心衰引起的胸腔积液C-C类趋化因子22和胸腔积液:一项前瞻性和双盲诊断准确性试验

IF 3.4 3区 医学 Q1 RESPIRATORY SYSTEM
Li Yan, Su-Na Cha, Yan Niu, Jian-Xun Wen, Wen Zhao, Cheng Yan, Hong-Zhe Zhu, Ying-Jun Wang, Ling Hai, Ting-Wang Jiang, Qianghua Zhou, José M Porcel, Wen-Qi Zheng, Zhi-De Hu
{"title":"心衰引起的胸腔积液C-C类趋化因子22和胸腔积液:一项前瞻性和双盲诊断准确性试验","authors":"Li Yan, Su-Na Cha, Yan Niu, Jian-Xun Wen, Wen Zhao, Cheng Yan, Hong-Zhe Zhu, Ying-Jun Wang, Ling Hai, Ting-Wang Jiang, Qianghua Zhou, José M Porcel, Wen-Qi Zheng, Zhi-De Hu","doi":"10.1136/bmjresp-2024-002823","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Previous studies have indicated that C-C class chemokine ligand 22 (CCL22) is involved in the pathogenesis of tuberculous pleural effusion and malignant pleural effusion. However, the diagnostic role of pleural fluid CCL22 levels in patients with undiagnosed pleural effusions remains to be elucidated.</p><p><strong>Methods: </strong>We prospectively recruited patients with undiagnosed pleural effusion who visited two centres (Hohhot and Changshu) in China. Pleural biopsy, microbiological culture and effusion cytology were used to verify the cause of pleural effusion. Pleural fluid CCL22 levels were measured using an ELISA. The diagnostic accuracy of CCL22 for identifying heart failure (HF) was evaluated using a receiver operating characteristic (ROC) curve, and the net benefit of CCL22 was evaluated using decision curve analysis (DCA). Net benefit was defined as the benefit associated with true positives minus the harms associated with false positives at various threshold probabilities.</p><p><strong>Results: </strong>We enrolled 153 and 58 patients in the Hohhot and Changshu cohorts, respectively. The cohort included 28 patients with HF and 183 patients with non-HF. Patients with HF had significantly lower pleural fluid CCL22 levels than non-HF patients. The area under the ROC curve (AUC) of CCL22 was 0.85 (95% CI: 0.77 to 0.93) in the Hohhot cohort and 0.87 (95% CI: 0.75 to 0.98) in the Changshu cohort. The AUC in the combined cohort was 0.85 (95% CI: 0.79 to 0.92), with a sensitivity of 0.82 (95% CI: 0.68 to 0.93) and a specificity of 0.73 (95% CI: 0.67 to 0.79) at the threshold of 150 ng/mL. DCA revealed a potential net benefit of pleural CCL22 determination in patients with undiagnosed pleural effusions.</p><p><strong>Conclusions: </strong>Pleural fluid CCL22 may be a potential diagnostic marker for HF-related pleural effusion. Owing to the small sample size of this study, further studies with larger sample sizes are needed to validate our findings.</p>","PeriodicalId":9048,"journal":{"name":"BMJ Open Respiratory Research","volume":"12 1","pages":""},"PeriodicalIF":3.4000,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12366591/pdf/","citationCount":"0","resultStr":"{\"title\":\"Pleural fluid C-C class chemokines 22 and pleural effusion due to heart failure: a prospective and double-blind diagnostic accuracy test.\",\"authors\":\"Li Yan, Su-Na Cha, Yan Niu, Jian-Xun Wen, Wen Zhao, Cheng Yan, Hong-Zhe Zhu, Ying-Jun Wang, Ling Hai, Ting-Wang Jiang, Qianghua Zhou, José M Porcel, Wen-Qi Zheng, Zhi-De Hu\",\"doi\":\"10.1136/bmjresp-2024-002823\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Previous studies have indicated that C-C class chemokine ligand 22 (CCL22) is involved in the pathogenesis of tuberculous pleural effusion and malignant pleural effusion. However, the diagnostic role of pleural fluid CCL22 levels in patients with undiagnosed pleural effusions remains to be elucidated.</p><p><strong>Methods: </strong>We prospectively recruited patients with undiagnosed pleural effusion who visited two centres (Hohhot and Changshu) in China. Pleural biopsy, microbiological culture and effusion cytology were used to verify the cause of pleural effusion. Pleural fluid CCL22 levels were measured using an ELISA. The diagnostic accuracy of CCL22 for identifying heart failure (HF) was evaluated using a receiver operating characteristic (ROC) curve, and the net benefit of CCL22 was evaluated using decision curve analysis (DCA). Net benefit was defined as the benefit associated with true positives minus the harms associated with false positives at various threshold probabilities.</p><p><strong>Results: </strong>We enrolled 153 and 58 patients in the Hohhot and Changshu cohorts, respectively. The cohort included 28 patients with HF and 183 patients with non-HF. Patients with HF had significantly lower pleural fluid CCL22 levels than non-HF patients. The area under the ROC curve (AUC) of CCL22 was 0.85 (95% CI: 0.77 to 0.93) in the Hohhot cohort and 0.87 (95% CI: 0.75 to 0.98) in the Changshu cohort. The AUC in the combined cohort was 0.85 (95% CI: 0.79 to 0.92), with a sensitivity of 0.82 (95% CI: 0.68 to 0.93) and a specificity of 0.73 (95% CI: 0.67 to 0.79) at the threshold of 150 ng/mL. DCA revealed a potential net benefit of pleural CCL22 determination in patients with undiagnosed pleural effusions.</p><p><strong>Conclusions: </strong>Pleural fluid CCL22 may be a potential diagnostic marker for HF-related pleural effusion. Owing to the small sample size of this study, further studies with larger sample sizes are needed to validate our findings.</p>\",\"PeriodicalId\":9048,\"journal\":{\"name\":\"BMJ Open Respiratory Research\",\"volume\":\"12 1\",\"pages\":\"\"},\"PeriodicalIF\":3.4000,\"publicationDate\":\"2025-08-18\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12366591/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"BMJ Open Respiratory Research\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1136/bmjresp-2024-002823\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"RESPIRATORY SYSTEM\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"BMJ Open Respiratory Research","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1136/bmjresp-2024-002823","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"RESPIRATORY SYSTEM","Score":null,"Total":0}
引用次数: 0

