Diagnostic value of tumor markers in lung adenocarcinoma-associated cytologically negative pleural effusions

European Chemistry Congress

June 16-18, 2016 Rome, Italy

Cheng-Chuan Su

Tzu Chi University, Taiwan

Posters & Accepted Abstracts: Chem Sci J

Abstract :

Cytology fails to detect neoplastic cells in 40�50% of malignant pleural effusions (PEs), which commonly accompany lung adenocarcinomas. Diagnostic accuracy of various tumor markers in lung adenocarcinoma-associated cytologically negative pleural effusions (LAC-CNPEs) has been poor. This study aimed to maximize diagnostic efforts in distinguishing LAC-CNPEs from benign PEs. Pleural effusion samples were collected from 74 lung adenocarcinoma patients with associated cytologically positive (41) and negative (33) effusions, and from 99 patients with benign conditions including tuberculosis (26), pneumonia (28), congestive heart failure (25), and liver cirrhosis (20). We evaluated the diagnostic sensitivity and optimal cutoff points for tumor markers Her-2/neu, Cyfra 21-1, and carcinoembryonic antigen (CEA) to distinguish LAC-CNPEs from benign PEs. Mean levels of Her-2/neu, Cyfra 21-1, and CEA were significantly higher in LAC-CNPEs than in benign pleural effusions (P= 0.0050, =0.0039, and <0.0001, respectively). The cutoff points for Her-2/neu, Cyfra 21-1, and CEA were optimally set at 3.6 ng/mL, 60 ng/mL, and 6.0 ng/mL. Their sensitivities ranged from 12.1%, to 30.3%, to 63.6%, respectively. CEA combined with Cyfra 21-1 increased diagnostic sensitivity to 66.7%. False-positive rates of these markers in benign PEs were 6.1%, 2.0% and 0%, respectively. Combining CEA with Cyfra 21-1 will provide the best differentiation between LACCNPEs and benign PEs with two tumor markers to date, and allows early diagnosis and early treatment for two-thirds of affected patients. sucpo@yahoo.com.tw