Spandidos Publications Logo
  • About
    • About Spandidos
    • Aims and Scopes
    • Abstracting and Indexing
    • Editorial Policies
    • Reprints and Permissions
    • Job Opportunities
    • Terms and Conditions
    • Contact
  • Journals
    • All Journals
    • Oncology Letters
      • Oncology Letters
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Oncology
      • International Journal of Oncology
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Molecular and Clinical Oncology
      • Molecular and Clinical Oncology
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Experimental and Therapeutic Medicine
      • Experimental and Therapeutic Medicine
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Molecular Medicine
      • International Journal of Molecular Medicine
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Biomedical Reports
      • Biomedical Reports
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Oncology Reports
      • Oncology Reports
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Molecular Medicine Reports
      • Molecular Medicine Reports
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • World Academy of Sciences Journal
      • World Academy of Sciences Journal
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Functional Nutrition
      • International Journal of Functional Nutrition
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Epigenetics
      • International Journal of Epigenetics
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Medicine International
      • Medicine International
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
  • Articles
  • Information
    • Information for Authors
    • Information for Reviewers
    • Information for Librarians
    • Information for Advertisers
    • Conferences
  • Language Editing
Spandidos Publications Logo
  • About
    • About Spandidos
    • Aims and Scopes
    • Abstracting and Indexing
    • Editorial Policies
    • Reprints and Permissions
    • Job Opportunities
    • Terms and Conditions
    • Contact
  • Journals
    • All Journals
    • Biomedical Reports
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Experimental and Therapeutic Medicine
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Epigenetics
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Functional Nutrition
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Molecular Medicine
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Oncology
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Medicine International
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Molecular and Clinical Oncology
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Molecular Medicine Reports
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Oncology Letters
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Oncology Reports
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • World Academy of Sciences Journal
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
  • Articles
  • Information
    • For Authors
    • For Reviewers
    • For Librarians
    • For Advertisers
    • Conferences
  • Language Editing
Login Register Submit
  • This site uses cookies
  • You can change your cookie settings at any time by following the instructions in our Cookie Policy. To find out more, you may read our Privacy Policy.

    I agree
Search articles by DOI, keyword, author or affiliation
Search
Advanced Search
presentation
Oncology Letters
Join Editorial Board Propose a Special Issue
Print ISSN: 1792-1074 Online ISSN: 1792-1082
Journal Cover
August-2018 Volume 16 Issue 2

Full Size Image

Sign up for eToc alerts
Recommend to Library

Journals

International Journal of Molecular Medicine

International Journal of Molecular Medicine

International Journal of Molecular Medicine is an international journal devoted to molecular mechanisms of human disease.

International Journal of Oncology

International Journal of Oncology

International Journal of Oncology is an international journal devoted to oncology research and cancer treatment.

Molecular Medicine Reports

Molecular Medicine Reports

Covers molecular medicine topics such as pharmacology, pathology, genetics, neuroscience, infectious diseases, molecular cardiology, and molecular surgery.

Oncology Reports

Oncology Reports

Oncology Reports is an international journal devoted to fundamental and applied research in Oncology.

Experimental and Therapeutic Medicine

Experimental and Therapeutic Medicine

Experimental and Therapeutic Medicine is an international journal devoted to laboratory and clinical medicine.

Oncology Letters

Oncology Letters

Oncology Letters is an international journal devoted to Experimental and Clinical Oncology.

Biomedical Reports

Biomedical Reports

Explores a wide range of biological and medical fields, including pharmacology, genetics, microbiology, neuroscience, and molecular cardiology.

Molecular and Clinical Oncology

Molecular and Clinical Oncology

International journal addressing all aspects of oncology research, from tumorigenesis and oncogenes to chemotherapy and metastasis.

World Academy of Sciences Journal

World Academy of Sciences Journal

Multidisciplinary open-access journal spanning biochemistry, genetics, neuroscience, environmental health, and synthetic biology.

International Journal of Functional Nutrition

International Journal of Functional Nutrition

Open-access journal combining biochemistry, pharmacology, immunology, and genetics to advance health through functional nutrition.

