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Soluble oncoprotein 185HER-2 in pleural fluid has limited usefulness for the diagnostic evaluation of malignant
José Manuel Porcel1, Antonieta Salud, Manuel Vives
1Department of Internal Medicine, Arnau de Vilanova University Hospital, Alcalde Rovira Roure 80, 25198 Lleida, Spain. jporcelp@yahoo.es
Objectives:
To investigate whether pleural levels of the soluble oncoprotein 185 HER-2 (sp185(HER-2)), individually or in combination with CEA and CA 15-3, were useful for the diagnosis of malignant effusions.
Design And Methods:
Levels of CEA, CA 15-3, and sp185(HER-2) were measured in the pleural fluid from 135 malignant and 103 benign effusions. Thresholds of these tumor markers were chosen for a diagnostic specificity of >or=99%.
Results:
Pleural sp185(HER-2) levels greater than 25 ng/mL were observed in 20% of breast and 10% of lung adenocarcinomas, and predicted a malignant effusion with a sensitivity of 7% and a likelihood ratio of 7.6. Combination of CEA and CA 15-3 resulted in 50% sensitivity, while adding sp185(HER-2) to this panel nonsignificantly increased sensitivity by 5% (P = 0.45). Only 1 patient with breast adenocarcinoma among 45 cytology-negative malignant effusions had sp185(HER-2) above the diagnostic cutoff point.
Conclusion:
Measurement of pleural fluid sp185(HER-2) has poor diagnostic performance in patients with malignant effusions.
