Development and Validation of a Scoring System for Early Diagnosis of Malignant Pleural Effusion Based on a Nomogram
BackgroundThe diagnostic value of clinical and laboratory features to differentiate between malignant pleural effusion (MPE) and benign pleural effusion (BPE) has not yet been established.ObjectivesThe present study aimed to develop and validate the diagnostic accuracy of a scoring system based on a...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2021-12-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2021.775079/full |
| _version_ | 1818399491070361600 |
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| author | Aihua Wu Zhigang Liang Songbo Yuan Shanshan Wang Weidong Peng Yijun Mo Jing Yang Yanqing Liu |
| author_facet | Aihua Wu Zhigang Liang Songbo Yuan Shanshan Wang Weidong Peng Yijun Mo Jing Yang Yanqing Liu |
| author_sort | Aihua Wu |
| collection | DOAJ |
| description | BackgroundThe diagnostic value of clinical and laboratory features to differentiate between malignant pleural effusion (MPE) and benign pleural effusion (BPE) has not yet been established.ObjectivesThe present study aimed to develop and validate the diagnostic accuracy of a scoring system based on a nomogram to distinguish MPE from BPE.MethodsA total of 1,239 eligible patients with PE were recruited in this study and randomly divided into a training set and an internal validation set at a ratio of 7:3. Logistic regression analysis was performed in the training set, and a nomogram was developed using selected predictors. The diagnostic accuracy of an innovative scoring system based on the nomogram was established and validated in the training, internal validation, and external validation sets (n = 217). The discriminatory power and the calibration and clinical values of the prediction model were evaluated.ResultsSeven variables [effusion carcinoembryonic antigen (CEA), effusion adenosine deaminase (ADA), erythrocyte sedimentation rate (ESR), PE/serum CEA ratio (CEA ratio), effusion carbohydrate antigen 19-9 (CA19-9), effusion cytokeratin 19 fragment (CYFRA 21-1), and serum lactate dehydrogenase (LDH)/effusion ADA ratio (cancer ratio, CR)] were validated and used to develop a nomogram. The prediction model showed both good discrimination and calibration capabilities for all sets. A scoring system was established based on the nomogram scores to distinguish MPE from BPE. The scoring system showed favorable diagnostic performance in the training set [area under the curve (AUC) = 0.955, 95% confidence interval (CI) = 0.942–0.968], the internal validation set (AUC = 0.952, 95% CI = 0.932–0.973), and the external validation set (AUC = 0.973, 95% CI = 0.956–0.990). In addition, the scoring system achieved satisfactory discriminative abilities at separating lung cancer-associated MPE from tuberculous pleurisy effusion (TPE) in the combined training and validation sets.ConclusionsThe present study developed and validated a scoring system based on seven parameters. The scoring system exhibited a reliable diagnostic performance in distinguishing MPE from BPE and might guide clinical decision-making. |
| first_indexed | 2024-12-14T07:21:31Z |
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| institution | Directory Open Access Journal |
| issn | 2234-943X |
| language | English |
| last_indexed | 2024-12-14T07:21:31Z |
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| series | Frontiers in Oncology |
| spelling | doaj.art-c13a364b666f44ceb79ac6989dfcbdf32022-12-21T23:11:36ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2021-12-011110.3389/fonc.2021.775079775079Development and Validation of a Scoring System for Early Diagnosis of Malignant Pleural Effusion Based on a NomogramAihua Wu0Zhigang Liang1Songbo Yuan2Shanshan Wang3Weidong Peng4Yijun Mo5Jing Yang6Yanqing Liu7Department of Laboratory Medicine, Ningbo First Hospital, Ningbo, ChinaDepartment of Thoracic Surgery, Ningbo First Hospital, Ningbo, ChinaDepartment of Clinical Laboratory, The Affiliated People Hospital of Ningbo University, Ningbo, ChinaDepartment of Laboratory Medicine, Ningbo First