Department of Respiratory and Critical Care Medicine, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, 646000, PR China; Inflammation & Allergic Diseases Research Unit, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, 646000, PR China.
Department of Laboratory Medicine, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, 646000, PR China.
Am J Med Sci. 2024 Aug;368(2):136-142. doi: 10.1016/j.amjms.2024.04.001. Epub 2024 Apr 5.
The distinction between lung adenocarcinoma-associated malignant pleural effusion (MPE) and tuberculous pleural effusion (TPE) continues to pose a challenge. This study sought to assess the supplementary value of tumor markers in enabling a differential diagnosis.
Data concerning tumor markers, which included carcinoembryonic antigen (CEA), cancer antigen 125 (CA125), cancer antigen 153 (CA153), cancer antigen 724 (CA724), neuron-specific enolase (NSE), cytokeratin19 fragment (Cyfra21-1), and squamous cell carcinoma antigen (SCCA), in both serum and pleural effusion samples, were retrospectively compiled from lung adenocarcinoma-associated MPE and TPE patients. A comparative analysis of tumor marker concentrations between the two groups was performed to assess diagnostic utility, followed by a multiple logistic regression to control for confounding variables.
While gender, serum CA125 and SCCA, and pleural effusion SCCA manifested comparability between the groups, distinctions were noted in patient age and the concentration of other tumor markers in serum and pleural effusion, which were notably elevated in the MPE group. Multiple logistic regression demonstrated a positive association between the risk of lung adenocarcinoma-associated MPE and levels of CEA and CA153 in serum and pleural effusion, as well as Cyfra21-1 in serum (P < 0.05). The odds ratio for CEA surpassed that of CA153 and Cyfra21-1.
CEA and CA153 in serum and pleural effusion, and Cyfra21-1 in serum emerge as biomarkers possessing supplementary diagnostic value in distinguishing lung adenocarcinoma-associated MPE from TPE. The diagnostic efficacy of CEA is superior to CA153 and Cyfra21-1. Conversely, the utility of CA125, CA724, NSE, and SCCA appears constrained.
肺腺癌相关恶性胸腔积液（MPE）与结核性胸腔积液（TPE）的鉴别仍然具有挑战性。本研究旨在评估肿瘤标志物在鉴别诊断中的补充价值。
回顾性收集肺腺癌相关 MPE 和 TPE 患者的肿瘤标志物数据，包括癌胚抗原（CEA）、糖类抗原 125（CA125）、糖类抗原 153（CA153）、糖类抗原 724（CA724）、神经元特异性烯醇化酶（NSE）、细胞角蛋白 19 片段（Cyfra21-1）和鳞状细胞癌抗原（SCCA）在血清和胸腔积液样本中的数据。对两组肿瘤标志物浓度进行比较分析，评估诊断效能，然后进行多因素逻辑回归控制混杂因素。
虽然性别、血清 CA125 和 SCCA 以及胸腔积液 SCCA 在两组之间具有可比性，但患者年龄和血清及胸腔积液中其他肿瘤标志物的浓度存在差异，MPE 组明显升高。多因素逻辑回归显示，血清和胸腔积液中 CEA 和 CA153 以及血清中 Cyfra21-1 水平与肺腺癌相关 MPE 的风险呈正相关（P<0.05）。CEA 的优势比超过 CA153 和 Cyfra21-1。
血清和胸腔积液中的 CEA 和 CA153 以及血清中的 Cyfra21-1 是鉴别肺腺癌相关 MPE 与 TPE 的具有补充诊断价值的生物标志物。CEA 的诊断效能优于 CA153 和 Cyfra21-1。相反，CA125、CA724、NSE 和 SCCA 的应用似乎受到限制。
