Key result
A multidimensional score incorporating age, glucose, proteins, and lactic acid achieved an area under the curve of 0.915 for differentiating tuberculous from malignant pleural effusion.
Why the study?
Does a diagnostic score including age, glucose, proteins, and lactic acid differentiate tuberculous from malignant pleural effusion in patients with lymphocytic pleural effusion?
Cohort (n=82)
No
Does a diagnostic score including age, glucose, proteins, and lactic acid differentiate tuberculous from malignant pleural effusion in patients with lymphocytic pleural effusion?
Effect estimate: AUC 0.915 (95% CI 0.825-0.968)
p-value: p=<0.001
A novel diagnostic score using age, glucose, proteins, and lactic acid demonstrates high accuracy in differentiating tuberculous from malignant lymphocytic pleural effusions.
May aid differentiation of tuberculous from malignant lymphocytic effusions; leaves open external validation before clinical adoption.
Differential diagnosis of lymphocytic pleural effusions between tuberculous (TBE) and malignant (ME) effusion is usually difficult in daily practice. Our aim was to develop a score to differentiate TBE from ME effusions. A cohort of 138 consecutive patients with pleural effusion was prospectively studied from May 2014 through June 2017. Glucose, lactate dehydrogenase (LDH), proteins, white cell count, lactic acid, and pH in the pleural fluid were measured. Pleural effusions other than lymphocytic, patients with a final diagnosis other than tuberculosis or malignancy, and patients who met Light's criteria for transudate were excluded. Eighty-two samples (47 TBE and 35 ME) were included in the analysis. Using logistic regression analysis and Wald test, we developed a score including age, glucose, proteins, and lactic acid. The receiver operating characteristic curve (ROC) for the score was determined, and the area under the curve (AUC) was calculated. A cutoff of eight points was required to achieve 93.5% sensitivity, 78% specificity, and a likelihood ratio of 4.26 to distinguish tuberculosis from malignant pleural effusion. The AUC of the score was 0.915 (95% CI = 0.82⁻0.96).
No takes yet. Share an insight, caveat, or question.
González et al. (2019) conducted a cohort in Lymphocytic pleural effusion (n=82). Multidimensional diagnostic score (age, glucose, proteins, lactic acid) vs. Gold standard diagnosis (culture/biopsy for tuberculosis vs cytology/biopsy for malignancy) was evaluated on Diagnostic accuracy (AUC) for differentiating tuberculous from malignant pleural effusion (AUC 0.915, 95% CI 0.825-0.968, p=<0.001). A multidimensional score incorporating age, glucose, proteins, and lactic acid achieved an area under the curve of 0.915 for differentiating tuberculous from malignant pleural effusion.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: