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Ratio of Carcino-Embryonic-Antigen in Serum and Pleural Fluid for the Diagnosis of Malignant Pleural Effusion

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A4688 - Ratio of Carcino-Embryonic-Antigen in Serum and Pleural Fluid for the Diagnosis of Malignant Pleural Effusion
Author Block: K. Hackner, P. Errhalt, S. Handzhiev; Department of Pneumonology, University Hospital Krems, Krems, Austria.
Rationale: Tumour markers in pleural fluid and their diagnostic value are subject to debate. Although there are several studies on this topic, no standardized cut-off values exist. We investigated the potential of a ratio of Carcino-Embryonic-Antigen (CEA) in pleural fluid and serum, serving as an individual marker for pleural cancer infestation. Methods: 202 consecutive patients with unclear pleural effusion have been included, 98 were diagnosed with histologically proven malignant pleural effusion and 104 had an effusion due to other, benign reason. CEA levels in pleural fluid and blood were measured in all patients and the ratio calculated. Results: By using ROC analysis, at the cut-off of 1.0 the CEA ratio showed a specificity of 92 % and sensitivity of 85 %. These results are higher than previous investigations on different tumour markers and/or their combined use for the pleural fluid.
Conclusion: In conclusion, the CEA pleura fluid/serum ratio might be a useful tool to predict malignant effusion. Results ≥1.0 in patients with non-malignant pleural cytology should lead to further investigations, like repeated cytological examination of the pleural fluid or thoracoscopic evaluation.
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