Diagnostics in Pleural Disease

Sundaralingam, Anand; Bedawi, Eihab; Rahman, Najib M.

doi:10.3390/diagnostics10121046

Cited by 16 publications

(16 citation statements)

References 113 publications

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“…Tuberculosis, pneumonia, and malignancy are among the most common causes of PE ( 2 , 3 , 11 ). In recent years, patients with BPE, such as TPE and PPE, can be clinically cured due to advances in treatment regimens and early diagnosis ( 2 , 22 ). Conversely, MPE usually indicates advanced malignant diseases related to heavy healthcare burden and a high mortality rate.…”

Section: Discussionmentioning

confidence: 99%

Development and Validation of a Scoring System for Early Diagnosis of Malignant Pleural Effusion Based on a Nomogram

Liang

Yuan

et al. 2021

Front. Oncol.

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BackgroundThe diagnostic value of clinical and laboratory features to differentiate between malignant pleural effusion (MPE) and benign pleural effusion (BPE) has not yet been established.ObjectivesThe present study aimed to develop and validate the diagnostic accuracy of a scoring system based on a nomogram to distinguish MPE from BPE.MethodsA total of 1,239 eligible patients with PE were recruited in this study and randomly divided into a training set and an internal validation set at a ratio of 7:3. Logistic regression analysis was performed in the training set, and a nomogram was developed using selected predictors. The diagnostic accuracy of an innovative scoring system based on the nomogram was established and validated in the training, internal validation, and external validation sets (n = 217). The discriminatory power and the calibration and clinical values of the prediction model were evaluated.ResultsSeven variables [effusion carcinoembryonic antigen (CEA), effusion adenosine deaminase (ADA), erythrocyte sedimentation rate (ESR), PE/serum CEA ratio (CEA ratio), effusion carbohydrate antigen 19-9 (CA19-9), effusion cytokeratin 19 fragment (CYFRA 21-1), and serum lactate dehydrogenase (LDH)/effusion ADA ratio (cancer ratio, CR)] were validated and used to develop a nomogram. The prediction model showed both good discrimination and calibration capabilities for all sets. A scoring system was established based on the nomogram scores to distinguish MPE from BPE. The scoring system showed favorable diagnostic performance in the training set [area under the curve (AUC) = 0.955, 95% confidence interval (CI) = 0.942–0.968], the internal validation set (AUC = 0.952, 95% CI = 0.932–0.973), and the external validation set (AUC = 0.973, 95% CI = 0.956–0.990). In addition, the scoring system achieved satisfactory discriminative abilities at separating lung cancer-associated MPE from tuberculous pleurisy effusion (TPE) in the combined training and validation sets.ConclusionsThe present study developed and validated a scoring system based on seven parameters. The scoring system exhibited a reliable diagnostic performance in distinguishing MPE from BPE and might guide clinical decision-making.

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Section: Discussionmentioning

confidence: 99%

Development and Validation of a Scoring System for Early Diagnosis of Malignant Pleural Effusion Based on a Nomogram

Liang

Yuan

et al. 2021

Front. Oncol.

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“…The pleura is the serous membrane that surrounds the lungs and thoracic cavity, consisting of two layers as parietal and visceral layers [1,2]. Pleural fluid is produced by the parietal pleura and reabsorbed by lymphatic channels [3]. A disruption in this homeostasis causes pleural effusion [3].…”

Section: Introductionmentioning

confidence: 99%

“…Pleural fluid is produced by the parietal pleura and reabsorbed by lymphatic channels [3]. A disruption in this homeostasis causes pleural effusion [3].…”

Section: Introductionmentioning

confidence: 99%

Seven-year retrospective analysis of pleural effusion cytologies and cytohistopathological correlation

