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
238P - Enfortumab-vedotin for metastatic urothelial carcinoma refractory to platinum-based chemotherapy and immune checkpoint inhibitors: A single institution experience
Presenter: Yuki Endo
Session: Poster Display
Resources:
Abstract
239P - Elevated baseline C-reactive protein is a prognostic indicator for OS in patients with metastatic non clear cell renal cell carcinoma treated with systemic therapy
Presenter: Ryuichi Mizuno
Session: Poster Display
Resources:
Abstract
240P - Efficacy and safety of first-line combination therapy with ipilimumab + nivolumab for metastatic renal cell carcinoma in a single institution in Japan
Presenter: Naoya Nagaya
Session: Poster Display
Resources:
Abstract
241P - First-line cabozantinib in metastatic renal cell carcinoma (mRCC): A real-world exploratory study from eastern India
Presenter: Tamojit Chaudhuri
Session: Poster Display
Resources:
Abstract
244P - Clinicopathologic feature and treatment outcome of metastatic non clear cell kidney cancer: A single centre experience from India
Presenter: Somnath Roy
Session: Poster Display
Resources:
Abstract
245P - The role of TGF-β in the formation of the protumor phenotype of circulating neutrophils at different stages of renal cancer
Presenter: Ilseya Myagdieva
Session: Poster Display
Resources:
Abstract
246P - Impact of renal impairment on first-line treatment in metastatic urothelial cancer
Presenter: Stephanie Wakeling
Session: Poster Display
Resources:
Abstract
247P - Adjuvant chemoradiotherapy in the management of bladder adenocarcinoma compared to multiple treatment modalities
Presenter: Othman Mohammed
Session: Poster Display
Resources:
Abstract
248P - Screening zinc homeostasis-related genes identifies metallothionein 1H (MT1H) as a potential prognostic biomarker in clear cell renal cell carcinoma (ccRCC)
Presenter: Eyad Al Masoud
Session: Poster Display
Resources:
Abstract
249P - The prognostic utility of Progestogen associated Endometrial protein (PAEP) gene expression in clear cell renal cell carcinoma (ccRCC)
Presenter: Leen Lataifeh
Session: Poster Display
Resources:
Abstract