Skip to main content

Der Stellenwert von Tumormarkerbestimmungen in der Diagnostik des malignen Pleuraergusses

  • Chapter
Thoraxchirurgie
  • 22 Accesses

Zusammenfassung

Die maligne Erkrankung ist vermutlich die häufigste Ursache für Pleuraexsudate bei Patienten jenseits des 6. Lebensjahrzehnts [6]. In der Ätiologie der malignen Pleuraergüsse führt das Bronchialkarzinom (30%), gefolgt von Mammakarzinom (25%), malignem Lymphom (20%) und Ovarialkarzinom (6%) [30]. In einer Analyse von 1716 Patienten mit Bronchialkarzinom präsentierten sich bereits 22,9% mit einem Pleuraerguß bei der Primärdiagnose [3]. Während des Krankheitsverlaufs trat sogar bei ca. 50% der Patienten mit disseminiertem Bronchialkarzinom ein Pleuraerguß auf [6, 16, 7].

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 54.99
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 69.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

Literatur

  1. Abel U, Berger J, Weber E (1984) Statistische Verfahren und Programme zur Validierung biologischer Marker. EDV in Biol und Med 15: 117–1215

    Google Scholar 

  2. Branscheid D, Bischoff H (1991) Chirurgische Therapie der primären und sekundären Pleuraerkrankungen. In: P. Drings, I. Vogt-Moykopf (Hrsg.) Thoraxtumoren. Springer-Verlag, Berlin Heidelberg New York: 285–296

    Google Scholar 

  3. Bülzebruck H (1988) Feldstudie Bronchialkarzinom zur Validierung des TNM Systems der UICC, BMFT-Bericht 0701911/0

    Google Scholar 

  4. Bülzebruck H, Drings P, Kayser K, Schulz V, Tuengerthal S, Vogt-Moykopf I (1991) Classification of lung cancer: first experiences with the new TNM classification (4th edition) Eur Respir J 4: 1197–1206

    PubMed  Google Scholar 

  5. Caputo V, Volpino P, Cangemi V, Mazzarino E (1983) Serum CEA in the prognostic evaluation and in the postoperatory follow-up of gastrointestinal and lung cancer. J Nucl Med Allied Sci 27: 87–97

    Google Scholar 

  6. Chernow B, Sahn SA (1977) Carcinomatous involvement of the pleura. Am J Med 63: 695–702

    Article  PubMed  CAS  Google Scholar 

  7. Cohen S, Hossain SA (1966) Primary carcinoma of the lung. A review of 417 histologically proved cases. Dis Chest 49: 67–74

    Article  PubMed  CAS  Google Scholar 

  8. Decker DA, Dines DE, Payne WS, Bernatz PE, Pairolero PC (1978) The significance of a cytologically negative pleural effusion in bronchogenic carcinoma. Chest 74: 640–642

    Article  PubMed  CAS  Google Scholar 

  9. Dekker A, Bupp PA (1978) Cytology of serous effusions. An investigation into the usefulness of cell blocks versus smears. Am J Clin Path 70: 855–860

    PubMed  CAS  Google Scholar 

  10. Dunn OJ (1964) Multiple comparisons using rank sums. Technometrics 6: 241–252

    Article  Google Scholar 

  11. Ebert W, Heger L, Kayser K, Drings P (1987) Der diagnostische Nutzen von CEA und Sialinsäure als Tumormarker bei Pleuraergüssen. In: Tumormarker-Aktuelle Aspekte und klinische Relevanz. G. Wüst (Hrsg) Steinkopff, Darmstadt: 130–131

    Google Scholar 

  12. Ebert W, Kayser K, Bülzebruck H, Vogt-Moykopf I (1988) Diagnostic validity of SCC antigen assays in squamous cell carcinoma of the lung. J Tumormarker Oncol 3: 35–44

    Google Scholar 

  13. Ebert W, Hug G, Stabrey A, Bülzebruck H, Drings P (1989) Evaluation of tumor markers NSE and CEA for the diagnosis and follow-up of small cell lung cancer. Ärztl Lab 35: 1–10

    Google Scholar 

  14. Ebert W, Welper-Rigling C, Leichtweis B, Bülzebruck H (1991) Elevated pleural effusion SCC antigen concentrations do not prove definitely malignancy secondary to metastatic squamous cell carcinoma of the lung. Tumordiagn Ther 12: 123–127

    Google Scholar 

  15. Ebert W, Stabrey A, Sibinger M, Schrenk M (1991) Value of pleural fluid hyaluronic acid and carcinoembryonic antigen determinations in the differential diagnosis between malignant mesothelioma and pleuritis carcinomatosa. Tumordiagn Ther 12: 1–6

    Google Scholar 

  16. Emerson GL, Emerson MS, Sherwood CE (1959) The natural history of carcinoma of the lung. J Thorac Cardiovasc Surg 37: 291–304

    CAS  Google Scholar 

  17. Ebert W, Leichtweis B, Bülzebruck H, Drings P. The role of IMx SCC assays in the detection and prognosis of primary squamous cell carcinoma of the lung. Diagn Oncol, im Druck

