Sensitivity and Specificity of CEA Examination

Oct 13, 2025 by miodeya.com 58 views

Introduction

Malignant pleural effusion is a common complication of lung cancer, characterized by the accumulation of fluid in the pleural space due to cancerous cells. Accurate diagnosis of malignant pleural effusion is crucial for effective treatment and management of the disease. One of the methods used to detect malignant pleural effusion is the examination of pleural fluid for Carcinoembryonic Antigen (CEA). In this study, we aimed to determine the sensitivity and specificity of CEA examination of pleural fluids in the diagnosis of malignant pleural effusion due to lung cancer.

Background

CEA is a protein that is often elevated in the blood and pleural fluid of patients with malignant pleural effusion. The level of CEA in pleural fluid has been shown to be a useful marker for diagnosing malignant pleural effusion. However, the sensitivity and specificity of CEA examination of pleural fluids in the diagnosis of malignant pleural effusion due to lung cancer have not been well established.

Methods

This study used a cross-sectional approach to determine the sensitivity and specificity of CEA examination of pleural fluids in the diagnosis of malignant pleural effusion due to lung cancer. We collected pleural fluid samples from patients with malignant pleural effusion due to lung cancer and patients with exudative pleural effusion not due to cancer. The level of CEA in each sample was measured using an enzyme-linked immunosorbent assay (ELISA) kit.

Results

The results of the study showed that the average level of CEA in pleural fluids in patients with malignant pleural effusion due to lung cancer was 799.83 ± 1481.05 ng/ml. In contrast, the level of CEA in patients with exudative pleural effusion not due to cancer was only 2.3 ± 4.2 ng/ml. These results indicate that the level of CEA increases above the normal value (> 5 ng/ml) has the potential to be an indicator of malignant pleural effusion.

Sensitivity and Specificity of CEA Examination

The sensitivity of CEA examination was recorded at 62.5%, with a higher specificity, which was 93.8%. In addition, the positive prediction value reached 90.9%, and the negative prediction value was 71.4%, with an overall accuracy of 78.125%. These results suggest that CEA examination of pleural fluids is a useful tool in the diagnosis of malignant pleural effusion due to lung cancer.

CEA Levels in Different Types of Pleural Effusion

Interestingly, the level of CEA pleural fluid also shows an increase in 6.3% of cases of exudative pleural effusion that are not originating from cancer, including in cases of complicated parapneumonia. In addition, positive CEA examination is more often found in massive malignant pleural effusion (72.7%) and hemorrhagic (60%).

Conclusion

From these results, it can be concluded that there is a significant difference between the group of malignant pleural effusion due to lung cancer and exudative pleural effusion groups not cancer in terms of CEA levels. CEA examination of pleural fluid can be a useful tool in the diagnosis, supporting the cytological examination that has been done previously. It also helps in planning more selective diagnostic steps and invasive actions that may be needed.

Implications for Clinical Practice

By understanding the sensitivity and specificity of CEA examination, doctors and medical personnel can be more appropriate in determining the diagnosis and treatment for patients with pleural effusion, especially those that may be caused by lung cancer. This contributes to improving the quality of care and better results for patients who face this health challenge.

Limitations of the Study

This study has several limitations. Firstly, the sample size was relatively small, which may have affected the accuracy of the results. Secondly, the study only included patients with malignant pleural effusion due to lung cancer and patients with exudative pleural effusion not due to cancer. Further studies are needed to investigate the sensitivity and specificity of CEA examination in other types of pleural effusion.

Future Directions

Future studies should aim to investigate the sensitivity and specificity of CEA examination in a larger sample size and in different types of pleural effusion. Additionally, the study should investigate the relationship between CEA levels and the severity of malignant pleural effusion.

Conclusion

In conclusion, this study demonstrated that CEA examination of pleural fluids is a useful tool in the diagnosis of malignant pleural effusion due to lung cancer. The sensitivity and specificity of CEA examination were found to be 62.5% and 93.8%, respectively. The study also showed that CEA levels are significantly higher in patients with malignant pleural effusion due to lung cancer compared to patients with exudative pleural effusion not due to cancer. Further studies are needed to confirm these findings and to investigate the relationship between CEA levels and the severity of malignant pleural effusion.

Q: What is CEA examination of pleural fluid?

A: CEA (Carcinoembryonic Antigen) examination of pleural fluid is a diagnostic test used to detect malignant pleural effusion, especially those caused by lung cancer. It involves measuring the level of CEA in the pleural fluid to determine if it is cancerous.

Q: What is the sensitivity and specificity of CEA examination?

A: The sensitivity of CEA examination was recorded at 62.5%, with a higher specificity, which was 93.8%. This means that CEA examination can detect 62.5% of cases of malignant pleural effusion due to lung cancer, but it can also produce false positives in 6.3% of cases of exudative pleural effusion not due to cancer.

Q: What is the positive prediction value and negative prediction value of CEA examination?

A: The positive prediction value of CEA examination was 90.9%, which means that if the CEA examination is positive, there is a 90.9% chance that the patient has malignant pleural effusion due to lung cancer. The negative prediction value was 71.4%, which means that if the CEA examination is negative, there is a 71.4% chance that the patient does not have malignant pleural effusion due to lung cancer.

Q: What are the implications of CEA examination for clinical practice?

A: CEA examination can be a useful tool in the diagnosis of malignant pleural effusion due to lung cancer. It can help doctors and medical personnel determine the diagnosis and treatment for patients with pleural effusion, especially those that may be caused by lung cancer. This contributes to improving the quality of care and better results for patients who face this health challenge.

Q: What are the limitations of the study?

A: The study has several limitations. Firstly, the sample size was relatively small, which may have affected the accuracy of the results. Secondly, the study only included patients with malignant pleural effusion due to lung cancer and patients with exudative pleural effusion not due to cancer. Further studies are needed to investigate the sensitivity and specificity of CEA examination in other types of pleural effusion.

Q: What are the future directions for research?

A: Future studies should aim to investigate the sensitivity and specificity of CEA examination in a larger sample size and in different types of pleural effusion. Additionally, the study should investigate the relationship between CEA levels and the severity of malignant pleural effusion.

Q: Can CEA examination be used as a standalone diagnostic test?

A: No, CEA examination should not be used as a standalone diagnostic test. It should be used in conjunction with other diagnostic tests, such as cytological examination, to confirm the diagnosis of malignant pleural effusion due to lung cancer.

Q: What are the potential risks and benefits of CEA examination?

A: The potential risks of CEA examination include false positives and false negatives, which can lead to unnecessary treatment or delayed diagnosis. The benefits of CEA examination include improved diagnostic accuracy and better patient outcomes.

Q: How can CEA examination be used in clinical practice?

A: CEA examination can be used in clinical practice as a diagnostic tool to help doctors and medical personnel determine the diagnosis and treatment for patients with pleural effusion, especially those that may be caused by lung cancer. It can also be used to monitor the response to treatment and to detect recurrence of the disease.

Q: What are the costs associated with CEA examination?

A: The costs associated with CEA examination are relatively low compared to other diagnostic tests. However, the costs may vary depending on the location and the laboratory performing the test.

Q: Can CEA examination be used in patients with other types of cancer?

A: Yes, CEA examination can be used in patients with other types of cancer, such as colorectal cancer, breast cancer, and pancreatic cancer. However, the sensitivity and specificity of CEA examination may vary depending on the type of cancer and the stage of the disease.