51P - Diagnostic value of carcinoembryonic antigen, lactate dehydrogenase and C-reactive protein in patients with pleural effusion undergoing VATS thorac...

Date 15 April 2016
Event European Lung Cancer Conference 2016 (ELCC) 2016
Session Poster lunch
Topics Thoracic Malignancies
Translational Research
Basic Principles in the Management and Treatment (of cancer)
Presenter Franco Lumachi
Citation Journal of Thoracic Oncology (2016) 11 (supplement 4): S57-S166. S1556-0864(16)X0004-4
Authors F. Lumachi1, R. Tozzoli2, A. Del Conte3, G.B. Chiara4, S. Basso4
  • 1Department Of Surgery, Oncology & Gastroenterology (discog), University of Padua, School of Medicine, 35128 - Padova/IT
  • 2Clinical Pathology Laboratory, Department Of Laboratory Medicine, S. Maria degli Angeli Hospital, 33170 - Pordenone/IT
  • 3Medical Oncology, S. Maria degli Angeli Hospital, 33170 - Pordenone/IT
  • 4Surgery 1, S. Maria degli Angeli Hospital, 33170 - Pordenone/IT

Abstract

Background

Pleural effusion (PE) complicates the clinical course of several thoracic lesions, including lung cancer, pulmonary metastases, pleural mesothelioma, cardiac failure, pneumonia and tuberculosis. The pre-surgical diagnosis is difficult, and several imaging studies and biological tumor markers (TM) have been used in differentiating between benign and malignant PE. For this purpose, we retrospectively evaluated the usefulness of four serum and pleural potential risk factors for cancer in patients with PE.

Methods

Data from a group of 163 patients with histologically confirmed benign (BPE, N = 46, age 67.9±10.2 years) and malignant (MPE, N = 117, age 68.5±13.5 years; p = 0.769) PE were reviewed. Serum (sCEA) and pleural (pCEA) carcinoembryonic antigen, serum lactate dehydrogenase (LDH), and serum C-reactive protein (CRP) measurements were available in 94, 141, 153, and 94 patients, respectively. CEA was measured with automated method of immuno-chemiluminescence (LOCI, Dimension Vista, Siemens HD, Camberley, UK), while both LHD and CRP were measured by standard colorimetric assay kits.

Results

Overall (MPE vs. BPE), sCEA, LDH, CRP, and pCEA values were 16.5±50.5 vs. 2.4±1.9 ng/mL (p = 0.113), 260.8±243.6 vs. 242.7±228.2 IU/L (p = 0.280), 4.4±4.7 vs. 5.6±5.8 mg/mL (p = 0.280), and 135.7±620.3 vs. 1.49±1.24 ng/mL (p = 0.218), respectively. The median value of each TM (sCEA = 2.1 ng/mL, LDH = 198 IU/L, CRP = 2.7 mg/L, pCEA = 12.8 ng/mL) was consider as cut-off value. The distribution of potential risk factors for malignancy in cases (MPE) and controls (BPE) are shown in the table. Odds ratio (OR) estimates with associated 95% confidence interval (CI) and the relative p-value are also reported. 51PT1

MarkerCasesControlsOR (95% CI)p
 n%>cut-offn%>cut-off  
sCEA6150.8%3336.4%1.81 9.76–4.31)0.179
sLDH11768.4%3644.4%2.70 (1.26–5.80)0.0094
sCRP5743.9%3754.1%0.66 (0.29–1.53)0.334
pCEA9558.9%4628.2%3.64 (1.70–7.80)0.0006

Conclusions

Serum LDH (p = 0.009) and pCEA (p = 0.0006) represent the most sensitive TM for malignancy, when a noninvasive evaluation of BPE vs. MPE is required.

Legal entity responsible for the study

University of Padua

Funding

University of Padua

Disclosure

All authors have declared no conflicts of interest.