    Google Scholar 

  18. Faravelli B, Diamore E, Nosenzo M (1984) Carcinoembryonic antigen in pleural effusions. Diagnostic value in malignant mesothelioma. Cancer 53: 1194–1197

    Article  PubMed  CAS  Google Scholar 

  19. Gail MH, Green SB (1976) A generalization of the one-side two-sample Kolmogrow-Smirnov statistic for evaluating diagnostic tests. Biometrics 32: 561–570

    Article  PubMed  CAS  Google Scholar 

  20. Gandhi AK, Nayar M, Bihari N, Chandra M (1989) Diagnostic value of carcinoembryonic antigen assay of pleural and peritoneal effusions in malignancy. Indian J Med Res 90: 22–26

    PubMed  CAS  Google Scholar 

  21. Greenhouse SW, Mantel N (1950) The evaluation of diagnostic tests. Biometrics 6: 399–412

    Article  PubMed  CAS  Google Scholar 

  22. Grunze H (1964) The comparative diagnostic accuracy, efficiency and specificity of cytologic techniques used in the diagnosis of malignant neoplasm in serous effusions of the pleural and pericardial cavities. Acta Cytol 8: 150–164

    PubMed  CAS  Google Scholar 

  23. Kaplan EL, Meier P (1958) Nonparametric estimation from incomplete observations. J Amer Stat Assoc 53: 457–481

    Article  Google Scholar 

  24. Klech H, Rona G, Hutter C, Bayer PM, Kummer F (1986) Diagnostic value of the combined determination of carcinoembryonic antigen (CEA) in pleural effusion and serum with an enzyme immunoassay. Wien Klin Wochenschr 98: 564–573

    PubMed  CAS  Google Scholar 

  25. Kruskal WH (1952) A nonparametric test for the several sampling problem. Ann Math Stat 23: 525–540

    Article  Google Scholar 

  26. Kutty CPK, Remenink E, Varkey B (1981) Malignant-appearing cells in pleural effusion due to pancreatitis. Case report and literature review. Acta Cytol 25: 412–416

    PubMed  CAS  Google Scholar 

  27. Law MR, Hudson ME, Turner-Warwick M (1984) Malignant mesothelioma of the pleura. Clinical aspects and symptomatic treatment. Eur J Resp Dis 65: 162–168

    CAS  Google Scholar 

  28. Lewis RJ, Sisler GE, Mackenzie W (1980) Diffuse mixed malignant pleural mesothelioma. Ann Thorac Surg 31: 53–60

    Article  Google Scholar 

  29. Leckie WSH, Tothill P (1965) Albumin turnover in pleural effusions. Clin Sci 29: 339–352

    PubMed  CAS  Google Scholar 

  30. Light RW (1983) Pleural diseases. Lea and Febiger, Philadelphia: 77–90

    Google Scholar 

  31. Livingstone RB, Mac Craken SD, Trauth CJ, Chen T (1982) Isolated pleural effusions in small cell carcinoma: Favorable prognosis. Chest 81: 208–211

    Article  Google Scholar 

  32. Mann HB, Whitney PR (1974) On a test of wether one of two random variables is stochastically larger than the other. Ann Math Stat 18: 50–60

    Article  Google Scholar 

  33. Martinez-Vea A, Gatell JM, Segura F, Heiman C, Elena M, Ballesta AM, Mundo MR (1982) Diagnostic value of tumoral markers in serous effusions: carcinoembryonic antigen, alpha 1-acidglycoprotein, alpha-fetoprotein, phosphohexose isomerase and beta 2-microglobulin. Cancer 50: 1783–1788

    Article  PubMed  CAS  Google Scholar 

  34. McKenna JM, Chandrasekar AJ, Henkin RE (1980) Diagnostic value of carcinoembryonic antigen in exudative pleural effusions. Chest 78: 587–590

    Article  PubMed  CAS  Google Scholar 

  35. Mezger J, Permanetter W, Gerbes AL, Wilmanns W, Lamerz R (1988) Tumor associated antigens in diagnosis of serous effusions. J Clin Pathol 41: 633–643

    Article  PubMed  CAS  Google Scholar 

  36. Mezger J, Lamerz R, Permanetter W (1990) Diagnostic significance of carcinoembryonic antigen in the differential diagnosis of malignant mesothelioma. J Thorac Cardiovasc Surg 100: 860–866

    PubMed  CAS  Google Scholar 

  37. Mountain CF (1988) Prognostic implications of the international staging system for lung cancer. Semin Oncol 3: 236–245

    Google Scholar 

  38. Niwa Y, Kishimoto H, Shimokata K (1985) Carcinomatous and tuberculous pleural effusions — comparision of tumor markers. Chest 87: 351–355

    Article  PubMed  CAS  Google Scholar 

  39. Pavesi F, Lotzniker M, Cremaschi P, Marbello L, Acquistapace L, Moratti R (1988) Detection of malignant pleural effusions by tumor marker evaluation. Eur J Cancer Clin Oncol 24: 1005–1011

