Diagnostic Value Of Combined Measurement Of MACC1 And CMET In Lung Adenocarcinoma Patients With Malignant Pleural Effusion

Objective Malignant pleural effusion(MPE) is a common exudative pleural effusion。Approximately 15 % of lung cancer patients have a pleural effusion at the time of initial diagnosis, and 50 % develop a pleural effusion in their courses。Especially adenocarcinoma was the most common lung cancer with malignant pleural effusion.Lung cancer with malignant pleural effusion is a systemic disease, can not treated by surgery or radiotherapy. Establishing the diagnosis of a malignant pleuraleffusion indicates advanced disease and is associated with limited survival, and seriously affect the quality of life. So it is important to identify benign and malignant pleural effusion. The diagnosis of MPE depends on cytology,but the sensitivity was low(30%-60%). Tumor markers have been widely used in clinical diagnosis of MPE. Carcinoembryonic antigen(CEA) is used most frequently, and has the biggest value for the diagnosis of MPE from lung adenocarcinoma. However, single laboratory indicators have different levels of false positive or false negative, it can not meet the needs of clinical work. So in the actual work often need to combine indicators to improve the accuracy of diagnosis of pleural effusion. So this paper aims at investigating the diagnostic value of combined measurement of MACC1,CEA and c-MET in lung adenocarcinoma patients with malignant pleural effusion.Methods Ninety-one patients with pleural effusions were observed, including 53 cases of malignant pleural effusions from lung adenocarcimoma and 38 cases of benign effusions.MACC1 and c-MET levels in plasma and pleural effusion were detected by ELISA.CEA was detected by radioimmunoassay.Results The expressions of MACC1,c-MET and CEA in the group of patients with malignant pleural effusion(MPE) from lung adenocarcinoma were significantly higher than those in the benign group(P<0.05).There was no significant difference of the expression of MACC1 and c-MET in plasma for the two groups(P>0.05).The expression of MACC1 was correlated significantly positive with the expression c-MET in pleural effusion(r:0.728,P<0.O1).A receiver operating characteristic(ROC) curve analysis was carried out to assess the value of MACC1, c-MET and CEA in MPE from lung adenocarcinoma patients. The cut-off values for MACC1, c-MET and CEA were defined at 90.98pg/ml,757.67ng/ml and 1.95ng/ml, respectively. The sensitivities of MACC1,c-MET and CEA were 62.26%,52.83% and 92.45%, and the specificities were 84.21%,84.21% and 92.11%, respectively.The sensitivity and specificity of combined detection of MACC1 and c-MET increased to 75.47% and 92.11%,respectively.Moreover,for MACC1,c-MET and CEA, the sensitivity and specificity combined detection increased to 98.11% and 97.37%, respectively.Conclusions The levels of MACC1 and c-MET increased in malignant pleural effusions from lung adenocarcinoma patients. There was no correlation between the levels and sex, age, smoking history, and lymph node metastasis and distant metastasis of lung adenocarcinoma patients.The value of MACC1 or c-MET in the diagnosis of lung adenocarcinoma with malignant pleural effusion were not superior to CEA.But it can be improve the diagnostic value when they combined measurement with CEA.