Role of cancer ratio and other new parameters in the differential diagnosis of malignant pleural effusion

Ren, Zenghua; Xu, Ling

doi:10.6061/clinics/2021/e2515

Clinics

2021

DOI: 10.6061/clinics/2021/e2515

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Role of cancer ratio and other new parameters in the differential diagnosis of malignant pleural effusion

Zenghua Ren

Ling Xu

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2023

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Age affects the diagnostic accuracy of the cancer ratio for malignant pleural effusion

Huang¹,

Chen²,

Gu³

et al. 2023

BMC Pulm Med

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Background and objective Cancer ratio (CR), which is defined as serum lactate dehydrogenase (LDH) to pleural fluid adenosine deaminase (ADA) ratio, has been reported to be a useful diagnostic marker for malignant pleural effusion (MPE). Whether its diagnostic accuracy is affected by age remains unknown. This study aimed to investigate the effects of age on the diagnostic accuracy of CR. Methods The participants in this study were from a prospective cohort (SIMPLE cohort, n = 199) and a retrospective cohort (BUFF cohort, n = 158). All participants were patients with undiagnosed pleural effusion (PE). We used receiver operating characteristic (ROC) curves to evaluate the diagnostic accuracy of CR. The effect of age on the diagnostic accuracy of CR was investigated by adjusting the upper limit of age for participant enrolment. Results Eighty-eight MPE patients were verified in the SIMPLE cohort, and thirty-five MPE patients were verified in the BUFF cohort. The AUCs of CR in the SIMPLE and BUFF cohorts were 0.60 (95% CI: 0.52–0.68) and 0.63 (95% CI: 0.54–0.71), respectively. In both cohorts, the AUCs of CR decreased with the advancement of age. Conclusion Age can affect the diagnostic accuracy of CR for MPE. CR has limited diagnostic value in older patients. Key message Cancer ratio is a promising diagnostic marker for malignant pleural effusion. This study revealed that its diagnostic accuracy decreased in older patients. Its diagnostic accuracy is overestimated by previous studies using tuberculosis and pneumonia patients as controls.

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Age affects the diagnostic accuracy of the cancer ratio for malignant pleural effusion

Huang¹,

Chen²,

Gu³

et al. 2023

BMC Pulm Med

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Role of cancer ratio and other new parameters in the differential diagnosis of malignant pleural effusion

Cited by 1 publication

References 15 publications

Age affects the diagnostic accuracy of the cancer ratio for malignant pleural effusion

Age affects the diagnostic accuracy of the cancer ratio for malignant pleural effusion

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