Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Oct 29;21(1):284.
doi: 10.1186/s12931-020-01557-z.

Auxiliary diagnostic value of tumor biomarkers in pleural fluid for lung cancer-associated malignant pleural effusion

Hai Zhang  1 , Changhui Li  1 , Fang Hu  1 , Xueyan Zhang  1 , Yinchen Shen  1 , Yuqing Chen  1 , Feng Li  2
Affiliations

Auxiliary diagnostic value of tumor biomarkers in pleural fluid for lung cancer-associated malignant pleural effusion

Hai Zhang et al. Respir Res. .

Abstract

Background: Pleural effusion (PE) can be divided into benign pleural effusion (BPE) and malignant pleural effusion (MPE). There is no consensus on the identification of lung cancer-associated MPE using the optimal cut-off levels from five common tumor biomarkers (CEA, CYFRA 21-1, CA125, SCC-Ag, and NSE). Therefore, we aimed to find indicators for the auxiliary diagnosis of lung cancer-associated MPE by analyzing and then validating the optimal threshold levels of these biomarkers in pleural fluid (PF) and serum, as well as the PF/serum ratio.

Patients and method: The study has two sets of patients, i.e. the training set and the test set. In the training set, 348 patients with PE, between January 1, 2016 and December 31, 2017, were divided into BPE and MPE based on the cytological diagnosis. Subsequently, the optimal cut-off levels of tumor biomarkers were analyzed. In the test set, the diagnostic compliance rate was verified with 271 patients with PE from January 1, 2018 to July 31, 2019 to evaluate the auxiliary diagnostic value of the aforementioned indicators.

Result: In the training set, PF CEA at the cut-off value of 5.23 ng/ml was the most effective indicator for MPE compared with other tumor biomarkers (all p < 0.001). In the test set, PF CEA at the cut-off value of 5.23 ng/ml showed the highest sensitivity, specificity and accuracy, positive and negative predictive value among other tumor biomarkers, which were 99.0%, 69.1%, 91.6%, 90.7%, and 95.9%, respectively.

Conclusion: PF CEA at the cut-off level of 5.23 ng/ml was the most effective indicator for identifying lung cancer-associated MPE among the five common tumor biomarkers.

Keywords: CEA; Lung cancer; Pleural effusion; Serum; Tumor markers.

PubMed Disclaimer

Conflict of interest statement

The authors state that they have no conflict of interests.

Figures

Fig. 1
Fig. 1
The patients’ selection flowchart
Fig. 2
Fig. 2
The ROC curves of the tumor biomarkers to distinguish between MPE and BPE
Fig. 3
Fig. 3
The verification results among the effective tumor biomarkers
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Wang S, Tian S, Li Y, Zhan N, Guo Y, Liu Y, et al. Development and validation of a novel scoring system developed from a nomogram to identify malignant pleural effusion. EBioMedicine. 2020;58:102924. doi: 10.1016/j.ebiom.2020.102924. - DOI - PMC - PubMed
    1. Thompson JC, Fan R, Black T, Yu GH, Savitch SL, Chien A, et al. Measurement and immunophenotyping of pleural fluid EpCAM-positive cells and clusters for the management of non-small cell lung cancer patients. Lung Cancer. 2019;127:25–33. doi: 10.1016/j.lungcan.2018.11.020. - DOI - PMC - PubMed
    1. Feng M, Zhu J, Liang L, Zeng N, Wu Y, Wan C, et al. Diagnostic value of tumor markers for lung adenocarcinoma-associated malignant pleural effusion: a validation study and meta-analysis. Int J Clin Oncol. 2017;22(2):283–290. doi: 10.1007/s10147-016-1073-y. - DOI - PubMed
    1. Thomas JM, Musani AI. Malignant pleural effusions: a review. Clin Chest Med. 2013;34(3):459–471. doi: 10.1016/j.ccm.2013.05.004. - DOI - PubMed
    1. Hooper C, Lee YC, Maskell N, BTS Pleural Guideline Group Investigation of a unilateral pleural effusion in adults: British Thoracic Society Pleural Disease Guideline 2010. Thorax. 2010;65(Suppl 2):ii4–17. doi: 10.1136/thx.2010.136978. - DOI - PubMed

Substances