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Tumor Markers in Pleural Fluid: A Comprehensive Study on Diagnostic Accuracy
Vladimir Aleksiev1,2, Daniel Markov3,4, Kristian Bechev4,5
1Department of Thoracic Surgery, UMHAT "Kaspela", 4001 Plovdiv, Bulgaria.
Diagnostics (Basel, Switzerland)
|January 25, 2025
Summary
Pleural fluid tumor markers like CEA and CA19-9 can help differentiate malignant from benign pleural effusions. CA72-4 demonstrated the highest diagnostic accuracy in this study.
Area of Science:
- Oncology
- Pulmonology
- Clinical Diagnostics
Background:
- Malignant pleural effusions (MPEs) significantly impact cancer patient quality of life, causing dyspnea.
- MPEs represent a substantial healthcare burden, affecting ~1 million individuals annually.
- Pleural metastasis occurs in ~20% of cancer patients during treatment.
Purpose of the Study:
- To evaluate the diagnostic utility of various tumor markers in pleural fluid.
- To differentiate malignant pleural effusions from benign ones using pleural fluid biomarkers.
- To identify the most effective tumor markers for diagnosing MPEs.
Main Methods:
- A case-control study involving 151 Bulgarian patients with hydrothorax.
- Comparison of tumor marker levels between 79 malignant and 72 benign pleural effusion cases.
- Receiver Operating Characteristic (ROC) analysis and Youden index for optimal cut-off values.
Main Results:
- Most tumor markers, including CEA and CA19-9, showed significant differences between malignant and non-malignant groups.
- CA72-4 exhibited the highest accuracy in distinguishing MPEs.
- PIVKA-II (Protein induced by vitamin K absence-II) showed the weakest performance.
Conclusions:
- Pleural fluid tumor markers are valuable, minimally invasive tools for diagnosing MPEs.
- Findings support improved diagnostic accuracy and personalized management for pleural pathologies.
- This research addresses a critical need in differentiating malignant from non-malignant pleural effusions.
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