dc.contributor.author | Saraya, Takeshi | |
dc.contributor.author | Ohkuma, Kosuke | |
dc.contributor.author | Koide, Takashi | |
dc.contributor.author | Goto, Hajime | |
dc.contributor.author | Takizawa, Hajime | |
dc.contributor.author | Light, Richard W. | |
dc.date.accessioned | 2020-04-22T20:42:24Z | |
dc.date.available | 2020-04-22T20:42:24Z | |
dc.date.issued | 2019-03 | |
dc.identifier.citation | Saraya, T., Ohkuma, K., Koide, T., Goto, H., Takizawa, H., & Light, R.W. (2019). A novel diagnostic method for distinguishing parapneumonic effusion and empyema from other diseases by using the pleural lactate dehydrogenase to adenosine deaminase ratio and carcinoembryonic antigen levels. Medicine, 98. | en_US |
dc.identifier.issn | 0025-7974 | |
dc.identifier.uri | http://hdl.handle.net/1803/9949 | |
dc.description.abstract | Pleural effusions are a common medical problem not only for pulmonologists but also for general physicians, often needing thoracentesis for a definite diagnosis. However, thoracentesis cannot always reveal malignant cells or microbiological evidence.
In this context, we prospectively enrolled a total of 289 patients with pleural effusions due to diverse etiologies: parapneumonic effusion (PPE) (63), empyema (22), tuberculous pleural effusion (TBPE) (54), malignant pleural effusion (MPE) (140), or chronic renal failure (CRF)/congestive heart failure (CHF) (10). The MPE group consisted of lung cancer (adenocarcinoma, n=90; squamous cell carcinoma, n=5; small cell carcinoma, n=4), malignant lymphoma (n=17), malignant mesothelioma (n=11), malignant melanoma (n=3), and metastasis from other organs (n=10).
This study demonstrated that the pleural lactate dehydrogenase (LDH) to adenosine deaminase (ADA) ratios differed significantly between patients with CHF/CRF, MPE, TBPE, empyema, and PPE. We discovered a simple method to differentiate pleural diseases based on the pleural LDH to ADA ratio and carcinoembryonic antigen (CEA). A pleural LDH to ADA ratio greater than 15.5 and a pleural CEA level of less than 5ng/mL is indicative of PPE or empyema rather than TBPE, MPE, or transudative pleural effusion (CRF, CHF).
This method has a sensitivity of 62.0%, a specificity of 91.0%, and an area under the receiver operating characteristic curve of 0.765 (95% confidence interval [CI]: 0678-0.852, P<.001), odds ratio of 16.6 (95% CI: 7.28-37.8, P<.001), a positive likelihood ratio (LR) of 6.8, and a negative LR of 0.02. | en_US |
dc.language.iso | en_US | en_US |
dc.publisher | Medicine | en_US |
dc.rights | Copyright © 2019 the Author(s). Published by Wolters Kluwer Health, Inc.
This is an open access article distributed under the terms of the Creative
Commons Attribution-Non Commercial License 4.0 (CCBY-NC), where it is
permissible to download, share, remix, transform, and buildup the work provided
it is properly cited. The work cannot be used commercially without permission
from the journal.
Medicine (2019) 98:13(e15003)
Received: 28 June 2018 / Received in final form: 23 October 2018 / Accepted: 6
March 2019
http://dx.doi.org/10.1097/MD.0000000000015003
Observational Study Medicine®
OPEN
1 | |
dc.source.uri | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6456121/ | |
dc.subject | empyema | en_US |
dc.subject | parapneumonic effusion | en_US |
dc.subject | pleural effusion | en_US |
dc.subject | pleural LDH/ADA ratio | en_US |
dc.title | A novel diagnostic method for distinguishing parapneumonic effusion and empyema from other diseases by using the pleural lactate dehydrogenase to adenosine deaminase ratio and carcinoembryonic antigen levels | en_US |
dc.type | Article | en_US |
dc.identifier.doi | 10.1097/MD.0000000000015003 | |