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Query: UMLS:C0032285 (pneumonia)
 54,520 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

One hundred ninety-one unselected fluid specimens submitted routinely for cytologic examination were assayed to determine whether the measurement of carcinoembryonic antigen (CEA) levels in pleural effusions is useful in detecting malignancy. The mean +/- SD CEA level of 103 benign effusions was 4.1 +/- 2.9 ng/ml. Only one benign effusion had a level greater than 12 ng/ml (18 ng/ml). Benign inflammatory effusions (pneumonia, empyema) had a higher mean CEA activity (6.2 +/- 3.4) than effusions caused by congestive heart failure (2.9 +/- 1.5) (p less than 0.001). Twenty-four (34%) of 70 malignant effusions had a CEA level greater than 12 ng/ml, and 28 (40%) were "positive" by cytologic study. Thirty-eight (54%) were detected by one or both methods. Ten malignant effusions were positive by CEA (greater than 12 ng/ml) alone. These data suggest that the determination of CEA activity levels, when used in conjunction with other clinical findings, may be useful in detecting malignant pleural effusions.
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PMID:Carcinoembryonic antigen levels in benign and malignant pleural effusions. 64 46

We compared carcinoembryonic antigen (CEA) levels in bronchoalveolar lavage (BAL) fluid and serum of patients with lung cancer, pneumonia, and healthy individuals to determine the usefulness of CEA in diagnosing lung cancer not visible endoscopically. Cancer patients had CEA lavage fluid levels (4,650 +/- 1,565 ng/mg of albumin) significantly higher than pneumonia patients (755 +/- 346 ng/mg) or healthy individuals, smokers (252 +/- 48 ng/ml), and non-smokers (175 +/- 6 ng/mg). In serum, CEA assay cannot discern between cancer (35 +/- 13 ng/ml) and pneumonia (4.6 +/- 1.4 ng/ml) (p = 0.06). Using 1,000 ng/mg of albumin as the cutting point in BAL fluid, sensitivity and specificity were 77 percent and 94 percent, respectively. In serum, 5 ng/ml provided a sensitivity of 55 percent and specificity of 91 percent. Positive and negative predictive values were 77 percent and 94 percent in BAL, respectively, and 62 percent and 89 percent in serum, respectively. Using a combination of serum and BAL fluid CEA levels, the sensitivity and specificity were 88 percent and positive and negative predictive values were 66 percent and 96 percent, respectively. When used in combination with serum levels of CEA or transbronchial biopsy, the diagnostic yield increased up to 88 percent. Thus, although CEA determination in BAL fluid improves diagnostic yield, it should not be used as the only diagnostic procedure.
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PMID:Usefulness of carcinoembryonic antigen determination in bronchoalveolar lavage fluid. A comparative study among patients with peripheral lung cancer, pneumonia, and healthy individuals. 191 58

To determine the clinical utility of airway carcinoembryonic antigen (CEA) concentrations to distinguish malignant from inflammatory airway disease in patients undergoing bronchoscopy, we determined CEA concentrations by enzyme immunoassay in bronchial washings recovered in 48 subjects, including 20 patients with central lung cancer, 18 patients with chronic bronchitis, and ten nonsmoking patients with a diagnosis of pneumonia or peripheral granuloma. Concentrations of CEA in bronchial washings were standardized by using the total protein concentration in recovered fluid (CEA/TP). Concentrations of CEA were significantly increased in bronchial washings recovered from both patients with chronic bronchitis and lung cancer compared with patients with pneumonia or granuloma (252 +/- 47 ng/mg and 199 +/- 64 ng/ml vs 62 +/- 11 ng/mg, SEM, p less than 0.005). Airway CEA concentrations in patients with chronic bronchitis were somewhat increased compared with concentrations recovered from a cancer-involved airway (252 +/- 47 ng/ml vs 199 +/- 64 ng/mg, SEM, p less than 0.05). Measurement of airway CEA concentrations is not useful in distinguishing malignant from inflammatory airway disease as airway concentrations of CEA may be markedly increased in patients with both conditions.
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PMID:Airway carcinoembryonic antigen concentrations in patients with central lung cancer or chronic bronchitis. 219 39