International Journal of Epigenetics

International Journal of Epigenetics

Publishes open-access research on using epigenetics to advance understanding and treatment of human disease.

Medicine International

Medicine International

An International Open Access Journal Devoted to General Medicine.

Journal Cover
August-2018 Volume 16 Issue 2

Full Size Image

Sign up for eToc alerts
Recommend to Library

  • Article
  • Citations
    • Cite This Article
    • Download Citation
    • Create Citation Alert
    • Remove Citation Alert
    • Cited By
  • Similar Articles
    • Related Articles (in Spandidos Publications)
    • Similar Articles (Google Scholar)
    • Similar Articles (PubMed)
  • Download PDF
  • Download XML
  • View XML
Article Open Access

Combination of procalcitonin, C‑reaction protein and carcinoembryonic antigens for discriminating between benign and malignant pleural effusions

  • Authors:
    • Mingde Ji
    • Xiaofei Zhu
    • Jie Dong
    • Shining Qian
    • Fei Meng
    • Wanjian Gu
    • Wen Qiu
  • View Affiliations / Copyright

    Affiliations: Department of Laboratory Medicine, Affiliated Hospital of Nanjing University of Traditional Chinese Medicine, Nanjing, Jiangsu 210029, P.R. China, Department of Immunology, Nanjing Medical University, Nanjing, Jiangsu 211166, P.R. China
    Copyright: © Ji et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
  • Pages: 1727-1735
    |
    Published online on: June 1, 2018
       https://doi.org/10.3892/ol.2018.8871
  • Expand metrics +
Metrics: Total Views: 0 (Spandidos Publications: | PMC Statistics: )
Metrics: Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )
Cited By (CrossRef): 0 citations Loading Articles...

This article is mentioned in:



Abstract

Pleural effusion (PE) is a common manifestation associated with certain chest diseases. However, there is no effective diagnostic marker with high sensitivity and specificity. The aim of the present study was to evaluate the diagnostic performance of several biomarkers in the use of detecting malignant pleural disorder. One hundred and fifty patients with a specific diagnosis of exudative PE were enrolled in this study and were divided into the benign PE group (n=93) and the malignant PE group (n=57). Thoracoscopy was conducted to identify the reasons for the PE. Biomarkers in pleural fluid and in sera were determined either by microparticle enzyme immunoassay [carcinoembryonic antigen (CEA)], fluorescence immunoassay [procalcitonin (PCT)] or light‑scattering turbidimetric immunoassay [C‑reaction protein (CRP)]. Then, correlation analysis and receiver‑operating characteristic (ROC) curve analysis individually or in combination were performed. The CRP and PCT levels were higher in benign PE than they were in malignant PE (PCT: P=0.017, P=0.032; CRP: P=0.001, P<0.001, respectively), while CEA levels were lower in benign PE than in malignant PE (CEA: P=0.001, P=0.001, respectively). During the ROC curve analysis, an optimal discrimination was identified by combining pleural CRP, pleural CEA and serum (s)PCT with an area under the curve of 0.973 (sensitivity, 98.9%; specificity, 89.5%). In the diagnosis of PE, there was no single biomarker that appeared to be adequately accurate. The combination of pleural CRP, pleural CEA and sPCT may represent an efficient diagnostic procedure for guiding the patient towards follow‑up clinical treatment.
View Figures

Figure 1

Figure 2

Figure 3

View References

1 

Braunschweig T, Chung JY, Choi CH, Cho H, Chen QR, Xie R, Perry C, Khan J and Hewitt SM: Assessment of a panel of tumor markers for the differential diagnosis of benign and malignant effusions by well-based reverse phase protein array. Diagn Pathol. 10:532015. View Article : Google Scholar : PubMed/NCBI

2 

Maskell NA and Butland RJ; Pleural Diseases Group, Standards of Care Committee, British Thoracic Society: BTS guidelines for the investigation of a unilateral pleural effusion in adults. Thorax. 58(Suppl 2): ii8–ii17. 2003. View Article : Google Scholar : PubMed/NCBI

