Soluble oncoprotein 185HER-2 in pleural fluid has limited usefulness for the diagnostic evaluation of malignant effusions.
ABSTRACT To investigate whether pleural levels of the soluble oncoprotein 185 HER-2 (sp185(HER-2)), individually or in combination with CEA and CA 15-3, were useful for the diagnosis of malignant effusions.
Levels of CEA, CA 15-3, and sp185(HER-2) were measured in the pleural fluid from 135 malignant and 103 benign effusions. Thresholds of these tumor markers were chosen for a diagnostic specificity of >or=99%.
Pleural sp185(HER-2) levels greater than 25 ng/mL were observed in 20% of breast and 10% of lung adenocarcinomas, and predicted a malignant effusion with a sensitivity of 7% and a likelihood ratio of 7.6. Combination of CEA and CA 15-3 resulted in 50% sensitivity, while adding sp185(HER-2) to this panel nonsignificantly increased sensitivity by 5% (P = 0.45). Only 1 patient with breast adenocarcinoma among 45 cytology-negative malignant effusions had sp185(HER-2) above the diagnostic cutoff point.
Measurement of pleural fluid sp185(HER-2) has poor diagnostic performance in patients with malignant effusions.
- SourceAvailable from: Christopher P PriceClinical Chemistry - CLIN CHEM. 01/2003; 49(10).
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ABSTRACT: To determine the usefulness of modifying Light's criteria for the separation of pleural transudates from exudates. Retrospective review of patients who underwent a diagnostic thoracentesis during a 2-year period. Community teaching hospital in Lleida, Spain. Clinical records and pleural fluid characteristics of 230 consecutive patients with pleural effusion underwent a detailed review. Thirty-five of these patients were excluded from the analysis. As suggested recently by Romero et al, different cutoff levels for the criteria of Light et al were applied and their accuracies were calculated. Thirty-nine (20%) pleural effusions were transudates and 156 (80%) were exudates. The accuracy of the criteria of Light et al for identifying exudates was 94.7% (confidence interval, 91.6 to 97.9) in comparison to our own modified criteria (93.1%; confidence interval, 89.5 to 96.7) and the criteria suggested by Romero et al (92.6%; confidence interval, 88.9 to 96.3). These differences were not statistically significant. Changing the classic Light's criteria with different cutoff points offers no advantages for discriminating between transudative and exudative pleural effusions.Chest 07/1996; 109(6):1503-7. · 5.85 Impact Factor
- Chest 01/2005; 126(6):1721-2. · 5.85 Impact Factor