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Antígeno carcinoembrionário no diagnóstico diferencial dos derrames pleurais Translated title: Carcinoembryonic antigen in differential diagnosis of pleural effusion

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      Abstract

      OBJETIVO: Analisar a sensibilidade e a especificidade da dosagem do CEA no diagnóstico diferencial do derrame pleural de pacientes portadores de doenças benígnas e malígnas. MÉTODO: Estudo contemporâneo de série de casos, realizado do Serviço de Cirurgia Torácica do Hospital Nossa Senhora da Conceição, Porto Alegre, Rio Grande do Sul. Entre julho de 2000 e julho de 2001, 64 pacientes foram submetidos à investigação etiológica de efusão pleural,e submetidos aos seguintes exames: pH, LDH, dosagem protêica, densidade, glicose, citologia diferencial, pesquisa de fungos e BAAR, gram e cultura com antibiograma, citopatologia, dosagem de CEA e biópsia pleural. RESULTADOS: Pacientes com derrames de etiologia maligna (n=26) tiveram resultado do CEA variando de zero a 5000ng/ml, enquanto nos de etiologia benígna os valores variaram de zero a 4,8ng/ml. Nível médio de CEA na efusão carcinomatosa foi de 431 ± 1237 ng/ml (média ± desvio padrão), significativamente maior que nos benignos (1,1 ± 1,0 ng/ml; p<0,001). A sensibilidade, para um ponto de corte de 5 ng/ml, foi de 61,5% e a especificidade de 100%. CONCLUSÃO: Em pacientes com efusão pleural, quando investigados do ponto de vista etiológico, a dosagem do CEA pode ser útil para critério diagnóstico.

      Translated abstract

      BACKGROUND: To analyze patients with diagnosis of benign or malignant diseases, in whose evolution develop pleural effusion, in which CEA measurement was questioned in relation to sensitivity and specificity in the differentiation of these two groups. METHODS: Prospective consecutive case series of the Department of Thoracic Surgery, Conceição Hospital, Porto Alegre, Brazil. From July 2000 to December 2001, 64 patients were subjected to clinical investigation in search for a pleural effusion aetiology. All patients underwent the following laboratory evaluation of pleural fluid: pH, LDH, proteins, density, glucose, differential cytology, bacterial culture, search for fungus and acid-fast bacilli, cytology, CEA determination and pleural biopsy. RESULTS: Patients with malignant etiologic diagnosis (n=26), had CEA results ranging from zero to 5000 ng/ ml, while benign cases results were from zero to 4.8 ng/ml. CEA level in malignant fluids was of 431 ± 1237 ng/ml (mean ± SE), significantly higher than benign fluids (1.1 ± 1.0 ng/ml; p< 0.001). Sensitivity, for a cut-off of 5 ng/ml, was 61.5% and specificity of 100%. CONCLUSION: We conclude that for patients with pleural effusion, CEA concentrations may represent an useful criteria to diagnosis.

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      Most cited references 12

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      Pleural diseases

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        A new classification of parapneumonic effusions and empyema.

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          Tumors markers in pleural effusion diagnosis

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            Author and article information

            Affiliations
            [1 ] Universidade Federal do Rio Grande Brazil
            [2 ] Hospital Nossa Senhora da Conceição Brazil
            Contributors
            Role: ND
            Role: ND
            Role: ND
            Journal
            rcbc
            Revista do Colégio Brasileiro de Cirurgiões
            Rev. Col. Bras. Cir.
            Colégio Brasileiro de Cirurgiões (Rio de Janeiro )
            1809-4546
            February 2005
            : 32
            : 1
            : 15-17
            S0100-69912005000100005 10.1590/S0100-69912005000100005

            http://creativecommons.org/licenses/by/4.0/

            Product
            Product Information: SciELO Brazil
            Categories
            SURGERY

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