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
540P - Phase III study of serplulimab plus chemotherapy as first-line therapy for advanced squamous non-small cell lung cancer: ASTRUM-004 Asian subgroup
Presenter: Caicun Zhou
Session: Poster Display
Resources:
Abstract
541P - Integrated analysis of randomized controlled trials IMpower130 and IMpower132 for advanced non-squamous non-small cell lung cancer (NSCLC)
Presenter: Hibiki Udagawa
Session: Poster Display
Resources:
Abstract
542P - First-line HLX07 plus serplulimab with or without chemotherapy versus serplulimab plus chemotherapy in advanced/recurrent squamous non-small cell lung cancer: A phase II study
Presenter: Zhen Wang
Session: Poster Display
Resources:
Abstract
543P - A multicenter retrospective study to investigate risk factors for immune checkpoint inhibitor-induced pneumonitis in non-small cell lung cancer patients with comorbid interstitial pneumonia
Presenter: Yuriko Ishida
Session: Poster Display
Resources:
Abstract
544P - Single cell level investigation of blood cells representing immune checkpoint inhibitor response in lung adenocarcinoma patients
Presenter: Juyong Seong
Session: Poster Display
Resources:
Abstract
545P - Completion of pembrolizumab in advanced non-small cell lung cancer: Real-world outcomes after two years of therapy (COPILOT)
Presenter: Andrew Fantoni
Session: Poster Display
Resources:
Abstract
546P - Combination therapy with anti-PD-1 antibody plus angiokinase inhibitor exerts synergistic antitumor effect against malignant mesothelioma via tumor microenvironment modulation
Presenter: Akio Tada
Session: Poster Display
Resources:
Abstract
547P - Immunotherapy outcome in advanced/metastatic lung cancer patients in real-world experience: Indian data
Presenter: Naveen K
Session: Poster Display
Resources:
Abstract
548P - B-Myb acts as a mentor instant promoter in non-small cell lung cancer by modifying the PD-1/PD-L1 axis
Presenter: Pan Xu
Session: Poster Display
Resources:
Abstract
549P - Drug-induced interstitial lung disease in patients with non-small cell lung cancer treated with immunotherapy for postoperative recurrence: Evaluation of CT findings and histopathological findings of the background lung
Presenter: shodai fujimoto
Session: Poster Display
Resources:
Abstract