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HelpTest Code PFCEA Carcinoembryonic Antigen (CEA), Pleural Fluid
Reporting Name
CEA, Pleural FluidUseful For
An adjuvant to cytology and imaging studies to differentiate between nonmalignant and malignant causes of pleural effusions
Performing Laboratory
Mayo Clinic Laboratories in Rochester
Specimen Type
Pleural FluidSpecimen Required
Container/Tube: Plain, plastic, screw-top tube
Specimen Volume: 2 mL
Specimen Minimum Volume
0.5 mL
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Pleural Fluid | Frozen (preferred) | 90 days | |
| Refrigerated | 14 days | ||
| Ambient | 7 days |
Reference Values
An interpretive report will be provided.
Day(s) Performed
Monday through Saturday
Test Classification
This test has been modified from the manufacturer's instructions. Its performance characteristics were determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the US Food and Drug Administration.CPT Code Information
82378
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| PFCEA | CEA, Pleural Fluid | 19169-2 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| PCEA | CEA, Pleural Fluid | 19169-2 |
| SITE9 | Site | 39111-0 |
Interpretation
A pleural fluid carcinoembryonic antigen (CEA) concentration of 3.5 ng/mL or higher is suspicious but not diagnostic of a malignant source of the effusion. This cutoff yielded a sensitivity of 52%, specificity of 95%, and part per volume of 93% in a study of 200 patients presenting with effusion. CEA concentrations were significantly higher in effusions caused by CEA-secreting malignancies, including lung, breast, ovarian, gastrointestinal, and colorectal cancers. However, effusions caused by non-CEA-secreting malignancies, including lymphoma, mesothelioma, leukemia, and melanoma, routinely had CEA concentrations below 3.5 ng/mL. Therefore, negative results should be interpreted with caution, especially in patients who have or are suspected of having a non-CEA-secreting malignancy.
Correlation of all tumor marker results with cytology and imaging is highly recommended.
Clinical Reference
1. Shitrit D, Zingerman B, Shitrit ABG, Shlomi D, Kramer MR: Diagnostic value of CYFRA 21-1, CEA, CA 19-9, CA 15-3, and CA 125 assays in pleural effusions: analysis of 116 cases and review of the literature. Oncologist. 2005 Aug;10(7):501-507
2. Hackbarth JS, Murata K, Reilly WM, Algeciras-Schimnich A: Performance of CEA and CA19-9 in identifying pleural effusions caused by specific malignancies. Clin Biochem. 2010 Sep;43(13-14):1051-1055
3. Garcia-Pachon E, Padilla-Navas I, Dosda MD, Miralles-Llopis A: Elevated level of carcinoembryonic antigen in nonmalignant pleural effusions. Chest. 1997 Mar;111(3):643-647
4. Hackner K, Errhalt P, Handzhiev S: Ratio of carcinoembryonic antigen in pleural fluid and serum for the diagnosis of malignant pleural effusion. Ther Adv Med Oncol. 2019 May 22;11:1758835919850341. doi: 10.1177/1758835919850341
5. Tozzoli R, Basso SMM, D'Aurizio F, Metus P, Lumachi F: Evaluation of predictive value of pleural CEA in patients with pleural effusions and histological findings: A prospective study and literature review. Clin Biochem. 2016 Nov;49(16-17):1227-1231. doi: 10.1016/j.clinbiochem.2016.08.006
Report Available
1 to 3 daysMethod Name
Immunoenzymatic Assay
Forms
If not ordering electronically, complete, print, and send an Oncology Test Request (T729) with the specimen.