Identification and diagnostic value of pleural fluid periostin and serum periostin of malignant pleural effusions in patients with non-small-cell lung cancer

Abstract

Background: Limited data are available for the diagnostic value, and the diagnostic sensitivity and specificity of pleural fluid periostin (pPOSTN) and serum periostin (sPOSTN) in malignant pleural effusion (MPE) caused by non-small-cell lung cancer (NSCLC).

Methods: We collected 84 pleural effusion samples, including 44 cases of MPE caused by NSCLC and 40 cases of benign pleural effusions (BPEs) from August 2018 to January 2019. The pPOSTN, sPOSTN, pleural fluid lactate dehydrogenase (pLDH), pleural effusion adenosine deaminase (pADA), pleural effusion total protein (pTP), pleural fluid glucose (pGLU), pleural effusion leukocyte count (pWBC), pleural effusion red cell count (pRBC), pleural effusion carbohydrate antigen 199 (pCA199), pleural fluid carbohydrate antigen 125 (pCA125), pleural effusion ferritin (pFer), serum total protein (sTP), and serum C-reactive protein (sCRP) were tested, and the obtained data were analyzed by statistical software.

Results: Compared to the BPE group, the pPOSTN level in the MPE group was observably lower, while the levels of sPOSTN, sPOSTN/pADA, pCA199/pADA, and pCA199/pPOSTN increased. The receiver operating characteristic (ROC) curve showed that the area under the ROC curve (AUC) (=0.844, 0.847, 0.841) of sPOSTN/pADA, pCA199/pADA, and pCA199/pPOSTN (cutoff = 11.86, 0.244, 0.015) was observably higher than other indicators for the diagnosis of MPE caused by NSCLC. Thus, the combined detection of pPOSTN, pCA125/pPOSTN, and pCA125/sCRP suggested that the AUC, sensitivity, and specificity was 0.912%, 95.45%, and 77.50% at the cutoff 0.317 and diagnostic performance was higher than sPOSTN/pADA or pCA199/pADA or pCA199/pPOSTN.

Conclusion: Combined detection of sPOSTN/pADA, pCA199/pADA, and pCA199/pPOSTN can be used as a good indicator for MPE caused by NSCLC.

Keywords: malignant pleural effusion; non-small-cell lung cancer; periostin.

Figure 1

Comparison of the parameters in pleural effusion from the two groups. A, The sPOSTN and pCA125 levels in the MPE group were obviously higher than those in the BPE group. The pPOSTN and sCRP levels in the MPE group were obviously lower than the BPE group. B, The pGLU, pRBC, pCA199, and sPOSTN/pADA levels in the MPE group was higher than those in the BPE group. The pADA and pWBC levels in the MPE group were obviously lower than those in the BPE group. C, The pCA199/pADA and pCA199/pPOSTN levels in the MPE group were obviously higher than those in the BPE group. *P < 0.5, **P < 0.01, and ***P < 0.001

Figure 2

Receiver operating characteristic curve of some parameters for malignant pleural effusion (MPE). At the cutoff = 0.317, the sensitivity and specificity of sPOSTN/pADA+pCA199/pADA+pCA199/pPOSTN were 95.45% and 77.50% for the diagnosis of MPE, and the AUC (0.912) was the highest among all markers tested