The diagnostic value of apolipoprotein E in malignant pleural effusion associated with non-small cell lung cancer

Clin Chim Acta. 2013 Jun 5:421:230-5. doi: 10.1016/j.cca.2013.03.013. Epub 2013 Mar 21.

Abstract

Background: Apolipoprotein E (apoE) levels have been shown to be elevated in pleural effusion of patients with non-small cell lung cancer (NSCLC). However, the diagnostic value of apoE in pleural effusion in NSCLC has not been well validated and established.

Methods: Samples of malignant pleural effusions (MPE) and benign effusions were collected and analyzed for apoE, tumor markers, and other biochemical changes.

Results: ApoE levels were significantly higher in MPE (n=160) than in benign pleural effusions (n=40). They were higher in adenocarcinoma-associated MPE than in squamous cell carcinoma- and large cell carcinoma-associated MPE. The receiver operating characteristic curve showed that the sensitivity and specificity of apoE for the diagnosis of MPE were 87.5% and 85.3%, respectively, at the cutoff 105 ng/ml, and the area under the curve (AUC) was 0.748. For the diagnosis of adenocarcinoma-associated MPE, apoE achieved sensitivity and specificity of 70.8% and 83.30%, respectively, and the AUC was the highest of all the markers.

Conclusions: ApoE levels are significantly increased in the pleural effusion of patients with NSCLC. Increased concentration of apoE in a pleural effusion is a potential marker for the diagnosis of MPE as well as for differential diagnosis of MPE in NSCLC.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adenocarcinoma / chemistry
  • Adenocarcinoma / diagnosis
  • Adult
  • Aged
  • Aged, 80 and over
  • Antigens, Neoplasm / chemistry
  • Apolipoproteins E / analysis*
  • Area Under Curve
  • Biomarkers, Tumor / analysis*
  • CA-125 Antigen / analysis
  • Carcinoembryonic Antigen / analysis
  • Carcinoma, Large Cell / chemistry
  • Carcinoma, Large Cell / diagnosis
  • Carcinoma, Non-Small-Cell Lung / chemistry
  • Carcinoma, Non-Small-Cell Lung / diagnosis*
  • Carcinoma, Squamous Cell / chemistry
  • Carcinoma, Squamous Cell / diagnosis
  • Female
  • Humans
  • Lung Neoplasms / chemistry
  • Lung Neoplasms / diagnosis*
  • Male
  • Membrane Proteins / analysis
  • Middle Aged
  • Organ Specificity
  • Pleural Effusion, Malignant / chemistry*
  • ROC Curve
  • Serpins / chemistry

Substances

  • Antigens, Neoplasm
  • Apolipoproteins E
  • Biomarkers, Tumor
  • CA-125 Antigen
  • Carcinoembryonic Antigen
  • MUC16 protein, human
  • Membrane Proteins
  • Serpins
  • squamous cell carcinoma-related antigen