Chun-Liang Lai

Diagnostic value of Her-2/neu, Cyfra 21-1, and carcinoembryonic antigen levels in malignant pleural effusions of lung adenocarcinoma

Aims: Cytology fails to detect neoplastic cells in 40–50% of cases of malignant pleural effusion, a condition that frequently accompanies lung adenocarcinoma. Published reports of diagnostic sensitivity of various tumour markers are inconsistent, and optimal cut‐off points have not been determined. This study aimed to evaluate the ability of three markers to discriminate lung adenocarcinoma‐associated malignant pleural effusion (LAC‐MPE) from benign effusion. Methods: Pleural effusion samples were collected from 41 patients with LAC‐MPE, and from 93 with various benign conditions. The diagnostic sensitivity and specificity for Her‐2/neu, Cyfra 21‐1, and carcinoembryonic antigen (CEA) were evaluated. Cut‐off points for these markers are optimally set at 3.6 µg/L, 60 µg/L, and 6.0 µg/L, respectively. Results: Her‐2/neu, Cyfra 21‐1, and CEA vary in their diagnostic accuracy to differentiate LAC‐MPE from benign pleural effusion: 79.85%, 88.81%, and 94.03%, respectively. CEA combined with Cyfra 21‐1 increases diagnostic sensitivity to 97.6%, with a specificity of 91.4%. Conclusions: With appropriate cut‐off points, CEA currently provides the best diagnostic accuracy. Combining CEA with Cyfra 21‐1 increases diagnostic sensitivity to nearly 100%. The results of the present study may help clinicians decide whether to obtain a cytological/histological specimen by invasive means to investigate a possible diagnosis of malignancy.

Diagnostic value of tumor markers in lung adenocarcinoma-associated cytologically negative pleural effusions.

Cytology fails to detect neoplastic cells in approximately 40% to 50% of malignant pleural effusions (PEs), which commonly accompany lung adenocarcinomas. The diagnostic accuracy of various tumor markers in lung adenocarcinoma‐associated cytologically negative pleural effusions (LAC‐CNPEs) has been poor. The current study attempted to maximize diagnostic efforts in distinguishing LAC‐CNPEs from benign PEs.

High prevalence of human herpesvirus type 8 infection in patients with pulmonary tuberculosis in Taiwan

Blood samples were collected from 101 untreated pulmonary tuberculosis (TB) patients and 101 age- and sex-matched healthy control subjects. TB patients had lower lymphocyte and a higher monocyte counts than control subjects (p <0.0001 for both). The seropositive rate of human herpesvirus (HHV) type 8 antibody was higher in patients (30/101) than in control subjects (15/101) (p = 0.01). Antibody titres in patients also exceeded those in control subjects (p 0.006). Lymphocyte and monocyte counts between seronegative and seropositive subjects were not different. Four patients were positive for HHV-8 DNA. The study revealed a significantly higher HHV-8 seroprevalence in untreated pulmonary TB patients than in general population.