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Morphology Of The PleuraOnly 14 pages are availabe for public view
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Abstract
This st1..1dy was acrrieG out to determine VJher:::her CEA
assay in both serum and pleural fluid of pat,ients .,,ith
pleural effusions is useful in detecting malignancy .
The study included 28 aptients with pleural effusion
( 17 cases were tuberculous and 11 cases lvere rralignant
and 20 normal subejcts as control .
The concentration of CEA in sera of the 20 control
ranged from 0 to 4.3 ng/ml , lvith a mean value of 1.6 ±
·, /7 ng/ml •
The ere an concentration of CEA level in thee seruw
of non-malignant cases was 3. 1 9 ± 2.1 2 ng /m 1 ’<>’hi.le ~or
pleural fluid was 0.96 ± 1.07 ng/ml •
1’he mean concentration of CEA level in serum of malignant
cases was 1 0. 6 8 ± 1 5. 7 9 ng /ml, vlhi l e for pleural
fluid was 40.64 ± 70.43 ng/ml . There was highly significant
difference of CEA level between malignant and nonmalignant
pleural effusions both in the ser<m·, and pleural
fl~id ( Higher in malignant acses ) The r:atio bet·ween the. level of CEA in the fluid and
the plasma vras greater than 2 in some patiE’uts •.vith
malignancy 1 but in others it was lOvler than 1 • Thus,
it offered that the ratio CEA in fluid I CEA in plasma
had no diagnostic value .
The mean average of ESR after one hour in non-malignant
cases vms 94.88 ± 31.73 , and after t\-10 hours 1
was 113.64 ± 27.32 , .,,hile it was 76.54 ± 36.13 and
96.81 ± 31.82 in malignant cases. The difference is
statistically insignificant •
The mean concentration of glucose in pleural fluid
in non malignant cases was 77.5 ± 16.9 while in nonrr:.
alignant cases 1 it was 103.4 ± 26.3 •rhis difference
is statistically significant ( Higher in malig11ant case~ ).
The mean concentration of protein in pleural fluid
in non-malignant cases was 5.4 ± 0.7 while it was 5.3
z 0.9 in malignant cases • This difference is statistically
insignificant .
Wl•en 10 ng/ml was taken as the cut-off, the diagnostic
of CEA assay in serum for malignancy was 18 %, the specificity
11}0 %, the predictive value of positive n:sults 100%, the predictive value of negatJ.ve results 65 %, and the
efficiency of the assay 68 % •
The corresponding values for effusion fluid v1ere
36 % • 100 % , 100 % 1 71 % 1 75 % respectively.
These data indicate that the effusion fluid CEA is
more predictive index to be considered in the assessment
of patients of malignant effusion •
from the results obtained in this study, it can be
concluded that there was a significant association between
n:alignancy and raised CEA in serum and pleural fluid
’l’hus 1 CEA estimation may be helpful in ussessme!lt of
)atienst with ntaliqnant pleural effusion .
The effusion fluld CEA is more predictive index ~han
serum CEA to be considered in assessment of these patients.
ESR, glucose and protein concentrations have little
value in differentiating tuberculous and malignant effusions