53 leads to red-cell fragmentation and hxmolysis. However, anaemia of this severity due to haemolysis of any kind would have produced a much higher bilirubin. Other factors such as decreased oncotic pressure3 (serumalbumin not available) and the loss of plasma volume described in association with bowel obstruction4 may have played important contributory roles in the pathogenesis of the oedema. We thank Dr Rowena
Spencer
and Dr Norman
Woody for
C.E.A. CONCENTRATIONS
(ng/ml) IN PLEURAL EFFUSIONS AND PLASMA
I
I
review-
ing the manuscript. Department of Pediatrics, Tulane University School of Medicine, New Orleans, Louisiana 70112, U.S.A.
JANE F. SEWARD JAIME ZUSMAN
CONCURRENT ASSAYS OF PLASMA AND PLEURAL-EFFUSION LEVELS OF CARCINOEMBRYONIC ANTIGEN IN THE DIAGNOSIS OF PULMONARY DISEASE concentrations of carcinoembryonic have been demonstrated in the plasma of patients with many different types of neoplasia including carcinomas of the colon5and bronchus.6The c.E.A. value seems to vary with the stage of disease and the quantity of tumour or the use of palliative therapy.’ Raised plasma-c.E.A. values are not, however, diagnostic of cancer because they are found in patients with various inflammatory diseases, including those of the lung.When a patient presents with a pleural effusion it is sometimes difficult to determinethe cause, unless malignant cells or bacteria are isolated from the pleural fluid. Biopsy is not always helpful. Several workers have compared plasma with pleural-effusion values for C.E.A. in an attempt to improve the diagnostic accuracy. Some have found raised pleural-fluid C.E.A. concentrates in patients with a variety of cancers and inflammatory lung diseases,9,lo while othersll,12 have found raised C.E.A. values only in patients with cancer. We have measured C.E.A. levels in plasma and pleural fluid to see if their combined estimation would help to separate patients with primary bronchial carcinoma from those with mesothelioma or inflammatory lung disease (empyema and tuberculosis). We measured C.E.A. concurrently in plasma and pleural fluid by double-antibody radioimmunoassay8 (normal plasma-c.E.A.
Spencer
and Dr Norman
Woody for
C.E.A. CONCENTRATIONS
(ng/ml) IN PLEURAL EFFUSIONS AND PLASMA
I
I
review-
ing the manuscript. Department of Pediatrics, Tulane University School of Medicine, New Orleans, Louisiana 70112, U.S.A.
JANE F. SEWARD JAIME ZUSMAN
CONCURRENT ASSAYS OF PLASMA AND PLEURAL-EFFUSION LEVELS OF CARCINOEMBRYONIC ANTIGEN IN THE DIAGNOSIS OF PULMONARY DISEASE concentrations of carcinoembryonic have been demonstrated in the plasma of patients with many different types of neoplasia including carcinomas of the colon5and bronchus.6The c.E.A. value seems to vary with the stage of disease and the quantity of tumour or the use of palliative therapy.’ Raised plasma-c.E.A. values are not, however, diagnostic of cancer because they are found in patients with various inflammatory diseases, including those of the lung.When a patient presents with a pleural effusion it is sometimes difficult to determinethe cause, unless malignant cells or bacteria are isolated from the pleural fluid. Biopsy is not always helpful. Several workers have compared plasma with pleural-effusion values for C.E.A. in an attempt to improve the diagnostic accuracy. Some have found raised pleural-fluid C.E.A. concentrates in patients with a variety of cancers and inflammatory lung diseases,9,lo while othersll,12 have found raised C.E.A. values only in patients with cancer. We have measured C.E.A. levels in plasma and pleural fluid to see if their combined estimation would help to separate patients with primary bronchial carcinoma from those with mesothelioma or inflammatory lung disease (empyema and tuberculosis). We measured C.E.A. concurrently in plasma and pleural fluid by double-antibody radioimmunoassay8 (normal plasma-c.E.A.
