid (80%), also with combination of CA 15-3 in serum, and CA 15-3, NSE and CEA in pleural fluid (80%). The highest specificity was obtained with combination of CA 15-3 in serum, and CA 15-3 and NSE in pleural fluid (100%), and also with combination of CA 15-3 in serum, and CA 15-3, NSE and CEA in pleural fluid (100%).

Key words

pleural effusion tumor markers 


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  1. 1.
    Chernow B, Sahn SA: Carcinomatous involvement of the pleura: an analysis of 96 patients. Am J Med 63: 695–702, 1977PubMedCrossRefGoogle Scholar
  2. 2.
    Marel M, Stastny B, Melinova L, et al: Diagnosis of pleural effusions. Experience with clinical studies, 1986 to 1990. Chest 107: 1598–1603, 1995PubMedCrossRefGoogle Scholar
  3. 3.
    Maskell NA, Butland RJ: Pleural Diseases Group, Standards of Care Committee, British Thoracic Society. BTS guidelines for the investigation of a unilateral pleural effusion in adults. Thorax 58 (Suppl 2): 8–17, 2003CrossRefGoogle Scholar
  4. 4.
    Loddenkemper R: Medical thoracoscopy. In: Textbook of Pleural Diseases. (Eds: Light RW, Gray Lee, YC), 2003, pp 498–512Google Scholar
  5. 5.
    Prakash UB, Reiman HM: Comparison of needle biopsy with cytologic analysis for the evaluation of pleural effusion: analysis of 414 cases. Mayo Clin Proc 60:158–164, 1985PubMedGoogle Scholar
  6. 6.
    Johanston WW: Cancer, 1985; Light RW, Approach to the patient. In: Pleural Diseases. (Ed: Light RW), 3rd ed, William & Wilkins, Baltimore, 1995, pp 75–82Google Scholar
  7. 7.
    Porcel JM, Vives M, Esquerda A, et al: Use of a panel of tumor markers (carcinoembryonic antigen, cancer antigen 125, carbohydrate antigen 15-3, and cytokeratin 19 fragments) in pleural fluid for the differential diagnosis of benign and malignant effusions. Chest 126: 1757–1763, 2004PubMedCrossRefGoogle Scholar
  8. 8.
    Richard WL: Tumor markers in undiagnosed pleural effusions. Chest 126: 1721–1722, 2004CrossRefGoogle Scholar
  9. 9.
    Ferrer J, Villarino MA, Encabo G, et al: Diagnostic utility of CYFRA 21-1, carcinoembryonic antigen, CA 125, neuron specific enolase, and squamous cell antigen level determinations in the serum and pleural fluid of patients with pleural effusions. Cancer 86: 1488–1495, 1999PubMedCrossRefGoogle Scholar
  10. 10.
    Garcia-Pachon E, Padilla-Navas I, Dosda MD, et al: Elevated level of carcinoembryonic antigen in nonmalignant pleural effusions. Chest 111: 643–647, 1997PubMedCrossRefGoogle Scholar
  11. 11.
    Alatas F, Alatas O, Metintas M, et al: Diagnostic value of CEA, CA 15-3, CA 19-9, CYFRA 21-1, NSE and TSA assay in pleural effusions. Lung Cancer 31: 9–16, 2001PubMedCrossRefGoogle Scholar
  12. 12.
    Ryu JS, Lee HJ, Cho JH, et al: The implication of elevated carcinoembryonic antigen level in pleural fluid of patients with non-malignant pleural effusion. Respirology 8: 487–491, 2003PubMedCrossRefGoogle Scholar
  13. 13.
    Villena V, Lopez-Encuentra A, Echave-Sustaeta, et al: Diagnostic value of CA 72-4, carcinoembryonic antigen, CA 15-3, and CA 19-9 assay in pleural fluid. A study of 207 patients. Cancer 78: 736–740, 1996PubMedCrossRefGoogle Scholar
  14. 14.
    Shimokata K, Totani Y, Nakanishi K, et al: Diagnostic value of cancer antigen 15-3 (CA15-3) detected by monoclonal antibodies (115D8 and DF3) in exudative pleural effusions. Eur Respir J 4: 341–344, 1988Google Scholar
  15. 15.
    Romero S, Fernandez C, Arriero JM, et al: CEA, CA 15-3 and CYFRA 21-1 in serum and pleural fluid of patients with pleural effusions. Eur Respir J 9: 17–23, 1996PubMedCrossRefGoogle Scholar
  16. 16.
    Hernandez L, Espasa A, Fernandez C, et al: CEA and CA 549 in serum and pleurai fluid of patients with pleural effusion. Lung Cancer 36: 83–89, 2002PubMedCrossRefGoogle Scholar
  17. 17.
    Pinto MM, Bernstein LH, Rudolph RA, et al: Diagnostic efficiency of carcinoembryonic antigen and CA125 in the cytological evaluation of effusions. Arch Pathol Lab Med 116: 626–631, 1992PubMedGoogle Scholar
  18. 18.
    McKenna JM, Chandrasekhar AJ, Henkln RE: Diagnostic value of carcinoembryonic antigen in exudative pleural effusions. Chest 78: 587–590, 1980PubMedCrossRefGoogle Scholar
  19. 19.
    Romero Candeira S, Hernandez Blasco L, Senent Espanol C, et al: Clinical usefulness of tumor markers in the diagnosis of pleural effusions. Carcinoembryonic antigen, alpha-fetoprotein and orosomucoid. Med Clin 86: 439–443, 1986Google Scholar
  20. 20.
    Garcia-Pachon E, Padilla Navas I, Querol M, Custardoy J. The behavior of carcinoembryonic antigen in pleural empyema. Med Clin 101: 237–238, 1993Google Scholar
  21. 21.
    Whiteside TL, Dekker A: Diagnostic significance of carcinoembryonic antigen levels in serous effusions. Correlation with cytology. Acta Cytol 23: 443–448, 1979PubMedGoogle Scholar
  22. 22.
    Niwa Y, Kishimoto H, Shimokata K: Carcinomatous and tuberculous pleural effusions. Comparison of tumor markers. Chest 87: 351–355, 1985PubMedCrossRefGoogle Scholar
  23. 23.
    Faravelli B, Nosenzo M, Razzetti A, et al: The role of concurrent determinations of pleural fluid and tissue carcinoembryonic antigen in the distinction of malignant mesothelioma from metastatic pleural malignancies. Eur J Cancer Clin Oncol 21: 1083–1087, 1985PubMedCrossRefGoogle Scholar
  24. 24.
    Mezger J, Calavrezos A, Brings P, et al: Value of serum and effusion fluid CEA levels for distinguishing between diffuse malignant mesothelioma and carcinomatous pleural metastases. Lung 172: 183–184, 1994PubMedCrossRefGoogle Scholar
  25. 25.
    Kuralay F, Tokgoz Z, Comlekci A: Diagnostic usefulness of tumor marker levels in pleural effusions of malignant and benign origin. Clin Chim Acta 300: 43–55, 2000PubMedCrossRefGoogle Scholar
  26. 26.
    Fenton KN, Richardson JD: Diagnosis and management of malignant pleural effusions. Am J Surg 170: 69–74, 1995PubMedCrossRefGoogle Scholar

Copyright information

© Arányi Lajos Foundation 2005

Authors and Affiliations

  • Sied Mohammad Ali Ghayumi
    • 1
  • Samrad Mehrabi
    • 1
  • Mehrnossh Doroudchi
    • 2
  • Abbas Ghaderi
    • 2
    • 3
  1. 1.Department of Internal MedicineShiraz University of Medical SciencesShirazIran
  2. 2.Departments of ImmunologyShiraz University of Medical SciencesShirazIran
  3. 3.Shiraz Institute for Cancer ResearchShiraz University of Medical SciencesShirazIran

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