胸腔积液中的可溶性癌蛋白185HER-2在恶性胸腔积液的诊断评估中作用有限。

Soluble oncoprotein 185HER-2 in pleural fluid has limited usefulness for the diagnostic evaluation of malignant effusions.

作者信息

Porcel José Manuel, Salud Antonieta, Vives Manuel, Esquerda Aureli, Rodríguez-Panadero Francisco

机构信息

Department of Internal Medicine, Arnau de Vilanova University Hospital, Alcalde Rovira Roure 80, 25198 Lleida, Spain.

出版信息

Clin Biochem. 2005 Nov;38(11):1031-3. doi: 10.1016/j.clinbiochem.2005.05.001. Epub 2005 May 31.

DOI:10.1016/j.clinbiochem.2005.05.001

PMID:15925354

Abstract

OBJECTIVES

To investigate whether pleural levels of the soluble oncoprotein 185 HER-2 (sp185(HER-2)), individually or in combination with CEA and CA 15-3, were useful for the diagnosis of malignant effusions.

DESIGN AND METHODS

Levels of CEA, CA 15-3, and sp185(HER-2) were measured in the pleural fluid from 135 malignant and 103 benign effusions. Thresholds of these tumor markers were chosen for a diagnostic specificity of >or=99%.

RESULTS

Pleural sp185(HER-2) levels greater than 25 ng/mL were observed in 20% of breast and 10% of lung adenocarcinomas, and predicted a malignant effusion with a sensitivity of 7% and a likelihood ratio of 7.6. Combination of CEA and CA 15-3 resulted in 50% sensitivity, while adding sp185(HER-2) to this panel nonsignificantly increased sensitivity by 5% (P = 0.45). Only 1 patient with breast adenocarcinoma among 45 cytology-negative malignant effusions had sp185(HER-2) above the diagnostic cutoff point.

CONCLUSION

Measurement of pleural fluid sp185(HER-2) has poor diagnostic performance in patients with malignant effusions.

摘要

目的

研究可溶性癌蛋白185 HER-2（sp185(HER-2)）的胸腔积液水平单独或与癌胚抗原（CEA）和糖类抗原15-3（CA 15-3）联合使用时，是否有助于恶性胸腔积液的诊断。

设计与方法

检测了135例恶性胸腔积液和103例良性胸腔积液患者胸腔积液中的CEA、CA 15-3和sp185(HER-2)水平。选择这些肿瘤标志物的阈值以获得≥99%的诊断特异性。

结果

在20%的乳腺癌和10%的肺腺癌患者中观察到胸腔sp185(HER-2)水平大于25 ng/mL，其预测恶性胸腔积液的敏感性为7%，似然比为7.6。CEA和CA 15-3联合检测的敏感性为50%，在此基础上加入sp185(HER-2)后敏感性非显著性增加5%（P = 0.45）。在45例细胞学检查阴性的恶性胸腔积液患者中，只有1例乳腺腺癌患者的sp185(HER-2)高于诊断临界值。