PDF(Pubmed)
Abstract：
UNASSIGNED: Serum carbohydrate antigen 50 (CA50) is an auxiliary diagnostic marker for various solid tumors, but it remains unclear whether CA50 in pleural fluid can assist in the diagnosis of malignant pleural effusion (MPE). This study aimed to evaluate the diagnostic accuracy of pleural fluid CA50 for MPE in pleural effusion patients with undetermined causes.
UNASSIGNED: This study prospectively recruited pleural effusion patients with undetermined causes who visited the Affiliated Hospital of Inner Mongolia Medical University between September 2018 and July 2021. We measured pleural fluid CA50 level with an electrochemiluminescence assay. We analyzed the diagnostic accuracy of CA50 and carcinoembryonic antigen (CEA) for MPE with the receiver operating characteristic (ROC) curve. The net benefits of CA50 and CEA were analyzed using the decision curve analysis (DCA).
UNASSIGNED: We enrolled 66 MPEs and 87 benign pleural effusions (BPEs). MPE patients had significantly higher CA50 and CEA than BPE patients. The area under the ROC curve (AUC) of CA50 was 0.72 (95% CI: 0.63-0.80). CA50 had a sensitivity of 0.30 (95% CI: 0.19-0.41) and a specificity of 1.00 (95% CI: 1.00-1.00) at the threshold of 15 IU/mL. The decision curve of CA50 was above the reference line at the calculated risk probability of between 0.30 and 1.00. Venn diagram indicated that some patients with low CEA (<50 or <150 ng/mL) and/or negative cytology can be identified by positive CA50 (>15 IU/mL).
UNASSIGNED: Pleural fluid CA50 has moderate accuracy and net benefit for detecting MPE. CA50 >15 IU/mL can be used to diagnose MPE. The combination of CA50 and CEA improves the diagnostic sensitivity for MPE.
UNASSIGNED: This study prospectively recruited pleural effusion patients with undetermined causes who visited the Affiliated Hospital of Inner Mongolia Medical University between September 2018 and July 2021. We measured pleural fluid CA50 level with an electrochemiluminescence assay. We analyzed the diagnostic accuracy of CA50 and carcinoembryonic antigen (CEA) for MPE with the receiver operating characteristic (ROC) curve. The net benefits of CA50 and CEA were analyzed using the decision curve analysis (DCA).
UNASSIGNED: We enrolled 66 MPEs and 87 benign pleural effusions (BPEs). MPE patients had significantly higher CA50 and CEA than BPE patients. The area under the ROC curve (AUC) of CA50 was 0.72 (95% CI: 0.63-0.80). CA50 had a sensitivity of 0.30 (95% CI: 0.19-0.41) and a specificity of 1.00 (95% CI: 1.00-1.00) at the threshold of 15 IU/mL. The decision curve of CA50 was above the reference line at the calculated risk probability of between 0.30 and 1.00. Venn diagram indicated that some patients with low CEA (<50 or <150 ng/mL) and/or negative cytology can be identified by positive CA50 (>15 IU/mL).
UNASSIGNED: Pleural fluid CA50 has moderate accuracy and net benefit for detecting MPE. CA50 >15 IU/mL can be used to diagnose MPE. The combination of CA50 and CEA improves the diagnostic sensitivity for MPE.
摘要：
■血清碳水化合物抗原50（CA50）是各种实体瘤的辅助诊断标记，但目前尚不清楚胸腔积液中的CA50是否有助于诊断恶性胸腔积液（MPE）。本研究旨在评估胸腔积液CA50对不明原因胸腔积液患者MPE的诊断准确性。
■本研究前瞻性招募2018年9月至2021年7月在内蒙古医科大学附属医院就诊的不明原因胸腔积液患者。我们用电化学发光测定法测量胸膜液CA50水平。我们用受试者工作特征（ROC）曲线分析了CA50和癌胚抗原（CEA）对MPE的诊断准确性。使用决策曲线分析(DCA)分析CA50和CEA的净益处。
■我们纳入了66例MPE和87例良性胸腔积液（BPE）。MPE患者的CA50和CEA明显高于BPE患者。CA50的ROC曲线下面积（AUC）为0.72（95％CI：0.63-0.80）。在阈值为15IU/mL时，CA50的敏感性为0.30（95％CI：0.19-0.41），特异性为1.00（95％CI：1.00-1.00）。在0.30和1.00之间的计算风险概率下，CA50的决策曲线高于参考线。维恩图表明，一些CEA低（<50或<150ng/mL）和/或细胞学阴性的患者可以通过CA50阳性（>15IU/mL）进行鉴定。
■胸膜液CA50具有中等的准确性和检测MPE的净收益。CA50>15IU/mL可用于诊断MPE。CA50和CEA的组合提高了MPE的诊断灵敏度。
■本研究前瞻性招募2018年9月至2021年7月在内蒙古医科大学附属医院就诊的不明原因胸腔积液患者。我们用电化学发光测定法测量胸膜液CA50水平。我们用受试者工作特征（ROC）曲线分析了CA50和癌胚抗原（CEA）对MPE的诊断准确性。使用决策曲线分析(DCA)分析CA50和CEA的净益处。
■我们纳入了66例MPE和87例良性胸腔积液（BPE）。MPE患者的CA50和CEA明显高于BPE患者。CA50的ROC曲线下面积（AUC）为0.72（95％CI：0.63-0.80）。在阈值为15IU/mL时，CA50的敏感性为0.30（95％CI：0.19-0.41），特异性为1.00（95％CI：1.00-1.00）。在0.30和1.00之间的计算风险概率下，CA50的决策曲线高于参考线。维恩图表明，一些CEA低（<50或<150ng/mL）和/或细胞学阴性的患者可以通过CA50阳性（>15IU/mL）进行鉴定。
■胸膜液CA50具有中等的准确性和检测MPE的净收益。CA50>15IU/mL可用于诊断MPE。CA50和CEA的组合提高了MPE的诊断灵敏度。
