1. Use of tumor markers for differential diagnosis of mesothelioma and secondary pleural malignancies
- Author
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Bruno Housset, Christos Chouaid, Jean-Paul Tillement, K. Atassi, Isabelle Monnet, Claire Fuhrman, Jean-Claude Duché, I Abd Alsamad, Annesi-Maesano, Isabella, Unité fonctionnelle de pharmacologie-toxicologie, CHI Créteil, Epidémiologie des maladies infectieuses et modélisation (ESIM), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre de recherche sur les Ions, les MAtériaux et la Photonique (CIMAP - UMR 6252), Centre National de la Recherche Scientifique (CNRS)-École Nationale Supérieure d'Ingénieurs de Caen (ENSICAEN), Normandie Université (NU)-Normandie Université (NU)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Université de Caen Normandie (UNICAEN), Normandie Université (NU), Fuhrman C, Duche JC, C Chouaid, Abd je Alsamad, K Atassi, je Monnet, JP Tillement, B Housset ., Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU)-École Nationale Supérieure d'Ingénieurs de Caen (ENSICAEN), Normandie Université (NU)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche sur les Matériaux Avancés (IRMA), Normandie Université (NU)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Institut national des sciences appliquées Rouen Normandie (INSA Rouen Normandie), Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Institut National des Sciences Appliquées (INSA)-Centre National de la Recherche Scientifique (CNRS)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Université de Rouen Normandie (UNIROUEN), and Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Institut National des Sciences Appliquées (INSA)-Centre National de la Recherche Scientifique (CNRS)
- Subjects
Male ,Mesothelioma ,Pathology ,Lung Neoplasms ,Pleural effusion ,MESH: Keratin-19 ,Tissue Polypeptide Antigen ,Clinical Biochemistry ,MESH: Antigens, Neoplasm ,Gastroenterology ,0302 clinical medicine ,Carcinoembryonic antigen ,Malignant pleural effusion ,Prospective Studies ,Carcinoma, Small Cell ,Hyaluronic Acid ,MESH: Aged ,MESH: Middle Aged ,medicine.diagnostic_test ,biology ,MESH: Carcinoma, Small Cell ,MESH: Carcinoma, Squamous Cell ,General Medicine ,Middle Aged ,respiratory system ,3. Good health ,Area Under Curve ,030220 oncology & carcinogenesis ,Carcinoma, Squamous Cell ,Keratins ,Female ,MESH: Pleural Effusion ,MESH: Carcinoembryonic Antigen ,medicine.medical_specialty ,Pleural Neoplasms ,Adenocarcinoma ,Sensitivity and Specificity ,MESH: Pleural Neoplasms ,Diagnosis, Differential ,03 medical and health sciences ,MESH: Tissue Polypeptide Antigen ,MESH: Diagnosis, Differential ,Antigens, Neoplasm ,Internal medicine ,Biomarkers, Tumor ,medicine ,Thoracoscopy ,Humans ,Aged ,Tumor marker ,Keratin-19 ,MESH: Humans ,MESH: Hyaluronic Acid ,MESH: Mesothelioma ,business.industry ,MESH: Adenocarcinoma ,MESH: Keratins ,MESH: ROC Curve ,medicine.disease ,MESH: Male ,MESH: Prospective Studies ,MESH: Sensitivity and Specificity ,MESH: Lung Neoplasms ,Carcinoembryonic Antigen ,respiratory tract diseases ,Pleural Effusion ,ROC Curve ,030228 respiratory system ,[SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie ,MESH: Tumor Markers, Biological ,biology.protein ,MESH: Area Under Curve ,[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie ,Differential diagnosis ,business ,MESH: Female - Abstract
International audience; STUDY OBJECTIVE: The aim of the study was to assess diagnosis value of tumor markers for differential diagnosis between mesothelioma and other pleural tumors. DESIGN AND METHODS: Prospective study of 85 patients attending our hospital with malignant pleural effusion. The diagnostic approach involved routine pleurocentesis followed by pleural needle. When precise diagnosis was not achieved, thoracoscopy with pleural biopsies was performed. Carcinoembryonic antigen (CEA), hyaluronic acid, tissue polypeptide antigen and cyfra 21 to 1 were measured in serum and pleural fluid. RESULTS: By using receiver operating characteristics curves and area under curves, the best diagnostic characteristics were obtained with pleural and serum CEA concentrations. The area under the curve was larger for pleural ACE than for serum ACE. The sensitivity and specificity of a pleural CEA level exceeding 3 ng/mL for ruling out the diagnosis of mesothelioma were 100% and 77%, respectively. CONCLUSION: A CEA level above 3 ng/mL in pleural fluid eliminated the diagnosis of mesothelioma, whereas the other markers were not sufficiently discriminant. However, despite a negative predictive value of 100% at a cutoff of 3 ng/mL, CEA assay in pleural fluid only avoids a small number of diagnostic thoracoscopies.
- Published
- 2000
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