A Meta-Analysis Comparing the Diagnostic Efficacy of Pleural Effusion and Serum Tumor Markers for Lung Cancer
ZHANG Zheyuan
HUI Yixin
TAO Yanying
YANG Jingdi
LI Yamei
Abstract：Objective To systematically evaluate the diagnostic efficacy and differences of tumor markers in pleural effusion and serum for diagnosing lung cancer.Methods Literature published up to November 10,2023,was retrieved from CNKI,Wanfang Database,Weipu Database,China Biomedical Literature Service System,PubMed,Web of Science,Embase,and the Cochrane Library.Two researchers independently screened studies containing both"pleural effusion and serum tumor markers for diagnosing lung cancer"and performed Meta-analysis.Results This study included 36 articles,with 2 771 lung cancer cases and 2 033 benign disease cases.The AUC of carcinoembryonic antigen(CEA)in pleural effusion for predicting lung cancer was better than that in serum[0.911(SE(AUC)=0.015)vs 0.847(SE(AUC)=0.018),P<0.05].No statistically significant differences were found in AUC between pleural effusion and serum for cytokeratin 19 fragment antigen 21-1(CYFRA21-1),neuron-specific enolase(NSE),and squamous cell carcinoma antigen(SCCA)(P>0.05).The sensitivity of all markers in pleural effusion was higher than in serum(P<0.05),while no statistically significant difference existed in specificity(P>0.05).Publication year,detection methods,study region,total case number,and lung cancer pathological types differentially affected the heterogeneity in sensitivity/specificity of CEA,CYFRA21-1,and NSE,serving as potential heterogeneity sources.No threshold effect existed except for pleural effusion NSE.No publication bias was observed except for pleural effusion CYFRA21-1.Sensitivity analyses revealed no significant alterations.Conclusion Pleural effusion CEA has superior diagnostic efficacy to serum and can assist in diagnosing patients with unexplained pleural effusion suspected of lung cancer.Pleural effusion CYFRA21-1,NSE,and SCCA exhibit higher sensitivity,potentially improving lung cancer detection rates.
Keywords：tumor markerpleural effusionlung cancerMeta-analysis
Publication Date：2025-08-20
Online Publishing Date：2025-09-18(First online date of this platform, not the publication date of the document)
Pages：10( 160-169 )