PuSH - Publication Server of Helmholtz Zentrum München: Clinical identification of malignant pleural effusions.

Navigation

Home

Deutsch

Research

Advanced Search

Browse by ...

... Journal

... Publication Type

... Research Data

... Publication Year

Publication overview

Support & Contact

Contact persons

Help

Data protection

Jia, J. ; Marazioti, A.* ; Voulgaridis, A.* ; Psallidas, I.* ; Lamort, A.-S. ; Iliopoulou, M.* ; Krontira, A.C.* ; Lilis, I.* ; Asciak, R.* ; Kanellakis, N.I.* ; Rahman, N.M.* ; Karkoulias, K.* ; Spiropoulos, K.* ; Liu, R.* ; Kaiser, J.C. ; Stathopoulos, G.T.

Clinical identification of malignant pleural effusions.

Transl. Oncol. 39:101800 (2023)

Publ. Version/Full Text

DOI

PMC

	Open Access Gold

Abstract
Metrics
Extra information

INTRODUCTION: Pleural effusions frequently signal disseminated cancer. Diagnostic markers of pleural malignancy at presentation that would assess cancer risk and would streamline diagnostic decisions remain unidentified. METHODS: A consecutive cohort of 323 patients with pleural effusion (PE) from different etiologies were recruited between 2013 and 2017 and was retrospectively analyzed. Data included history, chest X-ray, and blood/pleural fluid cell counts and biochemistry. Group comparison, receiver-operator characteristics, unsupervised hierarchical clustering, binary logistic regression, and random forests were used to develop the malignant pleural effusion detection (MAPED) score. MAPED was validated in an independent retrospective UK cohort (n = 238). RESULTS: Five variables showed significant diagnostic power and were incorporated into the 5-point MAPED score. Age > 55 years, effusion size > 50% of the most affected lung field, pleural neutrophil count 〈 2,500/mm³, effusion protein 〉 3.5 g/dL, and effusion lactate dehydrogenase > 250 U/L, each scoring one point, predicted underlying cancer with the area under curve(AUC) = 0.819 (P < 10^-15) in the derivation cohort. The integrated discrimination improvement of MAPED scores showed an increase compared to cytology (p <0.001). Decision curve analysis indicated that the MAPED score generated net clinical benefit. In the validation dataset, the AUC of MAPED scores was 0.723 ( P = 3 × 10^-9) for the MAPED score. Interestingly, MAPED correctly identified 33/42(79%) of cytology-negative patients that indeed had cancer. CONCLUSIONS: The MAPED score identifies malignant pleural effusions with satisfactory accuracy and can be used complementary to cytology to streamline diagnostic procedures. CONDENSED ABSTRACT: Diagnostic markers for malignant pleural effusions remain uncertain. The MAPED score identifies malignant pleural effusions and complements cytology and confers no additional risk to the patient or cost to the healthcare system.

Altmetric

Additional Metrics?

[➜Log in]

Edit extra informations Login

Publication type Article: Journal article

Document type Scientific Article

Corresponding Author

Keywords Aging And Cancer ; Lactate Dehydrogenase ; Malignant Pleural Effusion Size ; Neutrophil ; Protein; Validation

e-ISSN 1936-5233

Journal Translational Oncology

Quellenangaben Volume: 39, Article Number: 101800

Publisher Neoplasia Press

Publishing Place Ste 800, 230 Park Ave, New York, Ny 10169 Usa

Non-patent literature Publications

Reviewing status Peer reviewed

Institute(s) Lung Health and Immunity (LHI)
Institute of Radiation Medicine (IRM)

Grants
German Center for Lung Research (Deutsches Zentrum fur Lungenforschung, DZL)
Target Validation Project for Pharmaceutical Development ALTERNATIVE of the German Ministry for Education and Research (Bundesministerium fur Bildung und Forschung, BMBF)
German Research Society (Deutsche Forschungsgemeinschaft, DFG)
European Research Council 2010 Starting Independent Investigator