    Article  PubMed  CAS  Google Scholar 

  40. Peto R, Peto J (1972) Asymptomatically efficient rank invariant test procedures. J Royal Stat Soc 135: 185–206

    Article  Google Scholar 

  41. Petterson T, Klockars M, Fröseth B (1988) Neuron-specific enolase in the diagnosis of small-cell lung cancer with pleural effusion: a negative report. Eur Respir J 1: 698–700

    Google Scholar 

  42. Petterson T, Fröseth B, Riska MD, Klockars M (1988) Concentration of hyaluronic acid in pleural fluid as a diagnostic aid for malignant mesothelioma. Chest 94: 1037–1039

    Article  Google Scholar 

  43. Pierruci G, Lucivero G, Amoruso C, Bonomo L (1984) Diagnostic value of carcinoembryonic antigen (CEA) assay in pleural effusions. Tumori 70: 421–425

    Google Scholar 

  44. Plavec G, Lazarov A, Dangubic V, Odavic M (1990) Neuron-specific enolase in pleural effusions of various etiologies. Plucne-Bolesti 42: 88–91

    PubMed  CAS  Google Scholar 

  45. Poe RH, Israel RH, Utell MJ, Hall WJ, Greenblatt DW, Kalian MC (1984) Sensitivity, specificity, and predictive values of closed pleural biopsy. Arch Intern Med 144: 325–328

    Article  PubMed  CAS  Google Scholar 

  46. Prakash UBS, Reiman HM (1985) Comparison of needle biopsy with cytologic analysis for the evaluation of pleural effusions: Analysis of 114 cases. Mayo Clin Proc 60: 158–164

    PubMed  CAS  Google Scholar 

  47. Rapellino M, Pecchio F, Piantino P, Cellerino A (1990) Tumor marker determination in extra-hemetic fluids. J Nucl Med Allied Sci 34: 128–136

    Google Scholar 

  48. Romero S, Izquierdo M, Mauri M, Martin C, Almenar MV, Garcia R, Padilla I (1989) Diagnostic usefulness of neurospecific enolase determinations in pleural fluid. Med Clin Barc 93: 568–571

    PubMed  CAS  Google Scholar 

  49. Sahn SA (1988) The Pleura. State of the Art. Am Rev Resp Dis 138: 184–234

    Article  PubMed  CAS  Google Scholar 

  50. Sculier JP, Feld R, Evans WK (1985) CEA: A useful prognostic marker in small cell lung cancer. J Clin Oncol 3: 1349–1354

    PubMed  CAS  Google Scholar 

  51. Shimokata K, Niwa Y, Yamamoto M, Sasou H, Morishita M (1989) Pleural fluid neuron-specific enolase. A useful diagnostic marker for small cell lung cancer pleurisy. Chest 95: 602–603

    Article  PubMed  CAS  Google Scholar 

  52. Splinter TAW, Cooper EH, Kho GS, Oosterom R, Peake MD (1987) Neuron-specific enolase as a guide to the treatment of small cell lung cancer. Eur J Cancer Clin Oncol 23: 171–176

    Article  PubMed  CAS  Google Scholar 

  53. Spriggs AI, Boddington MM (1986) The Cytology of Effusions. 2nd ed. Grune and Stratton, New York

    Google Scholar 

  54. Tamura S, Nishigaki T, Moriwaki Y, Fujioka H, Fujii J, Yamamoto T, Nabeshima K, Hada T, Higashino K (1988) Tumor markers in pleural effusion diagnosis. Cancer 61: 298–302

    Article  PubMed  CAS  Google Scholar 

  55. Tomlinson SR, Sahn SA (1987) Invasive procedures in the diagnosis of pleural disease. Semin Respir Med 9: 30–36

    Article  Google Scholar 

  56. Vladutiu AO, Brason FW, Adler RH (1981) Differential diagnosis of pleural effusions: clinical usefulness of cell marker quantitation. Chest 79: 297–301

    Article  PubMed  CAS  Google Scholar 

  57. Whitaker D, Shilkin KB, Stuckey M, Nieuwhof WN (1986) Pleural fluid CEA levels in the diagnosis of malignant mesothelioma. Pathology 18: 328–329

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 1993 Dr. Dietrich Steinkopff Verlag, GmbH & Co. KG Darmstadt

About this chapter

Cite this chapter

Ebert, W., Schleifer, A., Leichtweis, B., Bülzebruck, H. (1993). Der Stellenwert von Tumormarkerbestimmungen in der Diagnostik des malignen Pleuraergusses. In: Vogt-Moykopf, I., Drings, P. (eds) Thoraxchirurgie. Steinkopff. https://doi.org/10.1007/978-3-642-72501-2_3

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-72501-2_3

  • Publisher Name: Steinkopff

  • Print ISBN: 978-3-642-72502-9

  • Online ISBN: 978-3-642-72501-2

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics