The Diagnostic Value Of Combined Detection CEA,CA125, CA153and CA199in Supernatants And Sediments Of Pleural Effusions

Objectiv:To inquiry into the diagnostic value of combined detection CEA, CA125, CA153and CA199in supernatants and sediments of pleural effusions.Methods:A total of130cases were enrolled. Of these patients,39had benign diseases (19trasudative effusions associated with cirrhosis and heart failure and20with non-malignant exudates:12pleuritis and8other inflammations) and91had malignant effusions (34breast cancers,27lung cancers,11ovary cancers,7mesotheliomas and12lymphomas). The levels of CEA, CA125, CA153and CA199in supernantants and sediments of pleural effusions were detected by ELISA. The tumour markers were also measured in the serum of the same patients.Results:In patients with breast, lung and ovarian cancers, the CEA pleural effusion levels were much higher than those in he pleural fluids of patients with benign disease, the difference was statistically significant (P<0.05, the patients with lung P<0.01). In patients with breast, lung, ovarian cancers and lymphomas, pleural effusion CA153levels were much higher than those in the pleural fluids of patients with benign disease, the difference was statistically significant (P<0.05, the patients with breast P<0.01). In patients with breast and lung cancers the CA125pleural effusion levels were6-fold higher levels in the pleural effusions of patients with benign disease, the difference was statistically significant (P<0.05). In patients with lung cancers the CA199pleural effusion levels were40-fold higher levels in the pleural effusions of patients with benign disease, the difference was statistically significant (P<0.05). The optimal cut-off values for pleural fluid were CEA2.1ng/ml, CA15341U/ml and CA125459U/ml. Using these cut-off values, CEA and CA153were found to be positive in all samples of the pleural effusions of breast cancer patients, the positivity were100%, the positivity of CA125was 88%. In lung cancers, the positivity of CEA was78%, CA153and CA125were the same70%. In ovarian cancers, the positivity of CEA andCA153were100%. CEA was very high in lung cancers, CA153was very high in breast cancers, the difference was statistically significant (P<0.05).Conclusions:The result suggests that the combined determination of tumour markers on supernatants and sediments of pleural effusion may provide additional information on the nature of pleural effusion, especially for cases with negative cytology. CA153and CEA appear to be good indicators for breast and lung cancer, respectively, and the use of cytosols of pleural effusion sediments of tumour markers is very useful, especially in cytologically negative cases.