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The diagnostic value of pleural fluid homocysteine in malignant pleural effusion
- Source :
- PLoS ONE 14(9): e0222616, RODIN. Repositorio de Objetos de Docencia e Investigación de la Universidad de Cádiz, Agencia Estatal de Meteorología (AEMET), PLoS ONE, Vol 14, Iss 9, p e0222616 (2019), PLoS ONE
- Publication Year :
- 2019
- Publisher :
- PUBLIC LIBRARY SCIENCE, 2019.
-
Abstract
- 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(%) = 100x( 1 +e(-z))(-1), where Z = 0.5471x[ HCY]+0.3846x[ 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.
- Subjects :
- Male
Pulmonology
Homocysteine
endocrine system diseases
Pleural effusion
Normal Distribution
Logistic regression
Biochemistry
Gastroenterology
chemistry.chemical_compound
Mathematical and Statistical Techniques
0302 clinical medicine
Carcinoembryonic antigen
Medicine and Health Sciences
Malignant pleural effusion
030212 general & internal medicine
Child
Aged, 80 and over
education.field_of_study
Multidisciplinary
biology
Statistics
Area under the curve
Middle Aged
Thorax
Body Fluids
Oncology
Child, Preschool
030220 oncology & carcinogenesis
Physical Sciences
Pleurae
Pleura
Regression Analysis
Medicine
Female
Anatomy
Research Article
Adult
medicine.medical_specialty
Adolescent
Science
Population
Research and Analysis Methods
Young Adult
03 medical and health sciences
Diagnostic Medicine
Internal medicine
Cancer Detection and Diagnosis
medicine
Humans
Statistical Methods
education
Aged
Receiver operating characteristic
business.industry
Infant
Biology and Life Sciences
Cancers and Neoplasms
Probability Theory
Probability Distribution
medicine.disease
digestive system diseases
Pleural Effusion, Malignant
Pleural Effusion
Metastatic Tumors
chemistry
biology.protein
business
Biomarkers
Mathematics
Subjects
Details
- Database :
- OpenAIRE
- Journal :
- PLoS ONE 14(9): e0222616, RODIN. Repositorio de Objetos de Docencia e Investigación de la Universidad de Cádiz, Agencia Estatal de Meteorología (AEMET), PLoS ONE, Vol 14, Iss 9, p e0222616 (2019), PLoS ONE
- Accession number :
- edsair.doi.dedup.....97195f87a8a8941f51b9f269d79e9c73