[Clinical value of CYFRA 21-1, HER-2/neu and NSE in differential diagnosis of pleural effusion].

AIM: To explore the clinical value of CYFRA 21-1, HER-2/neu and NSE as tumor markers for differential diagnosis of malignant and benign pleural effusion.

METHODS: Radioimmunoassay and ELISA were used to detect the serum and effusion levels of CYFRA 21-1, HER-2/neu and NSE in 62 patients with malignat pleural effusion and 48 patients with benign pleural effusion. The clinical properties were analyzed and the cut off values were determined through receiver operating characteristic(ROC) curve.

RESULTS: The levels of CYFRA 21-1, HER-2/neu and NSE in serum and pleural effusion in malignant groups were significant higher than those in benign group (P < 0.01).The levels of CYFRA 21-1, HER-2/neu and NSE in pleural effusion were obviously higher than those in serum (P < 0.01 or 0.05). The cut off value of NSE in serum was 11.40 μg/L, While the cut off value of NSE in pleural effusion was 16.47 μg/L. The cut off values of CYFRA 21-1 in serum and in pleural effusion were 4.94 μg/L and 7.70 μg/L respectively. The cut off values of HER-2/neu in serum and in pleural effusion were 2.50 μg/L and 3.50 μg/L, respectively. Independent examination of the levels of CYFRA 21-1, HER-2/neu and NSE in serum and pleural effusion showed that the area under ROC curve was (0.852, 0.932), (0.867, 0.887) and (0.773, 0.846), respectively. Double-combined detection enlarged the area under ROC curve, while three-combined detection caused an increase in the area under ROC curve up to 0.999.

CONCLUSION: The detection of CYFRA 21-1, HER-2/neu and NSE in pleural effusion has certain clinical significance in differential diagnosis of malignant and benign effusions. ROC curve can be used to determine the cut off values. Given the limitation of single index, comprehensive application of multiple indexes may increase the accuracy of diagnosis.