Differentiating Malignant from Tubercular Pleural Effusion by Cancer Ratio Plus (Cancer Ratio: Pleural Lymphocyte Count)
Background. We performed prospective validation of the cancer ratio (serum LDH : pleural ADA ratio), previously reported as predictive of malignant effusion retrospectively, and assessed the effect of combining it with “pleural lymphocyte count” in diagnosing malignant pleural effusion (MPE). Method...
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| Format: | Article |
| Language: | English |
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Wiley
2016-01-01
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| Series: | Canadian Respiratory Journal |
| Online Access: | http://dx.doi.org/10.1155/2016/7348239 |
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| author | Akash Verma Rucha S. Dagaonkar Dominic Marshall John Abisheganaden R. W. Light |
| author_facet | Akash Verma Rucha S. Dagaonkar Dominic Marshall John Abisheganaden R. W. Light |
| author_sort | Akash Verma |
| collection | DOAJ |
| description | Background. We performed prospective validation of the cancer ratio (serum LDH : pleural ADA ratio), previously reported as predictive of malignant effusion retrospectively, and assessed the effect of combining it with “pleural lymphocyte count” in diagnosing malignant pleural effusion (MPE). Methods. Prospective cohort study of patients hospitalized with lymphocyte predominant exudative pleural effusion in 2015. Results. 118 patients, 84 (71.2%) having MPE and 34 (28.8%) having tuberculous pleural effusion (TPE), were analysed. In multivariate logistic regression analysis, cancer ratio, serum LDH : pleural fluid lymphocyte count ratio, and “cancer ratio plus” (ratio of cancer ratio and pleural fluid lymphocyte count) correlated positively with MPE. The sensitivity and specificity of cancer ratio, ratio of serum LDH : pleural fluid lymphocyte count, and “cancer ratio plus” were 0.95 (95% CI 0.87–0.98) and 0.85 (95% CI 0.68–0.94), 0.63 (95% CI 0.51–0.73) and 0.85 (95% CI 0.68–0.94), and 97.6 (95% CI 0.90–0.99) and 94.1 (95% CI 0.78–0.98) at the cut-off level of >20, >800, and >30, respectively. Conclusion. Without incurring any additional cost, or requiring additional test, effort, or time, cancer ratio maintained and “cancer ratio plus” improved the specificity of cancer ratio in identifying MPE in the prospective cohort. |
| format | Article |
| id | doaj-art-ed2184d0fdf14ca7bf86e2d5cef5d027 |
| institution | Kabale University |
| issn | 1198-2241 1916-7245 |
| language | English |
| publishDate | 2016-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Canadian Respiratory Journal |
| spelling | doaj-art-ed2184d0fdf14ca7bf86e2d5cef5d0272025-02-03T01:01:41ZengWileyCanadian Respiratory Journal1198-22411916-72452016-01-01201610.1155/2016/73482397348239Differentiating Malignant from Tubercular Pleural Effusion by Cancer Ratio Plus (Cancer Ratio: Pleural Lymphocyte Count)Akash Verma0Rucha S. Dagaonkar1Dominic Marshall2John Abisheganaden3R. W. Light4Department of Respiratory and Critical Care Medicine, Tan Tock Seng Hospital, 308433, SingaporeDepartment of Respiratory and Critical Care Medicine, Tan Tock Seng Hospital, 308433, SingaporeDepartment of Medicine, Imperial College London, London SW7 2AZ, UKDepartment of Respiratory and Critical Care Medicine, Tan Tock Seng Hospital, 308433, SingaporePulmonary Disease Program, Vanderbilt University, 1161 21st Ave. South, Nashville, TN 37232, USABackground. We performed prospective validation of the cancer ratio (serum LDH : pleural ADA ratio), previously reported as predictive of malignant effusion retrospectively, and assessed the effect of combining it with “pleural lymphocyte count” in diagnosing malignant pleural effusion (MPE). Methods. Prospective cohort study of patients hospitalized with lymphocyte predominant exudative pleural effusion in 2015. Results. 118 patients, 84 (71.2%) having MPE and 34 (28.8%) having tuberculous pleural effusion (TPE), were analysed. In multivariate logistic regression analysis, cancer ratio, serum LDH : pleural fluid lymphocyte count ratio, and “cancer ratio plus” (ratio of cancer ratio and pleural fluid lymphocyte count) correlated positively with MPE. The sensitivity and specificity of cancer ratio, ratio of serum LDH : pleural fluid lymphocyte count, and “cancer ratio plus” were 0.95 (95% CI 0.87–0.98) and 0.85 (95% CI 0.68–0.94), 0.63 (95% CI 0.51–0.73) and 0.85 (95% CI 0.68–0.94), and 97.6 (95% CI 0.90–0.99) and 94.1 (95% CI 0.78–0.98) at the cut-off level of >20, >800, and >30, respectively. Conclusion. Without incurring any additional cost, or requiring additional test, effort, or time, cancer ratio maintained and “cancer ratio plus” improved the specificity of cancer ratio in identifying MPE in the prospective cohort.http://dx.doi.org/10.1155/2016/7348239 |
| spellingShingle | Akash Verma Rucha S. Dagaonkar Dominic Marshall John Abisheganaden R. W. Light Differentiating Malignant from Tubercular Pleural Effusion by Cancer Ratio Plus (Cancer Ratio: Pleural Lymphocyte Count) Canadian Respiratory Journal |
| title | Differentiating Malignant from Tubercular Pleural Effusion by Cancer Ratio Plus (Cancer Ratio: Pleural Lymphocyte Count) |
| title_full | Differentiating Malignant from Tubercular Pleural Effusion by Cancer Ratio Plus (Cancer Ratio: Pleural Lymphocyte Count) |
| title_fullStr | Differentiating Malignant from Tubercular Pleural Effusion by Cancer Ratio Plus (Cancer Ratio: Pleural Lymphocyte Count) |
| title_full_unstemmed | Differentiating Malignant from Tubercular Pleural Effusion by Cancer Ratio Plus (Cancer Ratio: Pleural Lymphocyte Count) |
| title_short | Differentiating Malignant from Tubercular Pleural Effusion by Cancer Ratio Plus (Cancer Ratio: Pleural Lymphocyte Count) |
| title_sort | differentiating malignant from tubercular pleural effusion by cancer ratio plus cancer ratio pleural lymphocyte count |
| url | http://dx.doi.org/10.1155/2016/7348239 |
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