Impact of pericardial fluid glucose level and computed tomography attenuation values on diagnosis of malignancy-related pericardial effusion
Abstract Background We evaluated malignancy according to the characteristics of pericardial fluid in symptomatic Japanese patients undergoing pericardiocentesis and computed tomography (CT). Methods This was a retrospective, single-center, observational study of 125 symptomatic patients undergoing p...
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| Format: | Article |
| Language: | English |
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BMC
2021-06-01
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| Series: | BMC Cardiovascular Disorders |
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| Online Access: | https://doi.org/10.1186/s12872-021-02091-6 |
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| author | Takashi Nakamura Mana Okune Masakazu Yasuda Heitaro Watanabe Masafumi Ueno Kenji Yamaji Kazuki Mizutani Takashi Kurita Gaku Nakazawa |
| author_facet | Takashi Nakamura Mana Okune Masakazu Yasuda Heitaro Watanabe Masafumi Ueno Kenji Yamaji Kazuki Mizutani Takashi Kurita Gaku Nakazawa |
| author_sort | Takashi Nakamura |
| collection | DOAJ |
| description | Abstract Background We evaluated malignancy according to the characteristics of pericardial fluid in symptomatic Japanese patients undergoing pericardiocentesis and computed tomography (CT). Methods This was a retrospective, single-center, observational study of 125 symptomatic patients undergoing pericardiocentesis. The patients were classified into two groups: a malignancy group and a non-malignancy group, according to the primary disease and cytology of the pericardial effusion (PE). We compared the pericardial fluid sample and CT measurements between both groups. Results All patients were diagnosed as having exudative PE by Light’s criteria. PE with malignant cells was demonstrated in 76.8% of the malignancy group patients. Pericardial to serum lactate dehydrogenase (LDH) ratio > 0.6, as one of Light’s criteria, was associated with malignancy (p = 0.017). Lower serum brain natriuretic peptide (BNP) concentration was also associated with malignancy (BNP: 126.9 ± 89.8 pg/ml vs 409.2 ± 97.7 pg/ml, malignancy vs non-malignancy groups, respectively; p = 0.037). A significant difference was observed in pericardial fluid glucose level between the malignancy and non-malignancy groups (pericardial fluid glucose: 78.24 ± 48.29 mg/dl vs 98.41 ± 44.85, respectively; p = 0.048). Moreover, CT attenuation values (Hounsfield units (HU)) tended to be higher in the malignancy group vs the non-malignancy group (22.7 [interquartile range (IQR), 17.4–26.0] vs 17.4 [IQR, 13.7–26.4], respectively; p = 0.08). The sensitivity and specificity of pericardial fluid glucose level ≤ 70 mg/dl and CT attenuation values > 20 HU were 40.9% and 89.6%, respectively, in the malignancy group. The positive- and negative predictive values of pericardial fluid glucose level ≤ 70 mg/dl and CT attenuation values > 20 HU were 85.7% and 50.0%, respectively, in the malignancy group. Pericardial fluid glucose level ≤ 70 mg/dl and CT attenuation values > 20 HU were cutoff values associated with malignancy (p = 0.012). Conclusions Lower pericardial fluid glucose level with higher CT attenuation values may suggest malignancy-related PE. |
| first_indexed | 2024-12-16T23:21:43Z |
| format | Article |
| id | doaj.art-ff7a4084ad2840a1a3c22d6c4f8b2b6e |
| institution | Directory Open Access Journal |
| issn | 1471-2261 |
| language | English |
| last_indexed | 2024-12-16T23:21:43Z |
| publishDate | 2021-06-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Cardiovascular Disorders |
| spelling | doaj.art-ff7a4084ad2840a1a3c22d6c4f8b2b6e2022-12-21T22:12:10ZengBMCBMC Cardiovascular Disorders1471-22612021-06-0121111010.1186/s12872-021-02091-6Impact of pericardial fluid glucose level and computed tomography attenuation values on diagnosis of malignancy-related pericardial effusionTakashi Nakamura0Mana Okune1Masakazu Yasuda2Heitaro Watanabe3Masafumi Ueno4Kenji Yamaji5Kazuki Mizutani6Takashi Kurita7Gaku Nakazawa8Division of Cardiology, Department of Internal Medicine, Kindai University Faculty of MedicineDivision of Cardiology, Department of Internal Medicine, Kindai University Faculty of MedicineDivision of Cardiology, Department of Internal Medicine, Kindai