3 

Yoon DW, Cho JH, Choi YS, Kim J, Kim HK, Zo JI and Shim YM: Predictors of survival in patients who underwent video-assisted thoracic surgery talc pleurodesis for malignant pleural effusion. Thorac Cancer. 7:393–398. 2016. View Article : Google Scholar : PubMed/NCBI

4 

Porcel JM, Vives M, Esquerda A, Salud A, Pérez B and Rodríguez-Panadero F: Use of a panel of tumor markers (carcinoembryonic antigen, cancer antigen 125, carbohydrate antigen 15-3, and cytokeratin 19 fragments) in pleural fluid for the differential diagnosis of benign and malignant effusions. Chest. 126:1757–1763. 2004. View Article : Google Scholar : PubMed/NCBI

5 

Catarino PA and Goldstraw P: The future in diagnosis and staging of lung cancer: Surgical techniques. Respiration. 73:717–732. 2006. View Article : Google Scholar : PubMed/NCBI

6 

Gu P, Huang G, Chen Y, Zhu C, Yuan J and Sheng S: Diagnostic utility of pleural fluid carcinoembryonic antigen and CYFRA 21-1 in patients with pleural effusion: A systematic review and meta-analysis. J Clin Lab Anal. 21:398–405. 2007. View Article : Google Scholar : PubMed/NCBI

7 

Liang QL, Shi HZ, Qin XJ, Liang XD, Jiang J and Yang HB: Diagnostic accuracy of tumour markers for malignant pleural effusion: A meta-analysis. Thorax. 63:35–41. 2008. View Article : Google Scholar : PubMed/NCBI

8 

Ryu JS, Lee HJ, Cho JH, Han HS and Lee HL: The implication of elevated carcinoembryonic antigen level in pleural fluid of patients with non-malignant pleural effusion. Respirology. 8:487–491. 2003. View Article : Google Scholar : PubMed/NCBI

9 

Alataş F, Alataş O, Metintaş M, Colak O, Harmanci E and Demir S: Diagnostic value of CEA, CA 15-3, CA 19-9, CYFRA 21-1, NSE and TSA assay in pleural effusions. Lung Cancer. 31:9–16. 2001. View Article : Google Scholar : PubMed/NCBI

10 

Villena V, López-Encuentra A, Echave-Sustaeta J, Martín-Escribano P, Ortuño-de-Solo B and Estenoz-Alfaro J: Diagnostic value of CA 549 in pleural fluid. Comparison with CEA, CA 15.3 and CA 72.4. Lung Cancer. 40:289–294. 2003.

11 

Shitrit D, Zingerman B, Shitrit AB, Shlomi D and Kramer MR: Diagnostic value of CYFRA 21-1, CEA, CA 19-9, CA 15-3, and CA 125 assays in pleural effusions: Analysis of 116 cases and review of the literature. Oncologist. 10:501–507. 2005. View Article : Google Scholar : PubMed/NCBI

12 

Lee JH and Chang JH: Diagnostic utility of serum and pleural fluid carcinoembryonic antigen, neuron-specific enolase, and cytokeratin 19 fragments in patients with effusions from primary lung cancer. Chest. 128:2298–2303. 2005. View Article : Google Scholar : PubMed/NCBI

13 

Mehanic S and Baljic R: The importance of serum procalcitonin in diagnosis and treatment of serious bacterial infections and sepsis. Mater Sociomed. 25:277–281. 2013. View Article : Google Scholar : PubMed/NCBI

14 

Uzzan B, Cohen R, Nicolas P, Cucherat M and Perret GY: Procalcitonin as a diagnostic test for sepsis in critically ill adults and after surgery or trauma: A systematic review and meta-analysis. Crit Care Med. 34:1996–2003. 2006. View Article : Google Scholar : PubMed/NCBI

15 

Nijsten MW, Olinga P, The TH, de Vries EG, Koops HS, Groothuis GM, Limburg PC, ten Duis HJ, Moshage H, Hoekstra HJ, et al: Procalcitonin behaves as a fast responding acute phase protein in vivo and in vitro. Crit Care Med. 28:458–461. 2000. View Article : Google Scholar : PubMed/NCBI

