Szturmowicz M, Tomkowski W, Fijalkowska A, Kupis W, Cieslik A, Demkow U, Langfort R, Wiechecka A, Orlowski T, Torbicki A
Department of Internal Medicine, National Institute of Tuberculosis and Lung Diseases, Warsaw - Pola.
Int J Biol Markers. 2005 Jan-Mar;20(1):43-49. doi: 10.5301/JBM.2008.318.
A positive cytology result in pericardial fluid is the gold standard for recognition of malignant pericardial effusion. Unfortunately, in 30-50% of patients with malignant pericardial effusion cytological examination of the pericardial fluid is negative. Tumor marker assessment in pericardial fluid may help to recognize malignant pericardial effusion. The aim of our study was to estimate the value of CYFRA 21-1 and CEA measurement in pericardial fluid for the recognition of malignant pericardial effusion. To our knowledge this is the first study on CYFRA 21-1 assessment in pericardial effusion. The examined group consisted of 50 patients with malignant pericardial effusion and 34 patients with non-malignant pericardial effusion. Median CEA concentrations in malignant pericardial effusion and non-malignant pericardial effusion were 80 ng/mL (0-317) and 0.5 ng/mL (0-18.4), respectively (p<0.001). Median CYFRA 21-1 concentrations in malignant pericardial effusion and non-malignant pericardial effusion were 260 ng/mL (5.3-10080) and 22.4 ng/mL (1.87-317.6), respectively (p<0.001). The optimal cutoff value for CYFRA 21-1 in pericardial effusion was 100 ng/mL. CYFRA 21-1 >100 ng/mL or CEA >5 ng/mL were found in 14/15 patients with malignant pericardial effusion and negative pericardial fluid cytology. We therefore strongly recommend the use of CYFRA 21-1 and/or CEA in addition to pericardial fluid cytology for the recognition of malignant pericardial effusion. (Int J Biol Markers 2005; 20: 43-49).
心包积液细胞学检查结果呈阳性是诊断恶性心包积液的金标准。遗憾的是，在30%-50%的恶性心包积液患者中，心包积液的细胞学检查结果为阴性。心包积液中的肿瘤标志物评估可能有助于诊断恶性心包积液。我们研究的目的是评估心包积液中细胞角蛋白19片段（CYFRA 21-1）和癌胚抗原（CEA）检测对于诊断恶性心包积液的价值。据我们所知，这是第一项关于心包积液中CYFRA 21-1评估的研究。研究组包括50例恶性心包积液患者和34例非恶性心包积液患者。恶性心包积液和非恶性心包积液中CEA的中位浓度分别为80 ng/mL（0-317）和0.5 ng/mL（0-18.4）（p<0.001）。恶性心包积液和非恶性心包积液中CYFRA 21-1的中位浓度分别为260 ng/mL（5.3-10080）和22.4 ng/mL（1.87-317.6）（p<0.001）。心包积液中CYFRA 21-1的最佳临界值为100 ng/mL。在15例心包积液细胞学检查结果为阴性的恶性心包积液患者中，有14例患者的CYFRA 21-1>100 ng/mL或CEA>5 ng/mL。因此，我们强烈建议在心包积液细胞学检查的基础上增加CYFRA 21-1和/或CEA检测以诊断恶性心包积液。（《国际生物学标志物杂志》2005年；20：43-49）
