Role of Pleural Fluid Cea Level in Pleural Fluid Analysis Abstract

Pleural fluid cytology is usually the initial diagnostic tool in pleural fluid analysis. However, the conventional cytological evaluation of pleural effusion in detecting malignancy has a sensitivity wide range – from 22 to 81%. Measurement of carcinoembryogenic antigen (CEA) level in pleural fluid may be valuable in the diagnosis of malignant pleural effusion. The study was performed on 70 different patient samples at the Department of Pathology and Serology Section, Department of Microbiology of TUTH from March 14, 2004 to March 13, 2005. CEA levels in pleural effusions were above cut off value (10ng/ml) in 19 out of 70 samples. Out of 19 cases, 14 (73.7%) were malignant pleural effusion. CEA level was elevated in 3 benign condition (15.8%) and 2 suspicious cases (10.5%). At cut off value of 10ng/ml, pleural fluid CEA had sensitivity of 58.3%, specificity of 92.7%, and positive and negative predictive values of 82.3% and 79.1% respectively. CEA level was above the cut off value in 55.6% of cytology negative malignant pleural effusions. The pleural fluid CEA level assay in patient with malignant effusions is a valuable adjunct to pleural cytology, especially with negative cytology when the clinical presentation cannot clearly exclude an underlying malignancy.