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Abstract：
BACKGROUND: This study aimed to establish and validate a novel scoring system based on a nomogram for the differential diagnosis of malignant pleural effusion (MPE) and benign pleural effusion (BPE).
METHODS: Patients with PE and confirmed aetiology who underwent diagnostic thoracentesis were included in this study. One retrospective set (N = 1261) was used to develop and internally validate the predictive model. The clinical, radiological and laboratory features were collected and subjected to logistic regression analyses. The primary predictive model was displayed as a nomogram and then modified into a novel scoring system, which was externally validated in an independent set (N = 172).
RESULTS: The novel scoring system was composed of fever (3 points), erythrocyte sedimentation rate (4 points), effusion adenosine deaminase (7 points), serum carcinoembryonic antigen (CEA) (4 points), effusion CEA (10 points) and effusion/serum CEA (8 points). With a cutoff value of 15 points, the area under the curve, specificity and sensitivity for identifying MPE were 0.913, 89.10%, and 82.63%, respectively, in the training set, 0.922, 93.48%, 81.51%, respectively, in the internal validation set and 0.912, 87.61%, 81.36%, respectively, in the external validation set. Moreover, this scoring system was exclusively applied to distinguish lung cancer with PE from tuberculous pleurisy and showed a favourable diagnostic performance in the training and validation sets.
CONCLUSIONS: This novel scoring system was developed from a retrospective study and externally validated in an independent set based on six easily accessible clinical variables, and it exhibited good diagnostic performance for identifying MPE.
BACKGROUND: NFSC grants (no. 81572942, no. 81800094).
METHODS: Patients with PE and confirmed aetiology who underwent diagnostic thoracentesis were included in this study. One retrospective set (N = 1261) was used to develop and internally validate the predictive model. The clinical, radiological and laboratory features were collected and subjected to logistic regression analyses. The primary predictive model was displayed as a nomogram and then modified into a novel scoring system, which was externally validated in an independent set (N = 172).
RESULTS: The novel scoring system was composed of fever (3 points), erythrocyte sedimentation rate (4 points), effusion adenosine deaminase (7 points), serum carcinoembryonic antigen (CEA) (4 points), effusion CEA (10 points) and effusion/serum CEA (8 points). With a cutoff value of 15 points, the area under the curve, specificity and sensitivity for identifying MPE were 0.913, 89.10%, and 82.63%, respectively, in the training set, 0.922, 93.48%, 81.51%, respectively, in the internal validation set and 0.912, 87.61%, 81.36%, respectively, in the external validation set. Moreover, this scoring system was exclusively applied to distinguish lung cancer with PE from tuberculous pleurisy and showed a favourable diagnostic performance in the training and validation sets.
CONCLUSIONS: This novel scoring system was developed from a retrospective study and externally validated in an independent set based on six easily accessible clinical variables, and it exhibited good diagnostic performance for identifying MPE.
BACKGROUND: NFSC grants (no. 81572942, no. 81800094).
摘要：
背景：本研究旨在建立并验证一种基于列线图的新型评分系统，用于恶性胸腔积液（MPE）和良性胸腔积液（BPE）的鉴别诊断。
方法：本研究纳入了肺栓塞患者和确诊的病因，并接受了诊断性胸腔穿刺术。使用一个回顾性集(N=1261)来开发和内部验证预测模型。临床，收集放射学和实验室特征并进行逻辑回归分析.主要预测模型显示为列线图，然后修改为新的评分系统，在一个独立的集合中进行了外部验证(N=172)。
结果：新颖的评分系统由发烧（3分）组成，红细胞沉降率（4分），积液腺苷脱氨酶（7分），血清癌胚抗原（CEA）（4分），积液CEA(10分)和积液/血清CEA(8分)。截止值为15点，曲线下的面积,鉴定MPE的特异性和敏感性分别为0.913，89.10%，和82.63%，分别,在训练集中，0.922,93.48%,81.51%,分别,在内部验证集中，0.912、87.61%，81.36%，分别,在外部验证集中。此外，该评分系统仅用于区分肺癌合并PE和结核性胸膜炎,并在训练集和验证集中显示出良好的诊断表现.
结论：这种新颖的评分系统是根据回顾性研究开发的，并基于六个易于获取的临床变量在独立的集合中进行了外部验证。它在识别MPE方面表现出良好的诊断性能。
背景：NFSC授权（编号：81572942号81800094)。
方法：本研究纳入了肺栓塞患者和确诊的病因，并接受了诊断性胸腔穿刺术。使用一个回顾性集(N=1261)来开发和内部验证预测模型。临床，收集放射学和实验室特征并进行逻辑回归分析.主要预测模型显示为列线图，然后修改为新的评分系统，在一个独立的集合中进行了外部验证(N=172)。
结果：新颖的评分系统由发烧（3分）组成，红细胞沉降率（4分），积液腺苷脱氨酶（7分），血清癌胚抗原（CEA）（4分），积液CEA(10分)和积液/血清CEA(8分)。截止值为15点，曲线下的面积,鉴定MPE的特异性和敏感性分别为0.913，89.10%，和82.63%，分别,在训练集中，0.922,93.48%,81.51%,分别,在内部验证集中，0.912、87.61%，81.36%，分别,在外部验证集中。此外，该评分系统仅用于区分肺癌合并PE和结核性胸膜炎,并在训练集和验证集中显示出良好的诊断表现.
结论：这种新颖的评分系统是根据回顾性研究开发的，并基于六个易于获取的临床变量在独立的集合中进行了外部验证。它在识别MPE方面表现出良好的诊断性能。
背景：NFSC授权（编号：81572942号81800094)。
