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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...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
SAGE Publications
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10026088/ https://www.ncbi.nlm.nih.gov/pubmed/36927281 http://dx.doi.org/10.1177/17534666231155745 |
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author | Jiang, Meng-Ping Wen, Jian-Xun Hai, Ling Jiang, Ting-Wang Huang, Jin-Hong Chen, Hong Wang, Ya-Fei Zheng, Wen-Qi Hu, Zhi-De Yan, Li |
author_facet | Jiang, Meng-Ping Wen, Jian-Xun Hai, Ling Jiang, Ting-Wang Huang, Jin-Hong Chen, Hong Wang, Ya-Fei Zheng, Wen-Qi Hu, Zhi-De Yan, Li |
author_sort | Jiang, Meng-Ping |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-10026088 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | SAGE Publications |
record_format | MEDLINE/PubMed |
spelling | pubmed-100260882023-03-21 Diagnostic accuracy of pleural fluid to serum carcinoembryonic antigen ratio and delta value for malignant pleural effusion: findings from two cohorts Jiang, Meng-Ping Wen, Jian-Xun Hai, Ling Jiang, Ting-Wang Huang, Jin-Hong Chen, Hong Wang, Ya-Fei Zheng, Wen-Qi Hu, Zhi-De Yan, Li Ther Adv Respir Dis Original Research 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. SAGE Publications 2023-03-17 /pmc/articles/PMC10026088/ /pubmed/36927281 http://dx.doi.org/10.1177/17534666231155745 Text en © The Author(s), 2023 https://creativecommons.org/licenses/by-nc/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page (https://us.sagepub.com/en-us/nam/open-access-at-sage). |
spellingShingle | Original Research Jiang, Meng-Ping Wen, Jian-Xun Hai, Ling Jiang, Ting-Wang Huang, Jin-Hong Chen, Hong Wang, Ya-Fei Zheng, Wen-Qi Hu, Zhi-De Yan, Li Diagnostic accuracy of pleural fluid to serum carcinoembryonic antigen ratio and delta value for malignant pleural effusion: findings from two cohorts |
title | Diagnostic accuracy of pleural fluid to serum carcinoembryonic
antigen ratio and delta value for malignant pleural effusion: findings from two
cohorts |
title_full | Diagnostic accuracy of pleural fluid to serum carcinoembryonic
antigen ratio and delta value for malignant pleural effusion: findings from two
cohorts |
title_fullStr | Diagnostic accuracy of pleural fluid to serum carcinoembryonic
antigen ratio and delta value for malignant pleural effusion: findings from two
cohorts |
title_full_unstemmed | Diagnostic accuracy of pleural fluid to serum carcinoembryonic
antigen ratio and delta value for malignant pleural effusion: findings from two
cohorts |
title_short | Diagnostic accuracy of pleural fluid to serum carcinoembryonic
antigen ratio and delta value for malignant pleural effusion: findings from two
cohorts |
title_sort | diagnostic accuracy of pleural fluid to serum carcinoembryonic
antigen ratio and delta value for malignant pleural effusion: findings from two
cohorts |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10026088/ https://www.ncbi.nlm.nih.gov/pubmed/36927281 http://dx.doi.org/10.1177/17534666231155745 |
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