Abstract 525P
Background
To develop a predictive scoring system for the diagnosis of malignant pleural effusion in patients with lung cancer.
Methods
Retrospective analysis of pleural fluid cytology was conducted in lung cancer patients with malignant pleural effusion (MPE) between 2018 and 2020. Multivariable logistic regression was used to explore the potential predictors for MPE. The selected logistic coefficients were transformed into a diagnostic predictive scoring system. Internal validation was done using the bootstrapping procedure.
Results
The data of pleural fluid cytology from 99 lung cancer patients with MPE were analyzed. Sixty-four positive pleural cytology patients were found (64.65%). The predictive indicators included ratio of pleural fluid to serum LDH greater than 0.6, ratio of pleural fluid to serum protein greater than 0.5, pleural fluid LDH > 555 IU/L, and pleural fluid sugar > 60 mg/dL. and double tap for pleural cytology were used for the derivation of the diagnostic prediction model. The score-based model showed that the area under the receiver operating characteristic curve was 0.82 (95% CI 0.72-0.92). The developed MPE score ranged from zero to 17. The cut-off point was 11 with 91.67% of specificity, 59.09% of sensitivity, positive predictive value of 0.93, and negative predictive value of 0.55. The measurement of the calibration was illustrated using a calibration plot (p-value = 0.88 for the Hosmer-Lemeshow based goodness of fit). Internal validation with 1,000 bootstrap resampling showed a good discrimination. Table: 525P
Potential predictors | Odds ratio | 95% CI | p-value | Coefficients | Score |
Pleural fluid LDH ≤555 IU/L | 1 | reference | - | - | 0 |
Pleural fluid LDH >555 IU/L | 14.86 | 1.66-133.08 | 0.016 | 2.7 | 5 |
Pleural fluid sugar ≤60 mg/dL | 1 | reference | - | - | 0 |
Pleural fluid sugar >60 mg/dL | 63.86 | 5.48-743.97 | 0.001 | 4.16 | 7 |
Pleural fluid protein/serum protein ratio ≤ 0.5 | 1 | reference | - | - | 0 |
Pleural fluid protein/serum protein ratio > 0.5 | 1.77 | 0.26-12.14 | 0.561 | 0.57 | 1 |
Pleural fluid LDH/serum LDH ratio ≤ 0.6 | 1 | reference | - | - | 0 |
Pleural fluid LDH/serum LDH ratio > 0.6 | 2.33 | 0.28-19.05 | 0.431 | 0.84 | 1 |
No double tap for pleural cytology | 1 | reference | - | - | 0 |
Double tap for pleural cytology | 5.1 | 1.16-22.40 | 0.031 | 1.63 | 3 |
Conclusions
The MPE-Lung score, as the diagnostic prediction model can be used in planning for more efficient diagnosis of MPE in lung cancer patients.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
16P - Patient and healthcare practitioner preferences in early-stage triple-negative breast cancer treatment: A discrete choice experiment
Presenter: Jiun-I Lai
Session: Poster Display
Resources:
Abstract
17P - Initial outcomes of the ACT Now PRIME CARE for breast cancer: Prevention of Breast canceR (screening/ stage shifting) utilizing Integrated MobilE Clinics and pAtient Reported online Evaluations and Education
Presenter: Herdee Gloriane Luna
Session: Poster Display
Resources:
Abstract
18P - Optimizing premenopausal HR+ HER2–ve eBC management in India: Insights from expert consensus
Presenter: Anitha Ramesh
Session: Poster Display
Resources:
Abstract
19P - Referral patterns among breast cancer patients in county-level hospitals in China
Presenter: Ping Lu
Session: Poster Display
Resources:
Abstract
20P - Real-world treatment of HER2+ and HR+/HER2- early breast cancer in county areas of China
Presenter: Ping Lu
Session: Poster Display
Resources:
Abstract
21P - Duration of breast cancer trials: Analysis of predicted versus actual completion date
Presenter: Daniëlle Verschoor
Session: Poster Display
Resources:
Abstract
22P - Impact of an online Asian genetic risk calculator on risk perception: Cancer-related distress and uptake of genetic counselling among Malaysian breast cancer patients (The ARiCa Study)
Presenter: HEAMANTHAA Padmanabhan
Session: Poster Display
Resources:
Abstract
23P - Consensus statements and expert recommendations for BRCAm breast cancer in the Asia-Pacific region (STREAM-AP)
Presenter: Soo Chin Lee
Session: Poster Display
Resources:
Abstract
24P - Germline genetic testing for hereditary cancer: A retrospective analysis in a single site referral centre in Malaysia
Presenter: Vivian Lee
Session: Poster Display
Resources:
Abstract
25P - Clinical presentations and prognostication of HER2-low breast cancer in Taiwan
Presenter: Bo-Fang Chen
Session: Poster Display
Resources:
Abstract