Hospital, Ningbo, ChinaDepartment of Respiratory and Critical Care Medicine, The Affiliated People Hospital of Ningbo University, Ningbo, ChinaDepartment of Laboratory Medicine, Ningbo First Hospital, Ningbo, ChinaDepartment of Respiratory and Critical Care Medicine, Ningbo First Hospital, Ningbo, ChinaDepartment of Laboratory Medicine, Ningbo First Hospital, Ningbo, ChinaBackgroundThe diagnostic value of clinical and laboratory features to differentiate between malignant pleural effusion (MPE) and benign pleural effusion (BPE) has not yet been established.ObjectivesThe present study aimed to develop and validate the diagnostic accuracy of a scoring system based on a nomogram to distinguish MPE from BPE.MethodsA total of 1,239 eligible patients with PE were recruited in this study and randomly divided into a training set and an internal validation set at a ratio of 7:3. Logistic regression analysis was performed in the training set, and a nomogram was developed using selected predictors. The diagnostic accuracy of an innovative scoring system based on the nomogram was established and validated in the training, internal validation, and external validation sets (n = 217). The discriminatory power and the calibration and clinical values of the prediction model were evaluated.ResultsSeven variables [effusion carcinoembryonic antigen (CEA), effusion adenosine deaminase (ADA), erythrocyte sedimentation rate (ESR), PE/serum CEA ratio (CEA ratio), effusion carbohydrate antigen 19-9 (CA19-9), effusion cytokeratin 19 fragment (CYFRA 21-1), and serum lactate dehydrogenase (LDH)/effusion ADA ratio (cancer ratio, CR)] were validated and used to develop a nomogram. The prediction model showed both good discrimination and calibration capabilities for all sets. A scoring system was established based on the nomogram scores to distinguish MPE from BPE. The scoring system showed favorable diagnostic performance in the training set [area under the curve (AUC) = 0.955, 95% confidence interval (CI) = 0.942–0.968], the internal validation set (AUC = 0.952, 95% CI = 0.932–0.973), and the external validation set (AUC = 0.973, 95% CI = 0.956–0.990). In addition, the scoring system achieved satisfactory discriminative abilities at separating lung cancer-associated MPE from tuberculous pleurisy effusion (TPE) in the combined training and validation sets.ConclusionsThe present study developed and validated a scoring system based on seven parameters. The scoring system exhibited a reliable diagnostic performance in distinguishing MPE from BPE and might guide clinical decision-making.https://www.frontiersin.org/articles/10.3389/fonc.2021.775079/fullmalignant pleural effusionscoring systemprediction modelnomogramtuberculous pleurisy effusion |
| spellingShingle | Aihua Wu Zhigang Liang Songbo Yuan Shanshan Wang Weidong Peng Yijun Mo Jing Yang Yanqing Liu Development and Validation of a Scoring System for Early Diagnosis of Malignant Pleural Effusion Based on a Nomogram Frontiers in Oncology malignant pleural effusion scoring system prediction model nomogram tuberculous pleurisy effusion |
| title | Development and Validation of a Scoring System for Early Diagnosis of Malignant Pleural Effusion Based on a Nomogram |
| title_full | Development and Validation of a Scoring System for Early Diagnosis of Malignant Pleural Effusion Based on a Nomogram |
| title_fullStr | Development and Validation of a Scoring System for Early Diagnosis of Malignant Pleural Effusion Based on a Nomogram |
| title_full_unstemmed | Development and Validation of a Scoring System for Early Diagnosis of Malignant Pleural Effusion Based on a Nomogram |
| title_short | Development and Validation of a Scoring System for Early Diagnosis of Malignant Pleural Effusion Based on a Nomogram |
| title_sort | development and validation of a scoring system for early diagnosis of malignant pleural effusion based on a nomogram |
| topic | malignant pleural effusion scoring system prediction model nomogram tuberculous pleurisy effusion |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2021.775079/full |
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