胸膜液与血清癌胚抗原比值和δ值对恶性胸腔积液的诊断准确性:来自两个队列的发现。

IF 3.3 3区 医学 Q2 RESPIRATORY SYSTEM
Meng-Ping Jiang, Jian-Xun Wen, Ling Hai, Ting-Wang Jiang, Jin-Hong Huang, Hong Chen, Ya-Fei Wang, Wen-Qi Zheng, Zhi-De Hu, Li Yan
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引用次数: 2

摘要

背景:胸膜液癌胚抗原(CEA)是恶性胸腔积液(MPE)被广泛应用的诊断标志物。近年来的研究表明,血清CEA的PF值也是MPE的一个有希望的诊断参数。目的:探讨PF与血清CEA比值及δ CEA (PF减去血清CEA)对MPE诊断的附加价值。方法:回顾性队列(BUFF)和前瞻性队列(SIMPLE)纳入胸腔积液患者。从病历中提取患者的临床特征。通过受试者工作特征(ROC)曲线、净重分类改善(NRI)和综合判别改善(IDI)评估CEA比值和δ CEA的诊断价值。结果:BUFF队列共纳入148例患者,SIMPLE队列共纳入164例患者。BUFF队列有46例MPE患者和102例良性胸腔积液(BPE)患者,SIMPLE队列有85例MPE患者和79例BPE患者。在这两个队列中,MPE患者的pfcea、血清CEA、CEA比率和δ CEA均显著升高。在BUFF队列中,PF CEA、CEA ratio和delta CEA的ROC曲线下面积(auc)分别为0.78 (95% CI: 0.67-0.88)、0.80 (95% CI: 0.72-0.89)和0.83 (95% CI: 0.75-0.91), SIMPLE队列中分别为0.89 (95% CI: 0.83-0.94)、0.86 (95% CI: 0.80-0.92)和0.84 (95% CI: 0.78-0.91)。PF CEA、CEA比值、δ CEA的aus差异无统计学意义。结论:CEA比值和δ值不能对PF CEA提供附加诊断价值。临床不应采用同时测定血清和PF CEA的方法。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Diagnostic accuracy of pleural fluid to serum carcinoembryonic antigen ratio and delta value for malignant pleural effusion: findings from two cohorts.

Diagnostic accuracy of pleural fluid to serum carcinoembryonic antigen ratio and delta value for malignant pleural effusion: findings from two cohorts.

Diagnostic accuracy of pleural fluid to serum carcinoembryonic antigen ratio and delta value for malignant pleural effusion: findings from two cohorts.

Diagnostic accuracy of pleural fluid to serum carcinoembryonic antigen ratio and delta value for malignant pleural effusion: findings from two cohorts.

Background: Pleural fluid (PF) carcinoembryonic antigen (CEA) is a widely used diagnostic marker for malignant pleural effusion (MPE). Recent studies revealed that PF to serum CEA was also a promising diagnostic parameter for MPE.

Objective: We aimed to investigate whether PF to serum CEA ratio and delta CEA (PF minus serum CEA) provided added value to PF CEA in diagnosing MPE.

Methods: Patients with pleural effusion in a retrospective cohort (BUFF) and a prospective cohort (SIMPLE) were included. The clinical characteristics of the patients were extracted from their medical records. The diagnostic value of CEA ratio and delta CEA was estimated by a receiver operating characteristics (ROC) curve, net reclassification improvement (NRI), and integrated discrimination improvement (IDI).

Results: A total of 148 patients in the BUFF cohort and 164 patients in the SIMPLE cohort were enrolled. The BUFF cohort had 46 MPE patients and 102 benign pleural effusion (BPE) patients, and the SIMPLE cohort had 85 MPE patients and 79 BPE patients. In both cohorts, MPE patients had significantly higher PF CEA, serum CEA, CEA ratio, and delta CEA. The area under ROC curves (AUCs) of PF CEA, CEA ratio, and delta CEA were 0.78 (95% CI: 0.67-0.88), 0.80 (95% CI: 0.72-0.89) and 0.83 (95% CI: 0.75-0.91) in the BUFF cohort, and 0.89 (95% CI: 0.83-0.94), 0.86 (95% CI: 0.80-0.92), and 0.84 (95% CI: 0.78-0.91) in the SIMPLE cohort. The differences between the AUCs of PF CEA, CEA ratio, and delta CEA did not reach statistical significance. The continuous NRI and IDI of CEA ratio and delta CEA were <0.

Conclusion: CEA ratio and delta value cannot provide added diagnostic value to PF CEA. The simultaneous determination of serum and PF CEA should not be adopted in clinical practice.

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来源期刊
CiteScore
6.90
自引率
0.00%
发文量
57
审稿时长
15 weeks
期刊介绍: Therapeutic Advances in Respiratory Disease delivers the highest quality peer-reviewed articles, reviews, and scholarly comment on pioneering efforts and innovative studies across all areas of respiratory disease.
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