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
571P - Dacomitinib in treatment-naïve EGFR-mutant NSCLC patients with multiple brain metastases: Initial efficacy and safety data from a phase II study
Presenter: Yongfeng Yu
Session: Poster Display
Resources:
Abstract
572P - Multivariable five-year survival prediction model for prognosing patients with EGFR-mutated NSCLC treated with EGFR-TKIs
Presenter: Qi-An Wang
Session: Poster Display
Resources:
Abstract
573P - LUMINATE-103: Real-world treatment patterns and outcomes of patients (pts) with epidermal growth factor receptor mutant (EGFR MU), non-squamous (NSQ) locally advanced/metastatic non-small cell lung cancer (a/mNSCLC): Pooled analysis of large US electronic health record (EHR) datasets
Presenter: Byoung Chul Cho
Session: Poster Display
Resources:
Abstract
574P - Efficacy and safety of dacomitinib in treatment-naïve patients with advanced NSCLC harboring uncommon EGFR mutations
Presenter: Lin Wu
Session: Poster Display
Resources:
Abstract
575P - Efficacy and safety of dacomitinib in treatment-naïve patients with advanced NSCLC and brain metastasis: A multicenter cohort study
Presenter: Puyuan Xing
Session: Poster Display
Resources:
Abstract
576P - Clonality of both EGFR and co-occurring TP53 mutations affect the treatment efficacy of the third-generation EGFR-TKIs in advanced-stage EGFR-mutant non-small cell lung cancer
Presenter: Wen Feng Fang
Session: Poster Display
Resources:
Abstract
577P - A study of the efficacy and safety of amivantamab in EGFR exon 20 insertion (E20I) mutations in NSCLC
Presenter: Daeho Choi
Session: Poster Display
Resources:
Abstract
578P - Tyrosine kinase inhibitor treatment of elderly patients with epidermal growth factor receptor mutated advanced non-small cell lung cancer: A multi-institute retrospective study
Presenter: Ling-Jen Hung
Session: Poster Display
Resources:
Abstract
579P - Real-world study of dacomitinib as first-line treatment for patients with EGFR-mutant non-small cell lung cancer
Presenter: Ji Eun Shin
Session: Poster Display
Resources:
Abstract
580P - Efficacy and safety of dacomitinib as first-line treatment for advanced non-small cell lung cancer (NSCLC) patients with epidermal growth factor receptor <italic>(EGFR)</italic> 21L858R mutation: A multicenter, ambispective, consecutive case-series study
Presenter: Shouzheng Wang
Session: Poster Display
Resources:
Abstract