Topolcan O, Holubec L, Polivkova V, Svobodova S, Pesek M, Treska V, Safranek J, Hajek T, Bartunek L, Rousarova M, Finek J
Department of Nuclear Medicine, Charles University, Medical School and Teaching Hospital Plzen, Czech Republic.
Anticancer Res. 2007 Jul-Aug;27(4A):1921-4.
The aim of this study was to determine the diagnostic capabilities of tumor markers in pleural effusion and their importance for assessment of the etiology of pleural effusions.
In pleural effusions from 166 patients hospitalized during the period 2003-2005 at the Department of Oncology and Radiotherapy, Faculty Hospital in Pilsen, the following tumor markers were determined: thymidine kinase (TK), neuron-specific enolase (NSE), cytokeratins [tissue polypeptide antigen (TPA), tissue polypeptide-specific antigen (TPS) and cytokeratin fragment 19 (CYFRA 21-1)], carcinoembryonic antigen (CEA) and mucinous markers (CA 15-3, CA 19-9, CA 125). The inflammatory marker procalcitonin-PCT was also assessed.
Tumor markers CA 125, TPA, TPS were significantly elevated in exudates, irrespective of the etiology, as a non-specific reaction in mesothelial cells. TK had a sensitivity of over 80% for all the types of cancer examined, while CA 15-3 had a sensitivity of over 90%.
Significant positivity of PCT and CA 15-3 in pleural effusions indicate a suspicion of inflammatory disease. Positivity of TK and CA 15-3 indicate a strong suspicion of malignant exudates.
本研究旨在确定肿瘤标志物在胸腔积液中的诊断能力及其对评估胸腔积液病因的重要性。
对2003年至2005年期间在皮尔森市大学医院肿瘤与放射治疗科住院的166例患者的胸腔积液，检测了以下肿瘤标志物：胸苷激酶（TK）、神经元特异性烯醇化酶（NSE）、细胞角蛋白[组织多肽抗原（TPA）、组织多肽特异性抗原（TPS）和细胞角蛋白片段19（CYFRA 21-1）]、癌胚抗原（CEA）和黏液性标志物（CA 15-3、CA 19-9、CA 125）。还评估了炎症标志物降钙素原（PCT）。
无论病因如何，肿瘤标志物CA 125、TPA、TPS在渗出液中均显著升高，这是间皮细胞的一种非特异性反应。TK对所有检测的癌症类型敏感性超过80%，而CA 15-3敏感性超过90%。
胸腔积液中PCT和CA 15-3显著阳性提示怀疑有炎症性疾病。TK和CA 15-3阳性提示高度怀疑恶性渗出液。
