Key result
Higher pleural effusion TK1 distinguishes malignant from benign effusions with ~89% sensitivity.
Why the study?
The effectiveness of thymidine kinase 1 concentration in pleural effusion for diagnosis and management of malignant pleural effusion was unclear.
Does pleural effusion TK1 concentration improve diagnosis and predict survival in patients with malignant pleural effusion?
Observational (n=210)
Does pleural effusion TK1 concentration improve diagnosis and predict survival in patients with malignant pleural effusion?
Pleural effusion TK1 concentration is a useful diagnostic biomarker and independent prognostic predictor for malignant pleural effusion.
OBJECTIVE: Thymidine kinase 1 (TK1) is a key enzyme in the pyrimidine salvage pathway. Increased TK1 concentration correlates with cell division. TK1 is an emerging biomarker in cancer diagnosis; however, its effectiveness in diagnosis and management for malignant pleural effusion (MPE) is unclear. We evaluated the diagnostic efficiency and prognostic value of pleural effusion TK1 (pTK1) concentration for MPE. METHODS: From 2013 to 2017, 210 pleural effusion samples were collected from 160 patients diagnosed with MPE and 50 patients diagnosed with benign pleural effusion (BPE). TK1 concentrations in pleural effusion were measured by chemiluminescence dot blot assays. The median follow-up was 12 months. We constructed a receiver-operating characteristic (ROC) curve to find the optimal cutoff value for MPE diagnosis. The hazard ratios were estimated using a multivariable Cox proportional hazard model. A nomogram was drawn to illustrate the prognostic characteristics of MPE. RESULTS: The TK1 concentration in pleural effusion was significantly higher in MPE than BPE (P < 0.001), and patients with MPE could be distinguished by an optimal cutoff value of 3.10 pmol/L with a sensitivity of 0.894 and a specificity of 0.800. The multivariate analysis suggested that pTK1 concentration was an independent predictor of survival in patients with MPE. CONCLUSIONS: The diagnostic and prognostic prediction of MPE may be improved by measuring pTK1 concentration and utilizing a multivariate nomogram.
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Tian et al. (2019) conducted an observational in Malignant pleural effusion (n=210). Pleural effusion Thymidine kinase 1 (pTK1) concentration vs. Benign pleural effusion (BPE) was evaluated on Diagnosis of malignant pleural effusion (Sensitivity 0.894, Specificity 0.800, p=<0.001). Pleural effusion TK1 concentration was significantly higher in malignant than benign effusions (P<0.001), distinguishing MPE with 0.894 sensitivity and 0.800 specificity at a 3.10 pmol/L cutoff.
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