Chonnam Med J.  1998 Jun;34(1):19-29.

Clinical Significance of Adenosine Deaminase and CYFRA 21-1 in the Differential Diagnosis of Tuberculous and Malignant Pleural Effusion

• Hwang JH
• Jang IG
• Kim YI
• Park HK
• Lim SC
• Kim YC
• Park KO

Abstract

BACKGROUND
The differentiation of tuberculous pleural effusion from the other causes of exudative pleural effusion remained difficult even with aids of biochemical analyses and pleural biopsy. CYFRA 21-1 is a useful tumor marker in the management of patients with lung cancer and especially with non-small cell lung cancer(NSCLC). Several tumor markers have been evaluated in pleural fluid, but the value of CYFRA 21-1 assay and of combination of ADA has not been firmly established. The purpose of this study was to compare the diagnostic usefulness of ADA and CYFRA 21-1 in exudative pleural effusion. METHOD: Pleural fluid obtained from 113 patients (tuberculosis: 57, malignant:56; squamous cell carcinoma 15, adenocarcinoma 25, small cell carcinoma 6, large cell carcinoma 3, undetermined 7)with exduative pleural effusion were processed for cell counts, biochemical analysis including ADA and CYFRA 21-1(immunoradiometric assay.
RESULTS
1) There was no difference in sex between malignant and tuberculous pleural effusion. But smoking history and age in malignant pleural effusion were higher than those of tuberculous effusion. 2) Tuberculous pleural fluid showed significantly higher levels of ADA than malignant pleural effusion (50.7+/-6.7 vs. 18.2+/-3.7 U/L). CYFRA 21-1 level of pleural fluid was significantly higher in malignant effusion compared to tuberculous effusion(88.6+/-16.6 vs. 28.7+/-6.4 ng/ml). 3) There was no statistical correlation between CYFRA 21-1 and ADA in tuberculous and malignant pleural effusion. Also there was no correction between pleural fluid and serum CYFRA 21-1. 4) Logistic regression analysis, CYFRA 21-1 and ADA were calculated as independent variables discriminating the cause of tuberculous and malignant effusion.
CONCLUSION
CYFRA 21-1 as well as ADA were considered as useful diagnostic method for the differential diagnosis of tuberculous from malignant pleural effusion.

Keyword

CYFRA 21-1; ADA; Pleural effusio

MeSH Terms

Adenocarcinoma
Adenosine Deaminase*
Adenosine*
Biopsy
Carcinoma, Large Cell
Carcinoma, Small Cell
Carcinoma, Squamous Cell
Cell Count
Diagnosis, Differential*
Humans
Logistic Models
Lung
Lung Neoplasms
Pleural Effusion
Pleural Effusion, Malignant*
Smoke
Smoking
Biomarkers, Tumor
Adenosine
Adenosine Deaminase
Smoke