High levels of tumor markers in pleural fluid correlate with poor survival in patients with adenocarcinomatous or squamous malignant effusions

Abstract Background The aim of this study was to determine whether several pleural fluid (PF) tumor markers, either alone or in combination, could be used to predict survival time of patients with malignant pleural effusion secondary to adenocarcinoma or squamous cell carcinoma. Methods A total of 2...

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Bibliographic Details
Published in:European journal of internal medicine 2009-07, Vol.20 (4), p.383-386
Main Authors: Bielsa, Silvia, Esquerda, Aureli, Salud, Antonieta, Montes, Ana, Arellano, Elena, Rodríguez-Panadero, Francisco, Porcel, José M
Format: Article
Language:English
Subjects:
Adenocarcinoma - metabolism
Adenocarcinoma - mortality
Adenocarcinoma - secondary
Aged
Biomarkers, Tumor - metabolism
Breast Neoplasms - pathology
CA-125 Antigen - metabolism
Cancer antigen 125
Carbohydrate antigen 15-3
Carcinoembryonic antigen
Carcinoembryonic Antigen - metabolism
Carcinoma, Squamous Cell - metabolism
Carcinoma, Squamous Cell - mortality
Carcinoma, Squamous Cell - secondary
Cytokeratin 19 fragments
Female
Gastrointestinal Neoplasms - pathology
Humans
Internal Medicine
Kaplan-Meier Estimate
Keratin-19 - metabolism
Lung Neoplasms - pathology
Male
Malignant pleural effusion
Middle Aged
Mucin-1 - metabolism
Pleural Effusion, Malignant - metabolism
Pleural Effusion, Malignant - mortality
Pleural Neoplasms - metabolism
Pleural Neoplasms - mortality
Pleural Neoplasms - secondary
Predictive Value of Tests
Survival
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Summary:Abstract Background The aim of this study was to determine whether several pleural fluid (PF) tumor markers, either alone or in combination, could be used to predict survival time of patients with malignant pleural effusion secondary to adenocarcinoma or squamous cell carcinoma. Methods A total of 224 patients with confirmed metastatic pleural malignancies due to adenocarcinoma or squamous cell carcinoma were enrolled. PF tumor markers were determined either by electrochemiluminescence immunoassay (CEA, CA 15-3, CYFRA 21-1) or microparticle enzyme immunoassay (CA 125) technologies. Cutoff points that predicted death during the first month after diagnoses, with a specificity of 60%, were selected for each marker, using receiver operating characteristic analysis. Results In patients with adenocarcinomatous or squamous malignant effusion, the combination of PF CA 125 ≥ 1000 U/mL and CYFRA 21-1 ≥ 100 ng/mL predicted a lower survival (4 vs. 11.7 months, p = 0.03; and 0.3 vs. 8.4 months, p = 0.003 respectively). This tumor marker combination remained as an independent predictor of poor outcome when adjusted for age and tumor type. Conclusion High PF tumor marker levels identify a subgroup of patients with a shorter median survival.
ISSN:0953-6205
1879-0828
DOI:10.1016/j.ejim.2008.11.009