摘要

背景:既往研究表明,C-C类趋化因子配体22 (CCL22)参与结核性胸腔积液和恶性胸腔积液的发病过程。然而,在未确诊的胸腔积液患者中,胸膜液CCL22水平的诊断作用仍有待阐明。方法:我们前瞻性地招募了在呼和浩特和常熟两个中心就诊的未确诊胸腔积液患者。胸膜活检、微生物培养和积液细胞学检查证实了胸腔积液的原因。采用ELISA法测定胸膜液CCL22水平。采用受试者工作特征(ROC)曲线评估CCL22诊断心力衰竭(HF)的准确性,采用决策曲线分析(DCA)评估CCL22的净效益。净收益被定义为在不同阈值概率下,与真阳性相关的收益减去与假阳性相关的危害。结果:我们在呼和浩特和常熟分别入组153例和58例患者。该队列包括28例心衰患者和183例非心衰患者。HF患者胸膜液CCL22水平明显低于非HF患者。呼和浩特队列CCL22的ROC曲线下面积(AUC)为0.85 (95% CI: 0.77 ~ 0.93),常熟队列为0.87 (95% CI: 0.75 ~ 0.98)。联合队列的AUC为0.85 (95% CI: 0.79 ~ 0.92),在阈值为150 ng/mL时,敏感性为0.82 (95% CI: 0.68 ~ 0.93),特异性为0.73 (95% CI: 0.67 ~ 0.79)。DCA显示,在未确诊的胸腔积液患者中,胸膜CCL22检测有潜在的净收益。结论:胸腔积液CCL22可能是hf相关胸腔积液的潜在诊断指标。由于本研究的样本量较小,需要进一步的更大样本量的研究来验证我们的发现。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Pleural fluid C-C class chemokines 22 and pleural effusion due to heart failure: a prospective and double-blind diagnostic accuracy test.

Pleural fluid C-C class chemokines 22 and pleural effusion due to heart failure: a prospective and double-blind diagnostic accuracy test.

Pleural fluid C-C class chemokines 22 and pleural effusion due to heart failure: a prospective and double-blind diagnostic accuracy test.

Pleural fluid C-C class chemokines 22 and pleural effusion due to heart failure: a prospective and double-blind diagnostic accuracy test.

Background: Previous studies have indicated that C-C class chemokine ligand 22 (CCL22) is involved in the pathogenesis of tuberculous pleural effusion and malignant pleural effusion. However, the diagnostic role of pleural fluid CCL22 levels in patients with undiagnosed pleural effusions remains to be elucidated.

Methods: We prospectively recruited patients with undiagnosed pleural effusion who visited two centres (Hohhot and Changshu) in China. Pleural biopsy, microbiological culture and effusion cytology were used to verify the cause of pleural effusion. Pleural fluid CCL22 levels were measured using an ELISA. The diagnostic accuracy of CCL22 for identifying heart failure (HF) was evaluated using a receiver operating characteristic (ROC) curve, and the net benefit of CCL22 was evaluated using decision curve analysis (DCA). Net benefit was defined as the benefit associated with true positives minus the harms associated with false positives at various threshold probabilities.

Results: We enrolled 153 and 58 patients in the Hohhot and Changshu cohorts, respectively. The cohort included 28 patients with HF and 183 patients with non-HF. Patients with HF had significantly lower pleural fluid CCL22 levels than non-HF patients. The area under the ROC curve (AUC) of CCL22 was 0.85 (95% CI: 0.77 to 0.93) in the Hohhot cohort and 0.87 (95% CI: 0.75 to 0.98) in the Changshu cohort. The AUC in the combined cohort was 0.85 (95% CI: 0.79 to 0.92), with a sensitivity of 0.82 (95% CI: 0.68 to 0.93) and a specificity of 0.73 (95% CI: 0.67 to 0.79) at the threshold of 150 ng/mL. DCA revealed a potential net benefit of pleural CCL22 determination in patients with undiagnosed pleural effusions.

Conclusions: Pleural fluid CCL22 may be a potential diagnostic marker for HF-related pleural effusion. Owing to the small sample size of this study, further studies with larger sample sizes are needed to validate our findings.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
BMJ Open Respiratory Research
BMJ Open Respiratory Research RESPIRATORY SYSTEM-
CiteScore
6.60
自引率
2.40%
发文量
95
审稿时长
12 weeks
期刊介绍: BMJ Open Respiratory Research is a peer-reviewed, open access journal publishing respiratory and critical care medicine. It is the sister journal to Thorax and co-owned by the British Thoracic Society and BMJ. The journal focuses on robustness of methodology and scientific rigour with less emphasis on novelty or perceived impact. BMJ Open Respiratory Research operates a rapid review process, with continuous publication online, ensuring timely, up-to-date research is available worldwide. The journal publishes review articles and all research study types: Basic science including laboratory based experiments and animal models, Pilot studies or proof of concept, Observational studies, Study protocols, Registries, Clinical trials from phase I to multicentre randomised clinical trials, Systematic reviews and meta-analyses.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信