Diagnostic Utility of Combined CEA, CA۱۵-۳ and CA۱۲۵ Biomarkers and Cytomorphology in Suspicious and Malignant Serosal Fluid

Background & Objective: Early detection of malignancies in the serous fluids has been remained an issue. A classic diagnostic tool for the ascites and pleural effusions is cytologic study (morphology) with approximately ۹۸% specificity for the detection of cancer cells. This study aimed to evaluate the diagnostic value of three complementary markers in the serosal fluids of patients with malignant cytology and suspected cases.Methods: Seventy two patients with serosal effusion treated in three teaching hospitals were studied. The cases underwent a diagnostic workup to determine the pleural effusion malignancy and etiologies. Complementary markers, including CEA, CA۱۵-۳, and CA۱۲۵ were measured in serosal fluids of three categories of benign, suspicious, and malignant. The study was carried out by Chemiluminescence immunoalayzer. The morphologies were re-evaluated by a consulting Cytopathologist.Results: Of ۷۲ serosal fluid specimens, ۴۱ (۵۶.۹%) were related to pleural effusion and ۳۱ (۴۳.۱%) were related to ascites. The sensitivity of CEA, CA۱۲۵, and CA۱۵-۳ biomarkers were ۶۴, ۸۴, and ۶۸%, respectively, and the specificity of each test was ۱۰۰, ۸۶, and ۹۶%, respectively. This was statistically achieved for the combination of the area of markers below the curve (AUC), ۰.۹۳ and ۹۰% sensitivity and ۹۱% specificity. Conclusion: The results suggest that complementary CA۱۲۵, CA۱۵-۳, and CEA markers assayed with well-developed immunoassay method might be useful in the differentiation between malignant and benign effusions while combined with conventional cytology. CA۱۲۵ yielded a significant correlation between cytomorphology and biomarkers based on the correlation coefficient analysis.

Keywords:

Body Fluids , CA ۱۲۵ , CA ۱۵-۳ , CEA , Chemiluminescence