Malignant pleural effusion risk based on a novel tool using homocysteine and carcinoembryonic antigen in pleural fluid: A multicenter study

Abstract

Introduction: This multicenter study aimed to evaluate the Malignant Pleural Effusion Risk (MPER) diagnostic accuracy in distinguishing between benign and malign pleural effusion.

Methods: MPER is based on pleural fluid Homocysteine (HCY) and carcinoembryonic antigen (CEA) that were measured using three different methods. MPER was calculated by assessing a previously published probabilistic model: Probability (%) = 100× (1 + e-z)-1, where Z = 0.5471 × [HCY] + 0.3846 × [CEA]-8.2671.

Results: A total of 301 patients were included (140 MPE). MPER demonstrated a high AUC (0.891), sensitivity (84.3 %), and specificity (80.7 %) with a cut-off > 35.3 %.

Conclusions: The MPER model demonstrated a high diagnostic accuracy supporting its use as a novel and powerful tool.

Keywords: Malignant; Pleural Diseases; Pleural Effusion; Pleural Effusions.