The Diagnostic Value of Estimating CA125 in the Differentiation between Tuberculous and Malignant Causes of Serous Pleural Effusion: A Pilot Study
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- Category: Vol. 81, December 2013
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The Diagnostic Value of Estimating CA125 in the Differentiation between Tuberculous and Malignant Causes of Serous Pleural Effusion: A Pilot Study, ELSAYED SALEM, AYMAN SALEM and AMAL ABD ELRASHEED
Abstract
CA 125 was first introduced as a tumor marker in ovarian malignancy, which was extended to other tumors. Later it was introduced in the diagnosis of abdominal tuberculosis. Recently it was studied in chest diseases with variable results. Such data are evident in the text of the present study, which was aiming at its possible use in differentiating tuberculous from malignant cases of serous pleural effusion. This was done in 31 such cases, in whom the etiologic diagnosis was definitely known by other authenticated means. The fluid was transudate in 10 cases and exudate in 21 cases. The tuberculosis or malignant etiology in these cases was proved by other means, in order to test the validity of estimating CA125 for the differentiation between such definite cases. CA125 was estimated in both the serum and pleural fluid in these patients. Its value was significantly higher in malignancy than in tuberculosis in both examined samples; figures being 48.4U/ml, 606U/ml in tuberculous cases as compared to 202U/ml and 1308U/ml in malignancy, either in the serum or pleural fluid, respectively. A cut-off point was calculated as 130U/ml in the serum and 750U/ml in the pleural fluid, to differentiate between the tuberculous and malignant etiology in such cases. It is recommended to apply the results of the present pilot study on a bigger number of patients and also in multiple centers. Another study of its validity when the etiology is disputed, in the so called idiopathic cases, the same as it was validated in already proved cases. Another recommendation is to evaluate its level in the follow-up of cases under specific therapy, to assess their future prognosis.