Detection of carcinoembryonic antigen levels in pleural effusion and serum and their ratio for differential diagnosis of pleural effusion resulting from tuberculosis and lung cancer.
10.12122/j.issn.1673-4254.2019.02.08
- Author:
Ruicheng LI
1
;
Zhaowei GAO
1
;
Ke DONG
1
;
Huiping WANG
1
;
Huizhong ZHANG
1
Author Information
1. Clinical Laboratory, Second Affiliated Hospital of Air Force Medical University, Xi'an 710038, China.
- Publication Type:Journal Article
- Keywords:
carcinoembryonic antigen;
clinical diagnosis;
lung cancer;
pleural effusion;
tuberculous pleurisy
- MeSH:
Carcinoembryonic Antigen;
analysis;
blood;
Case-Control Studies;
Diagnosis, Differential;
Humans;
Lung Neoplasms;
blood;
complications;
Pleural Effusion;
blood;
diagnosis;
immunology;
Pleural Effusion, Malignant;
blood;
chemistry;
diagnosis;
ROC Curve;
Retrospective Studies;
Sensitivity and Specificity;
Tuberculosis, Pulmonary;
complications
- From:
Journal of Southern Medical University
2019;39(2):175-180
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE:To study the clinical value of detecting carcinoembryonic antigen levels in pleural effusion (PCEA) and serum (SCEA) and their ratio (P/S) in the differential diagnosis of pleural effusions resulting from tuberculosis and lung cancer.
METHODS:This retrospectively study was conducted among 82 patients with pleural effusion caused by pulmonary tuberculous (TB; control group) and 120 patients with pleural effusion resulting from lung cancer in our hospital between April, 2016 and March, 2018. PCEA, SCEA and P/S were compared between the two groups and among the subgroups of lung cancer patients with squamous cell carcinoma (SqCa), adenocarcinoma (ACA), small cell carcinoma (SCLC). The receiveroperating characteristic curve (ROC) analysis was used to confirm the optimal critical value to evaluate the diagnostic efficiency of different combinations of PCEA, SCEA and P/S.
RESULTS:PCEA, SCEA and P/S were significantly higher in the overall cancer patients and in all the 3 subgroups of cancer patients than in the patients with TB ( < 0.05). The areas under the ROC curve of PCEA, SCEA and P/S were 0.925, 0.866 and 0.796, respectively; PCEA had the highest diagnostic value, whose diagnostic sensitivity, specificity, accurate rate, and diagnostic threshold were 83.33%, 96.34, 88.61%, and 3.26 ng/ml, respectively; SCEA had the lowest diagnostic performance; the diagnostic performance of P/S was between that of SCEA and PCEA, but its combination with SCEA greatly improved the diagnostic performance and reduced the rates of misdiagnosis and missed diagnosis. Parallel tests showed that the 3 indexes combined had significantly higher diagnostic sensitivity than each or any two of the single indexes ( < 0.05), but the diagnostic specificity did not differ significantly. The area under the ROC curve of combined detections of the 3 indexes was 0.941 for diagnosis of lung cancer-related pleural effusion, higher than those of any other combinations of the indexes.
CONCLUSIONS:The combined detection of PCEA, SCEA and P/S has a high sensitivity for diagnosis of lung cancer-related pleural effusion and provides important information for rapid and accurate diagnosis of suspected cases.
