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
392TiP - A prospective phase II study of individualized adjuvant therapy in patients with locally advanced hypopharyngeal cancer after neoadjuvant therapy
Presenter: Juyi Wen
Session: Poster Display
Resources:
Abstract
397P - Comparison between Y-site co-infusion versus standard dexamethasone for preventing hypersensitivity reactions from oxaliplatin administration: A randomized controlled trial
Presenter: jarearnjit Phavirunsiri
Session: Poster Display
Resources:
Abstract
398P - Evaluation of the effectiveness of denosumab therapy giant cell tumor of the pelvis
Presenter: Abbos Nurjabov
Session: Poster Display
Resources:
Abstract
399P - Long-term outcomes of patients with gastric cancer who received the best supportive care without any anticancer treatment
Presenter: Yohei Arihara
Session: Poster Display
Resources:
Abstract
401TiP - Oral opioid vs intravenous patient-controlled analgesia (PCA) with hydromorphone bolus-only or continuous infusion to maintain analgesia for severe cancer pain: A randomized phase III trial
Presenter: Cheng Huang
Session: Poster Display
Resources:
Abstract
407P - K-TrackTM: A streamlined personalized assay to detect molecular residual disease in solid tumors
Presenter: Nam Vo
Session: Poster Display
Resources:
Abstract
408P - Increased EGFR and MET expression and corresponding tumor microenvironment (TME) change in hepatocellular carcinoma (HCC) tissues after sorafenib (Sora) treatment
Presenter: Chia Jui Yen
Session: Poster Display
Resources:
Abstract
410P - Systematic evaluation of cell-free DNA fragmentation patterns for cancer diagnosis and enhanced cancer detection through integration of multiple fragmentations
Presenter: Xiangy-Yu Meng
Session: Poster Display
Resources:
Abstract
412P - Multiplex digital spatial profiling (DSP) of protein reveals distinct immune and molecular phenotypes in hepatocellular carcinoma
Presenter: Chia Jui Yen
Session: Poster Display
Resources:
Abstract
413P - Clinical utility of advanced features provided by circulating tumor DNA-based comprehensive genomic profiling
Presenter: Young-gon Kim
Session: Poster Display
Resources:
Abstract