Düzcü¹,

Ozturk²

2023

Curr Thorac Surg

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Background:The cytological examination of pleural effusions is a quick and effective diagnostic method used to elucidate the etiology. The aim of this study is to reveal cytopathological diagnosis distributions by retrospectively examining seven-year pleural cytology and analyze cyto-histopathological correlations in cases with biopsy in this study. Materials and Methods:In this study, 545 pleural fluid aspiration materials that resulted as Bolu Abant İzzet Baysal University İzzet Baysal Training and Research Hospital between 2014 and 2020 were evaluated retrospectively. The evaluation results were divided into four groups as inconclusive, negative for malignancy, suspected malignancy, and malignant cytology. The biopsy diagnoses of 64 cases were grouped as inadequate, benign, and malignant. Sensitivity and specificity values were calculated by looking at the relationship between cytology and biopsy diagnoses.Results: According to the cytology diagnoses, 435 cases (79.8%) were negative for malignancy, 43 cases (7.9%) were malignant, 32 cases (5.9%) were suspected of malignancy, and 35 cases (6.4%) were inconclusive. When the diagnoses of the cases with both cytology and biopsy analyses were compared, the sensitivity of the cytology was 96.7%, the specificity was 91.2%, the positive predictive value was 90.6%, and the negative predictive value was 96.7%. The biopsy and cytology results were found to be compatible (p < 0.05) Conclusions: Pleural effusion develops due to different etiologies, and the cytological examination of pleural fluid is an important diagnostic method for malignancy. In our region, the most common cause of pleural effusion is benign pathologies which are consistent with data in the literature. The correlations between cytology-and biopsy-based diagnosis results were found high.

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“…Pleural effusion (PE) is an abnormal accumulation of fluid in the pleural cavity. According to Light’s criteria, PE can be clinically classified as either exudate, which is most frequently caused by lung pleura and systemic disorders, or transudate, which is typically caused by cardiac, kidney, or liver failure [ 1 , 2 ]. Compared to a tissue biopsy, PE is obtained through a less invasive and uncomfortable process [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Assessment of a Large-Scale Unbiased Malignant Pleural Effusion Proteomics Study of a Real-Life Cohort

Zahedi

Carvalho

Ejtehadifar

et al. 2022

Cancers

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Background: Pleural effusion (PE) is common in advanced-stage lung cancer patients and is related to poor prognosis. Identification of cancer cells is the standard method for the diagnosis of a malignant PE (MPE). However, it only has moderate sensitivity. Thus, more sensitive diagnostic tools are urgently needed. Methods: The present study aimed to discover potential protein targets to distinguish malignant pleural effusion (MPE) from other non-malignant pathologies. We have collected PE from 97 patients to explore PE proteomes by applying state-of-the-art liquid chromatography-mass spectrometry (LC-MS) to identify potential biomarkers that correlate with immunohistochemistry assessment of tumor biopsy or with survival data. Functional analyses were performed to elucidate functional differences in PE proteins in malignant and benign samples. Results were integrated into a clinical risk prediction model to identify likely malignant cases. Sensitivity, specificity, and negative predictive value were calculated. Results: In total, 1689 individual proteins were identified by MS-based proteomics analysis of the 97 PE samples, of which 35 were diagnosed as malignant. A comparison between MPE and benign PE (BPE) identified 58 differential regulated proteins after correction of the p-values for multiple testing. Furthermore, functional analysis revealed an up-regulation of matrix intermediate filaments and cellular movement-related proteins. Additionally, gene ontology analysis identified the involvement of metabolic pathways such as glycolysis/gluconeogenesis, pyruvate metabolism and cysteine and methionine metabolism. Conclusion: This study demonstrated a partial least squares regression model with an area under the curve of 98 and an accuracy of 0.92 when evaluated on the holdout test data set. Furthermore, highly significant survival markers were identified (e.g., PSME1 with a log-rank of 1.68 × 10−6).

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Diagnostics in Pleural Disease

Cited by 16 publications

References 113 publications

Development and Validation of a Scoring System for Early Diagnosis of Malignant Pleural Effusion Based on a Nomogram

Development and Validation of a Scoring System for Early Diagnosis of Malignant Pleural Effusion Based on a Nomogram

Seven-year retrospective analysis of pleural effusion cytologies and cytohistopathological correlation

Assessment of a Large-Scale Unbiased Malignant Pleural Effusion Proteomics Study of a Real-Life Cohort

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