The diagnostic value of pleural fluid homocysteine in malignant pleural effusion


Autoři: Jose D. Santotoribio aff001;  Luis del Valle-Vazquez aff003;  Angela García-de la Torre aff004;  Daniel del Castillo-Otero aff006;  Juan-Bosco Lopez-Saez aff007;  Maria J. Sanchez del Pino aff002
Působiště autorů: Department of Laboratory Medicine, Puerto Real University Hospital, Cadiz, Spain aff001;  Department of Biomedicine, Biotechnology and Public Health, Cadiz University School of Medicine, Cadiz, Spain aff002;  Health Center Las Beatas, Alcala de Guadaira, Sevilla, Spain aff003;  Department of Laboratory Medicine, Virgen de la Victoria University Hospital, Malaga, Spain aff004;  Instituto de Investigacion Biomédica de Malaga (IBIMA), Malaga, Spain aff005;  Department of Pneumology, Puerto Real University Hospital, Cadiz, Spain aff006;  Department of Medicine, Cadiz University School of Medicine, Cadiz, Spain aff007;  Department of Internal Medicine, Puerto Real University Hospital, Cadiz, Spain aff008
Vyšlo v časopise: PLoS ONE 14(9)
Kategorie: Research Article
doi: 10.1371/journal.pone.0222616

Souhrn

Background

Pleural fluid homocysteine (HCY) can be useful for diagnosis of malignant pleural effusion (MPE). There are no published studies comparing the diagnostic accuracy of HCY with other tumour markers in pleural fluid for diagnosis of MPE. The aim was to compare the accuracy of HCY with that of carcinoembryonic antigen (CEA), cancer antigen (CA) 15.3, CA19.9 and CA125 in pleural fluid and to develop a probabilistic model using these biomarkers to differentiate benign (BPE) from MPE.

Methods

Patients with pleural effusion were randomly included. HCY, CEA, CA15.3, CEA19.9 and CA125 were quantified in pleural fluid. Patients were classified into two groups: MPE or BPE. By applying logistic regression analysis, a multivariate probabilistic model was developed using pleural fluid biomarkers. The diagnostic accuracy was determined by receiver operating characteristic (ROC) curves and calculating the area under the curve (AUC).

Results

Population of study comprised 133 patients (72 males and 61 females) aged between 1 and 96 years (median = 70 years), 81 BPE and 52 MPE. The logistic regression analysis included HCY (p<0.0001) and CEA (p = 0.0022) in the probabilistic model and excluded the other tumour markers. The probabilistic model was: HCY+CEA = Probability(%) = 100×(1+e-z)-1, where Z = 0.5471×[HCY]+0.3846×[CEA]–8.2671. The AUCs were 0.606, 0.703, 0.778, 0.800, 0.846 and 0.948 for CA125, CA19.9, CEA, CA15.3, HCY and HCY+CEA, respectively.

Conclusions

Pleural fluid HCY has higher accuracy for diagnosis of MPE than CEA, CA15.3, CA19.9 and CA125. The combination of HCY and CEA concentrations in pleural fluid significantly improves the diagnostic accuracy of the test.

Klíčová slova:

Biomarkers – Cancer detection and diagnosis – Diagnostic medicine – Normal distribution – Pleurae – Regression analysis – Pleural effusion – Metastatic tumors


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PLOS One


2019 Číslo 9

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