16 

Wacker C, Prkno A, Brunkhorst FM and Schlattmann P: Procalcitonin as a diagnostic marker for sepsis: A systematic review and meta-analysis. Lancet Infect Dis. 13:426–435. 2013. View Article : Google Scholar : PubMed/NCBI

17 

Brunkhorst R, Eberhardt OK, Haubitz M and Brunkhorst FM: Procalcitonin for discrimination between activity of systemic autoimmune disease and systemic bacterial infection. Intensive Care Med. 26(Suppl 2): S199–S201. 2000. View Article : Google Scholar : PubMed/NCBI

18 

Joo K, Park W, Lim MJ, Kwon SR and Yoon J: Serum procalcitonin for differentiating bacterial infection from disease flares in patients with autoimmune diseases. J Korean Med Sci. 26:1147–1151. 2011. View Article : Google Scholar : PubMed/NCBI

19 

Buhaescu I, Yood RA and Izzedine H: Serum procalcitonin in systemic autoimmune diseases-where are we now? Semin Arthritis Rheum. 40:176–183. 2010. View Article : Google Scholar : PubMed/NCBI

20 

Kim SE: Serum procalcitonin is a candidate biomarker to differentiate bacteremia from disease flares in patients with inflammatory bowel disease. Gut Liver. 10:491–492. 2016. View Article : Google Scholar : PubMed/NCBI

21 

Wang CY, Hsiao YC, Jerng JS, Ho CC, Lai CC, Yu CJ, Hsueh PR and Yang PC: Diagnostic value of procalcitonin in pleural effusions. Eur J Clin Microbiol Infect Dis. 30:313–318. 2011. View Article : Google Scholar : PubMed/NCBI

22 

Yang Y, Xie J, Guo F, Longhini F, Gao Z, Huang Y and Qiu H: Combination of C-reactive protein, procalcitonin and sepsis-related organ failure score for the diagnosis of sepsis in critical patients. Ann Intensive Care. 6:512016. View Article : Google Scholar : PubMed/NCBI

23 

Izhakian S, Wasser WG, Fox BD, Vainshelboim B and Kramer MR: The diagnostic value of the pleural fluid C-reactive protein in parapneumonic effusions. Dis Markers. 2016:75397802016. View Article : Google Scholar : PubMed/NCBI

24 

Xu C, Yu L, Zhan P and Zhang Y: Elevated pleural effusion IL-17 is a diagnostic marker and outcome predictor in lung cancer patients. Eur J Med Res. 19:232014. View Article : Google Scholar : PubMed/NCBI

25 

Antonangelo L, Sales RK, Corá AP, Acencio MM, Teixeira LR and Vargas FS: Pleural fluid tumour markers in malignant pleural effusion with inconclusive cytologic results. Curr Oncol. 22:e336–e341. 2015. View Article : Google Scholar : PubMed/NCBI

26 

Li H, Huang L, Tang H, Zhong N and He J: Pleural fluid carcinoembryonic antigen as a biomarker for the discrimination of tumor-related pleural effusion. Clin Respir J. 11:881–886. 2017. View Article : Google Scholar : PubMed/NCBI

27 

Gaspar MJ, de Miguel J, García Díaz JD and Díez M: Clinical utility of a combination of tumour markers in the diagnosis of malignant pleural effusions. Anticancer Res. 28:2947–2952. 2008.PubMed/NCBI

28 

Molina R, Bosch X, Auge JM, Filella X, Escudero JM, Molina V, Solé M and López-Soto A: Utility of serum tumor markers as an aid in the differential diagnosis of patients with clinical suspicion of cancer and in patients with cancer of unknown primary site. Tumour Biol. 33:463–474. 2012. View Article : Google Scholar : PubMed/NCBI

29 

Miédougé M, Rouzaud P, Salama G, Pujazon MC, Vincent C, Mauduyt MA, Reyre J, Carles P and Serre G: Evaluation of seven tumour markers in pleural fluid for the diagnosis of malignant effusions. Br J Cancer. 81:1059–1065. 1999. View Article : Google Scholar : PubMed/NCBI

30 

Blasi F, Stolz D and Piffer F: Biomarkers in lower respiratory tract infections. Pulm Pharmacol Ther. 23:501–507. 2010. View Article : Google Scholar : PubMed/NCBI

