Clinical significance of the combined assay of pleural fluid ADA activity and CEA level in the various pleural effusion.

Lee, Jong Hoon; Jang, Sang Ho; Lee, Hong Lyeol; Kwak, Seung Min; Chang, Jung Hyun; Kim, Byung Il; Cheon, Sun Hee; Kim, Se Kyu; Chang, Joong; Kim, Sung Kyu; Lee, Won Young

doi:1993.40.1.35

Tuberc Respir Dis > Volume 40(1); 1993 > Article

Original Article

Tuberculosis and Respiratory Diseases 1993;40(1):35-42.
DOI: https://doi.org/10.4046/trd.1993.40.1.35 Published online February 1, 1993.

Clinical significance of the combined assay of pleural fluid ADA activity and CEA level in the various pleural effusion.

Jong Hoon Lee, Sang Ho Jang, Hong Lyeol Lee, Seung Min Kwak, Jung Hyun Chang, Byung Il Kim, Sun Hee Cheon, Se Kyu Kim, Joong Chang, Sung Kyu Kim, Won Young Lee

Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea

흉막삼출 원인질환의 감별진단에 있어서 흉막액 Adenosine Deaminase 활성도 및 Carcinoembryonic Antigen * 병행측정의 임상적 의의

Abstract

Background
In order to establish the etiology of the pleural effusion, routine analysis of the fluid, bacteriologic studies, cytologic tests and pleural biopsies are currently being employed. However, even with the above mentioned tests, the exact causes cannot be determined in approximately 10 -20% of cases. The purpose of our study is to determine the diagnostic value of measuring ADA activity and CEA simultaneously in various pleural fluids which their etiologies have confirmed.
Methods
We have studied 61 cases of tuberculous pleural effusions, 17 cases of suspected tuberculous pleural effusions, 17 cases of malignant pleural effusions, 22 cases of suspected malignant pleural effusions, and 7 cases of parapneumonic pleural effusions. We have measured the ADA activity and CEA level simultaneously in pleural fluid samples in each cases.
Results
1) The ADA activity in tuberculous pleural effusion was significantly higher than that in malignant effusion 2) The CEA level in malignant pleural effusion was significantly higher than that in tuberculous effusion 3) With the cut.off values of the pleural fluid ADA activity more than 40 U/ L and the CEA level less than 12 ng/ mL, the sensitivity was 86 . 9% , and the specificity was 100% in the diagnosis of tuberculous effusion. With the cut.off values of the pleural fluid CEA level more than 12 g/ mL and the ADA activity less than 40 U/ L, the sensitivity was 76.5% , and the specificity was 100 % in the diagnosis of malignant effusion.
Conclusion
It is suggested that the combined assay of pleural fluid ADA activity and CEA level is very useful in the differential diagnosis of tuberculous and malignant pleural effusion

Key Words: Pleural effusion, Adenosine deaminase (ADA), Carcinoembryonic antigen (CEA)