Clinical Impact and Reliability of Carbonic Anhydrase XII in the Differentiation of Malignant and Tuberculous Pleural Effusions

Objective: To assess the practical utility of pleural fluid carbonic anhydrase XII (CAXII) quantification fordifferential diagnosis of effusions. Materials and
Methods: Fluid was collected prospectively from fifty patientspresenting with lymphocytic pleural effusions for investigation and CAXII was quantified by ELISA.
Results:Pleural fluid CAXII concentrations were significantly higher in lung cancer patients (n=30) than in tuberculouscontrols (n=20). The sensitivity and specificity of this biomarker were 60%and 75%, respectively. CAXIImeasurement was not inferior to cytological examination in the diagnosis and exclusion of pleural effusionsfrom lung cancer patitents (sensitivity 60% vs. 57%; specificity 75% vs. 100%; positive predictive value 77%;negative predictive value 54%). In patients with negative cytology, it offered a sensitivity of 54%.
Conclusions:Pleural fluid CAXII is elevated in pleural effusions from lung cancer patients. Measurement of CAXII may beused in the future as a valuable adjunct to cytology in the diagnostic assessment of patients with pleural effusionsrelated to lung cancer, especially when cytological examination is inconclusive.