The serum levels of five markers (CA-50, CA-19.9, CA-125, Enolase (NSE) carcinoembryonic antigen (CEA) were studied in 96 lung cancer patients and in 60 patients with benign diseases of the lung: sensitivity was 0.44, 0.41, 0.54, 0.23 and 0.38 respectively; specificity was 0.67, 0.87, 0.47, 0.93 and 0.97 respectively. Serum levels of CA-125 over 20 U/ml were found in 74% of patients with acute pneumonia. A good parallel existed between the clinical evolution of lung cancer and the variations in the serum level of CA-50, CA-19.9 and NSE. Although the pretreatment result was elevated, successive assays of the marker allowed the clinical evolution to be followed. Conflicting results were found with CA-125 and to a lesser extent with CEA. A close correlation existed between the serum levels CA-50 and CA-19.9 in the 2 groups of patients. In the absence of a specific marker for lung cancer, complementary information can be provided by means of a simultaneous determination of CEA, NSE, CA-19.9--or CA-50--and CA-125.
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PMID:Serum levels of CA-50, CA-19.9, CA-125, neuron specific enolase and carcinoembryonic antigen in lung cancer and benign diseases of the lung. 263 77

Levels of carcinoembryonic antigen(CEA)in the serum and pleural effusion in malignancies (65) and benign (25) of lung were determined. There are 20 cases of adenocarcinoma, 16 undifferentiated carcinoma, 7 squamous cell carcinoma, 4 alveolar carcinoma, 12 unclassified carcinoma, 1 polymorphous adenoma, 1 mesothelioma, 1 thymoma, 1 metastatic cancer from kidney and 2 metastatic breast cancer. In the benign lesions, there are 20 tuberculosis, 2 heart failure, 1 pneumonia, 1 empyema and 1 cirrhosis. The mean of the CEA level in the serum of lung cancer group was 12.63 ng/ml as compared with that of the tuberculosis group, 3.01 ng/ml (P less than 0.01). The level of CEA in pleural fluid in the lung cancer group was 57.30 ng/ml as compared with that of tuberculosis group, 5.55 ng/ml (P less than 0.01). The content of CEA in the serum and pleural fluid in lung cancer group was remarkably different (P less than 0.01). CEA level in the serum of adenocarcinoma is the highest (mean 15.51 ng/ml). If we set 5 ng/ml as the margin of normal CEA level in serum, the positive rate for cancer would be 54.2%. It is suggested that the margin of CEA normal value be set at 10 ng/ml for the pleural fluid. Higher readings may imply cancer.
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PMID:[Carcinoembryonic antigen assay in serum and pleural effusion of pulmonary malignancies and benign lesions]. 358 9

A specific radioimmunoassay for carcinoembryonic antigen was used to investigate aspects of its measurement in lung disease. The results confirm that serum carcinoembryonic antigen concentrations are higher in healthy smokers and patients with chronic obstructive bronchitis than in healthy non smokers (p less than 0.01). Corticosteroid treatment reduced the concentration in nine patients with bronchitis (p less than 0.05). Other inflammatory lung diseases (bronchiectasis, pneumonia, fibrosing alveolitis) are not associated with a raised serum carcinoembryonic antigen concentration. The sputum concentrations were about 100 times those found in serum and there was a positive correlation (r = 0.611 2p less than 0.01) between the concentrations in sputum and serum in patients with bronchitis. No preferential rise in sputum concentration was found in current smokers or patients with lung carcinoma (n = 16). A higher ratio of carcinoembryonic antigen to albumin concentration (p less than 0.05) was, however, found in lavage fluid obtained from the tumour site than in fluid from "normal" lung in the same patients, suggesting an increase in carcinoembryonic antigen secretion in the vicinity of the tumour. Despite this "local" effect the sputum concentration does not, however, appear to be a useful marker of lung carcinoma and the measurement could not be used as a screening test.
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PMID:Effect of cigarette smoking, pulmonary inflammation, and lung disease on concentrations of carcinoembryonic antigen in serum and secretions. 370 62