31 

Castelli GP, Pognani C, Meisner M, Stuani A, Bellomi D and Sgarbi L: Procalcitonin and C-reactive protein during systemic inflammatory response syndrome, sepsis and organ dysfunction. Crit Care. 8:R234–R242. 2004. View Article : Google Scholar : PubMed/NCBI

32 

Meidani M, Khorvash F, Abolghasemi H and Jamali B: Procalcitonin and quantitative C-reactive protein role in the early diagnosis of sepsis in patients with febrile neutropenia. South Asian J Cancer. 2:216–219. 2013. View Article : Google Scholar : PubMed/NCBI

33 

Magrini L, Travaglino F, Marino R, Ferri E, de Berardinis B, Cardelli P, Salerno G and Di Somma S: Procalcitonin variations after Emergency Department admission are highly predictive of hospital mortality in patients with acute infectious diseases. Eur Rev Med Pharmacol Sci. 17(Suppl 1): S133–S142. 2013.

Related Articles

  • Abstract
  • View
  • Download
  • Twitter
Copy and paste a formatted citation
Spandidos Publications style
Ji M, Zhu X, Dong J, Qian S, Meng F, Gu W and Qiu W: Combination of procalcitonin, C‑reaction protein and carcinoembryonic antigens for discriminating between benign and malignant pleural effusions. Oncol Lett 16: 1727-1735, 2018.
APA
Ji, M., Zhu, X., Dong, J., Qian, S., Meng, F., Gu, W., & Qiu, W. (2018). Combination of procalcitonin, C‑reaction protein and carcinoembryonic antigens for discriminating between benign and malignant pleural effusions. Oncology Letters, 16, 1727-1735. https://doi.org/10.3892/ol.2018.8871
MLA
Ji, M., Zhu, X., Dong, J., Qian, S., Meng, F., Gu, W., Qiu, W."Combination of procalcitonin, C‑reaction protein and carcinoembryonic antigens for discriminating between benign and malignant pleural effusions". Oncology Letters 16.2 (2018): 1727-1735.
Chicago
Ji, M., Zhu, X., Dong, J., Qian, S., Meng, F., Gu, W., Qiu, W."Combination of procalcitonin, C‑reaction protein and carcinoembryonic antigens for discriminating between benign and malignant pleural effusions". Oncology Letters 16, no. 2 (2018): 1727-1735. https://doi.org/10.3892/ol.2018.8871
Copy and paste a formatted citation
x
Spandidos Publications style
Ji M, Zhu X, Dong J, Qian S, Meng F, Gu W and Qiu W: Combination of procalcitonin, C‑reaction protein and carcinoembryonic antigens for discriminating between benign and malignant pleural effusions. Oncol Lett 16: 1727-1735, 2018.
APA
Ji, M., Zhu, X., Dong, J., Qian, S., Meng, F., Gu, W., & Qiu, W. (2018). Combination of procalcitonin, C‑reaction protein and carcinoembryonic antigens for discriminating between benign and malignant pleural effusions. Oncology Letters, 16, 1727-1735. https://doi.org/10.3892/ol.2018.8871
MLA
Ji, M., Zhu, X., Dong, J., Qian, S., Meng, F., Gu, W., Qiu, W."Combination of procalcitonin, C‑reaction protein and carcinoembryonic antigens for discriminating between benign and malignant pleural effusions". Oncology Letters 16.2 (2018): 1727-1735.
Chicago
Ji, M., Zhu, X., Dong, J., Qian, S., Meng, F., Gu, W., Qiu, W."Combination of procalcitonin, C‑reaction protein and carcinoembryonic antigens for discriminating between benign and malignant pleural effusions". Oncology Letters 16, no. 2 (2018): 1727-1735. https://doi.org/10.3892/ol.2018.8871
Follow us
  • Twitter
  • LinkedIn
  • Facebook
About
  • Spandidos Publications
  • Careers
  • Cookie Policy
  • Privacy Policy
How can we help?
  • Help
  • Live Chat
  • Contact
  • Email to our Support Team