Pleural fluid carbohydrate antigen 72-4 and malignant pleural effusion: a diagnostic test accuracy study.
Ther Adv Respir Dis
; 18: 17534666231222333, 2024.
Article
de En
| MEDLINE
| ID: mdl-38189269
ABSTRACT
BACKGROUND:
The prognosis of malignant pleural effusion (MPE) is poor. A timely and accurate diagnosis is the prerequisite for managing MPE patients. Carbohydrate antigen 72-4 (CA72-4) is a diagnostic tool for MPE.OBJECTIVE:
We aimed to evaluate the diagnostic accuracy of pleural fluid CA72-4 for MPE.DESIGN:
A prospective, preregistered, and double-blind diagnostic test accuracy study.METHODS:
We prospectively enrolled participants with undiagnosed pleural effusions from two centers in China (Hohhot and Changshu). CA72-4 concentration in pleural fluid was measured by electrochemiluminescence. Its diagnostic accuracy for MPE was evaluated by a receiver operating characteristic (ROC) curve. The net benefit of CA72-4 was determined by a decision curve analysis (DCA).RESULTS:
In all, 153 participants were enrolled in the Hohhot cohort, and 58 were enrolled in the Changshu cohort. In both cohorts, MPE patients had significantly higher CA72-4 levels than benign pleural effusion (BPE) patients. At a cutoff value of 8 U/mL, pleural fluid CA72-4 had a sensitivity, specificity, and area under the ROC curve (AUC) of 0.46, 1.00, and 0.79, respectively, in the Hohhot cohort. In the Changshu cohort, CA72-4 had a sensitivity, specificity, and AUC of 0.27, 0.94, and 0.86, respectively. DCA revealed the relatively high net benefit of CA72-4 determination. In patients with negative cytology, the AUC of CA72-4 was 0.67.CONCLUSION:
Pleural fluid CA72-4 helps differentiate MPE and BPE in patients with undiagnosed pleural effusions.Mots clés
Texte intégral:
1
Collection:
01-internacional
Base de données:
MEDLINE
Sujet principal:
Épanchement pleural
/
Épanchement pleural malin
Type d'étude:
Clinical_trials
/
Diagnostic_studies
/
Observational_studies
/
Prognostic_studies
Limites:
Humans
Langue:
En
Journal:
Ther Adv Respir Dis
/
Ther. adv. respir. dis. (Online)
/
Therapeutic advances in respiratory disease (Online)
Sujet du journal:
PNEUMOLOGIA
/
TERAPEUTICA
Année:
2024
Type de document:
Article
Pays d'affiliation:
Chine
Pays de publication:
Royaume-Uni