Serum levels of carcinoembryonic antigen (CEA) were analysed in patients with pneumonia of different etiology. Significant (p less than 0.01) increases in blood CEA levels occurred in all groups of pneumonia of bacterial etiology, i.e., pneumococcal, gram-negative or chlamydial. In viral pneumonia similar increases were observed, but the changes were not statistically significant, probably due to the small number of patients. In pneumonia of unknown etiology CEA behaved as in bacterial pneumonias. Maximal values between 5 and 15 micrograms/l CEA were common in pneumonia, the basal level usually being less than 5 micrograms/l. The severity of pneumonia, as judged by maximal erythrocyte sedimentation rate, correlated weakly with CEA levels in the bacterial group (p less than 0.05). In pneumonias of unknown etiology white blood cell counts and C-reactive protein levels correlated significantly with maximal CEA (p less than 0.01). In conclusion we have demonstrated, that in pneumonias of different etiology strongly but transiently increased blood CEA levels are the rule. The severity of pneumonia is not clearly correlated with CEA levels.
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PMID:Carcinoembryonic antigen (CEA) in blood in cases of pneumonia. 381 48

The diagnostic value of the novel tumor marker CYFRA 21-1 in malignant pleural fluid was assessed in comparison to carcinoembryonic antigen (CEA). CYFRA 21-1 and CEA were measured in pleural fluid obtained from patients with 108 malignant and benign diseases. The levels of pleural fluid CYFRA 21-1 in malignant diseases (median: 84.5 ng/ml) were statistically higher than those in benign diseases (median: 13.9 ng/ml; p < 0.01). The CYFRA 21-1 test was able to discriminate significantly between squamous cell lung cancer and pneumonia (p < 0.01), while pleural fluid CEA levels could not. Receiver operating characteristic (ROC) curve analysis showed that the CYFRA 21-1 test has an advantage over CEA because of its higher specificity. These results indicate that measurement of CYFRA 21-1 in pleural fluid is a new tool, in addition to cytologic examination, to discriminate between malignant and benign diseases.
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PMID:Clinical evaluation of CYFRA 21-1 in malignant pleural fluids. 753 17

The objective of this study was to verify whether the assay of carcinoembryonic antigen (CEA) in bronchoalveolar lavage fluid (BALF) can increase the sensitivity and specificity of serum CEA for the diagnosis of lung cancer. We examined 72 subjects, 53 males and 19 females, 18 affected with peripheral lung cancer (10 adenocarcinoma, 6 squamous cell carcinoma, 1 small cell lung cancer, 1 adenosquamous carcinoma), 19 with acute pneumonia, 14 with chronic obstructive pulmonary disease (COPD), 6 with interstitial lung disease (ILD), and 15 healthy subjects. CEA was assayed in blood and in BALF using microparticle enzyme immunoassay (MEIA) (IMX Abbott). The mean serum CEA value in the lung cancer group did not differ from that in each group of non-neoplastic subjects, neither was it different from that in healthy subjects. The mean BALF CEA in patients with lung cancer, pneumonia, and COPD was significantly increased compared with that in healthy subjects, whereas there was no difference between the three groups of patients. The ratio of BALF CEA was not significantly different in the three groups of patients. There were no differences according to the histological type of the tumour (adenocarcinoma or squamous cell carcinoma). Based on the results in healthy subjects, the upper limits of normal were defined for serum CEA, BALF CEA, and CEA/albumin ratio. Thus, the sensitivity of BALF CEA in detecting lung cancer (50%) was higher than that of serum CEA (33%), although clinically not useful. In addition, BALF CEA had only 59% specificity compared to 100% of serum CEA. The diagnostic accuracy was 79% for serum CEA and 56% for BALF CEA.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Bronchoalveolar lavage fluid level of carcinoembryonic antigen in the diagnosis of peripheral lung cancer. 766 86

A rare case of a 71-year-old man with malignant oncocytoma is presented. The tumour was found in the left parotid region with enlarged lymph nodes in the neck. The resected parotid mass consisted of three discrete nodules, each histologically characterized by a uniform proliferation of oncocytic tumour cells. The patient underwent repeated operations for recurrences and metastases, and eventually died of acute pneumonia 18 months after the first admission. Metastases to the lymph nodes, ribs, spine and liver had been clinically pointed out. Immunohistochemically, the tumour cells were positive for alpha-1-antitrypsin, alpha-1-antichymotrypsin, lactoferrin, secretory component and carcinoembryonic antigen (CEA), while they were negative for S-100 protein and HHF35 (muscle specific actin). Ultrastructural pictures disclosed numerous mitochondria in the cytoplasm of the tumour cells, revealing neither myofibrils nor secretory granules. These findings therefore support the concept that this tumour is of a glandular epithelial origin.
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PMID:Malignant oncocytoma of the parotid gland: a case report with an immunohistochemical and ultrastructural study. 844 23


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