University Faculty of MedicineDivision of Cardiology, Department of Internal Medicine, Kindai University Faculty of MedicineDivision of Cardiology, Department of Internal Medicine, Kindai University Faculty of MedicineDivision of Cardiology, Department of Internal Medicine, Kindai University Faculty of MedicineDivision of Cardiology, Department of Internal Medicine, Kindai University Faculty of MedicineDivision of Cardiology, Department of Internal Medicine, Kindai University Faculty of MedicineDivision of Cardiology, Department of Internal Medicine, Kindai University Faculty of MedicineAbstract Background We evaluated malignancy according to the characteristics of pericardial fluid in symptomatic Japanese patients undergoing pericardiocentesis and computed tomography (CT). Methods This was a retrospective, single-center, observational study of 125 symptomatic patients undergoing pericardiocentesis. The patients were classified into two groups: a malignancy group and a non-malignancy group, according to the primary disease and cytology of the pericardial effusion (PE). We compared the pericardial fluid sample and CT measurements between both groups. Results All patients were diagnosed as having exudative PE by Light’s criteria. PE with malignant cells was demonstrated in 76.8% of the malignancy group patients. Pericardial to serum lactate dehydrogenase (LDH) ratio > 0.6, as one of Light’s criteria, was associated with malignancy (p = 0.017). Lower serum brain natriuretic peptide (BNP) concentration was also associated with malignancy (BNP: 126.9 ± 89.8 pg/ml vs 409.2 ± 97.7 pg/ml, malignancy vs non-malignancy groups, respectively; p = 0.037). A significant difference was observed in pericardial fluid glucose level between the malignancy and non-malignancy groups (pericardial fluid glucose: 78.24 ± 48.29 mg/dl vs 98.41 ± 44.85, respectively; p = 0.048). Moreover, CT attenuation values (Hounsfield units (HU)) tended to be higher in the malignancy group vs the non-malignancy group (22.7 [interquartile range (IQR), 17.4–26.0] vs 17.4 [IQR, 13.7–26.4], respectively; p = 0.08). The sensitivity and specificity of pericardial fluid glucose level ≤ 70 mg/dl and CT attenuation values > 20 HU were 40.9% and 89.6%, respectively, in the malignancy group. The positive- and negative predictive values of pericardial fluid glucose level ≤ 70 mg/dl and CT attenuation values > 20 HU were 85.7% and 50.0%, respectively, in the malignancy group. Pericardial fluid glucose level ≤ 70 mg/dl and CT attenuation values > 20 HU were cutoff values associated with malignancy (p = 0.012). Conclusions Lower pericardial fluid glucose level with higher CT attenuation values may suggest malignancy-related PE.https://doi.org/10.1186/s12872-021-02091-6Pericardial effusionPericardial fluid glucose levelMalignancyCT attenuation values |
| spellingShingle | Takashi Nakamura Mana Okune Masakazu Yasuda Heitaro Watanabe Masafumi Ueno Kenji Yamaji Kazuki Mizutani Takashi Kurita Gaku Nakazawa Impact of pericardial fluid glucose level and computed tomography attenuation values on diagnosis of malignancy-related pericardial effusion BMC Cardiovascular Disorders Pericardial effusion Pericardial fluid glucose level Malignancy CT attenuation values |
| title | Impact of pericardial fluid glucose level and computed tomography attenuation values on diagnosis of malignancy-related pericardial effusion |
| title_full | Impact of pericardial fluid glucose level and computed tomography attenuation values on diagnosis of malignancy-related pericardial effusion |
| title_fullStr | Impact of pericardial fluid glucose level and computed tomography attenuation values on diagnosis of malignancy-related pericardial effusion |
| title_full_unstemmed | Impact of pericardial fluid glucose level and computed tomography attenuation values on diagnosis of malignancy-related pericardial effusion |
| title_short | Impact of pericardial fluid glucose level and computed tomography attenuation values on diagnosis of malignancy-related pericardial effusion |
| title_sort | impact of pericardial fluid glucose level and computed tomography attenuation values on diagnosis of malignancy related pericardial effusion |
| topic | Pericardial effusion Pericardial fluid glucose level Malignancy CT attenuation values |
| url | https://doi.org/10.1186/s12872-021-02091-6 |
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