Hybrid panel of biomarkers can be useful in the diagnosis of pleural and peritoneal effusions

Faria, Daniel K.; Faria, Caroline Silvério; Doi, Dimitria; Acencio, Milena Marques Pagliarelli; Antonângelo, Leila

doi:10.1016/j.cca.2019.07.015

Cited by 8 publications

(7 citation statements)

References 24 publications

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“…Only two (4.5%) other publications reported the frequency of HIV seropositivity among their study subjects, while the remaining did not provide any information [ 38 , 58 ]. Most researchers (24, 54.5%) used a definite (microbiologic and/or pathologic) reference criteria for diagnosing TPE [ 19 – 21 , 23 , 26 , 29 , 31 , 33 – 36 , 39 , 41 , 46 , 47 , 49 – 52 , 54 , 55 , 59 , 60 , 62 ]. Half of the publications had included patients with transudative effusions in the non-tuberculous group [ 20 , 21 , 24 – 26 , 32 , 33 , 36 , 37 , 40 , 42 , 44 , 47 , 48 , 50 , 54 , 55 , 57 – 61 ].…”

Section: Resultsmentioning

confidence: 99%

“…The IFN-γ assay was performed using enzyme-linked immunosorbent assay (ELISA) in most (40, 88.9%) studies. Four (8.9%) studies used another method, and one (2.2%) study did not specify the assay technique ( S3 Table ) [ 20 , 34 , 43 , 60 , 62 ]. Three studies reported data on two or more diagnostic thresholds for the assays ( S2 Table ) [ 23 , 32 , 45 ].…”

Section: Resultsmentioning

confidence: 99%

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Comparative accuracy of pleural fluid unstimulated interferon-gamma and adenosine deaminase for diagnosing pleural tuberculosis: A systematic review and meta-analysis

et al. 2021

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Objective We compared diagnostic accuracy of pleural fluid adenosine deaminase (ADA) and interferon-gamma (IFN-γ) in diagnosing tuberculous pleural effusion (TPE) through systematic review and comparative meta-analysis. Methods We queried PubMed and Embase databases to identify studies providing paired data for sensitivity and specificity of both pleural fluid ADA and IFN-γ for diagnosing TPE. We used hierarchical summary receiver operating characteristic (HSROC) plots and HSROC meta-regression to model individual and comparative diagnostic performance of the two tests. Results We retrieved 376 citations and included 45 datasets from 44 publications (4974 patients) in our review. Summary estimates for sensitivity and specificity for ADA were 0.88 (95% CI 0.85–0.91) and 0.91 (95% CI 0.89–0.92), while for IFN-γ they were 0.91 (95% CI 0.89–0.94) and 0.96 (95% CI 0.94–0.97), respectively. HSROC plots showed consistently greater diagnostic accuracy for IFN-γ over ADA across the entire range of observations. HSROC meta-regression using test-type as covariate yielded a relative diagnostic odds ratio of 2.22 (95% CI 1.68–2.94) in favour of IFN-γ, along with better summary sensitivity and specificity figures. No prespecified subgroup variable significantly influenced the summary diagnostic accuracy estimates. Conclusion Pleural fluid IFN-γ estimation has better diagnostic accuracy than ADA estimation for diagnosis of TPE.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Comparative accuracy of pleural fluid unstimulated interferon-gamma and adenosine deaminase for diagnosing pleural tuberculosis: A systematic review and meta-analysis

et al. 2021

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“…Few studies have assessed the utility of clinical and laboratory variables in diagnosing malignant effusions based on the mathematical predictive models. Our predictive model established on the basis of ETC/cluster count and effusion CEA could attain a relatively higher diagnostic value (AUC of 0.939 in the training set and 0.948 in the validation set through ROC analysis) compared with the results from previous studies. , Given that effusion CEA has long been tested as an useful marker of malignant effusions and could easily obtained in clinical settings, − we predict that our predictive model may act as a simple and useful diagnostic tool in patients with malignant effusions.…”

Section: Resultsmentioning

confidence: 72%

High Efficient Isolation of Tumor Cells by a Three Dimensional Scaffold Chip for Diagnosis of Malignant Effusions

Tian

Cheng

Guo

et al. 2020

ACS Appl. Bio Mater.

