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[Diagnostic value of tissue polypeptide antigen in pleural effusions with malignant pleural mesothelioma]
T Tokuyama1, T Yoneda, K Hamada
1Second Department of Internal Medicine, Nara Medical University, Japan.
Abstract:
There are no known tumor makers of malignant pleural mesothelioma. We measured the concentration of TPA in the pleural effusions from patients with malignant pleural mesothelioma and from patients with other pleural diseases, evaluate its clinical usefulness. The concentration of TPA was more than 7,000 U/l (mean: 18,600 +/- 9,867 U/l, n = 5) in all patients with malignant pleural mesothelioma, but it was less than 4,000 U/l in those with benign asbestos pleurisy and other benign pleural effusion (benign asbestos pleurisy 1,598 +/- 570, n = 5: p < 0.01, tuberculous pleurisy 1.37 +/- 759, n = 11: p < 0.01, others 2,497 +/- 2,152 n = 3: p < 0.05). The concentration of TPA in the pleural effusions was not significantly different between malignant pleural mesothelioma and lung cancer (12,287 +/- 17,070 U/l). However, in all patients with lung cancer and high TPA concentrations, cytologically malignant cells were detected in the pleural effusions. TPA was high in all five patients with malignant pleural mesothelioma, but cytologically malignant cells were detected in only one patient. Only in malignant pleural mesothelioma (not in other benign disease or in lung cancer) was the concentration of TPA more than 4,000 U/l, and no evidence of malignancy was obtained by cytological methods. These findings suggest that assessing TPA in the pleural effusion might contribute to the diagnosis of malignant pleural mesothelioma.
Insights
Tissue polypeptide antigen (TPA) levels in pleural effusions may aid in diagnosing malignant pleural mesothelioma. Elevated TPA concentrations were observed in mesothelioma patients, distinguishing them from benign pleural diseases.
Area of Science:
- Oncology
- Pulmonology
- Biomarker Research
Background:
- Malignant pleural mesothelioma lacks established tumor markers.
- Accurate diagnosis is crucial for effective treatment and patient outcomes.
Purpose of the Study:
- To evaluate the clinical utility of tissue polypeptide antigen (TPA) concentration in pleural effusions for diagnosing malignant pleural mesothelioma.
- To differentiate malignant pleural mesothelioma from other pleural diseases, including benign conditions and lung cancer.
Main Methods:
- Measurement of TPA concentration in pleural effusions from patients with malignant pleural mesothelioma, benign asbestos pleurisy, tuberculous pleurisy, other benign pleural effusions, and lung cancer.
- Comparison of TPA levels across different patient groups.
- Correlation of TPA levels with cytological findings for malignancy detection.
Main Results:
- TPA concentrations were significantly elevated (>7,000 U/l) in all malignant pleural mesothelioma patients (mean 18,600 U/l).
- TPA levels were below 4,000 U/l in patients with benign pleural diseases (benign asbestos pleurisy, tuberculous pleurisy, others).
- TPA levels in malignant pleural mesothelioma were not significantly different from lung cancer, but cytologically malignant cells were detected in all lung cancer patients with high TPA, unlike in mesothelioma.
Conclusions:
- Elevated TPA concentration (>4,000 U/l) in pleural effusions, particularly when cytology is negative for malignancy, strongly suggests malignant pleural mesothelioma.
- TPA assessment in pleural effusions shows potential as a valuable diagnostic tool for malignant pleural mesothelioma, complementing traditional methods.