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High efficient detection of effusion tumor cells (ETCs) has great clinical significance to identify malignant from benign effusions, but few strategies are designed to enrich and identify tumor cells from effusions. Herein, we developed a three-dimensional scaffold microchip (3D scaffold chip) which could efficiently isolate individual ETC and ETC cluster (ETC/cluster) from pleural effusions and ascites by molecular recognition and physical obstruction. The 3D scaffold chip could enrich ETCs with 94.7% capture efficiency from 2 mL effusions in 20 min and was successfully applied to analysis of pleural effusions or ascites from 152 patients. The results showed that patients with malignant effusions possessed a much higher number of ETC/cluster than that of patients with benign effusions and receiver operating characteristic (ROC) analysis revealed that ETC/cluster count can be used as a complementary biomarker for diagnosis of malignant effusions. Finally, univariate and multivariate logistic regression analyses were adopted to find effusion variables with statistical difference in diagnosis of malignant effusions, and three variables (ETC/cluster count and effusion carcinoembryonic antigen) were selected to establish a three-marker predictive model for differentiating malignant and benign effusions in the training set. ROC analysis revealed that the AUC (area under the curve), sensitivity, and specificity of the predictive model were 0.939, 90.4%, and 91.8%, respectively. The three-marker predictive model was successfully applied to the validation set and proved that this model was promising for clinical diagnosis of effusions from patients.

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“…It was finally found that calprotectin showed a considerably high diagnostic accuracy for MPE (AUC, 0.96). However, these results were not confirmed by three subsequent studies (41)(42)(43), which showed that the diagnostic accuracy (i.e., the AUC) of calprotectin in MPE was 0.68 (41), <0.50 (42), and 0.85 (43), respectively. This results inconsistency may be attributable to the wide disease spectrum in the different study cohorts, as well as to the use of different calprotectin assays.…”

Section: Calprotectinmentioning

confidence: 77%

Pleural biomarkers in diagnostics of malignant pleural effusion: a narrative review

Zhang¹,

Li²,

Lippi³

et al. 2021

Transl Lung Cancer Res

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Although cytology and pleural biopsy of pleural effusion (PE) are the gold standards for diagnosing malignant pleural effusion (MPE), these tools' diagnostic accuracy is plagued by some limitations such as low sensitivity, considerable inter-observer variation and invasiveness. The assessment of PE biomarkers may hence be seen as an objective and non-invasive diagnostic alternative in MPE diagnostics. In this review, we summarize the characteristics and diagnostic accuracy of available PE biomarkers, including carcinoembryonic antigen (CEA), neuron-specific enolase (NSE), carbohydrate antigens 125 (CA125), carbohydrate antigen 19-9 (CA19-9), carbohydrate antigen 15-3 (CA15-3), a fragment of cytokeratin 19 (CYFRA 21-1), chitinase-like proteins (CLPs), vascular endothelial growth factor (VEGF) and its soluble receptor, endostatin, calprotectin, cancer ratio, homocysteine, apolipoprotein E (Apo-E), B7 family members, matrix metalloproteinase (MMPs) and tissue-specific inhibitors of metalloproteinases (TIMPs), reactive oxygen species modulator 1 (Romo1), tumor-associated macrophages (TAMs) and monocytes, epigenetic markers (e.g., cell-free microRNA and mRNA). We summarized the evidence from systematic review and meta-analysis for traditional tumor markers' diagnostic accuracy. According to the currently available evidence, we conclude that the traditional tumor markers have high specificity (around 0.90) but low sensitivity (around 0.50). The diagnostic accuracy of novel tumor markers needs to be validated by further studies. None of these tumor biomarkers would have sufficient diagnostic accuracy to confirm or exclude MPE when used alone. A multi-biomarker strategy, also encompassing the use of artificial intelligence algorithms, may be a valuable perspective for improving the diagnostic accuracy of MPE.

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Hybrid panel of biomarkers can be useful in the diagnosis of pleural and peritoneal effusions

Cited by 8 publications

References 24 publications

Comparative accuracy of pleural fluid unstimulated interferon-gamma and adenosine deaminase for diagnosing pleural tuberculosis: A systematic review and meta-analysis

Comparative accuracy of pleural fluid unstimulated interferon-gamma and adenosine deaminase for diagnosing pleural tuberculosis: A systematic review and meta-analysis

High Efficient Isolation of Tumor Cells by a Three Dimensional Scaffold Chip for Diagnosis of Malignant Effusions

Pleural biomarkers in diagnostics of malignant pleural effusion: a narrative review

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