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Novel clinical biomarkers in blood and pleural effusion for diagnosing patients with tuberculosis distinguishing from malignant tumor
Wang, Jian1; Feng, Zhe Xiang2; Ren, Tao2; Meng, Wei Yu1; Khan, Imran1; Fan, Xing Xing1; Pan, Hu Dan3; Liu, Liang3; Tang, Yi Jun2; Yao, Xiao Jun1; Li, Run Ze3; Wang, Mei Fang2; Leung, Elaine Lai Han2,4,5
2022-10-14
Source PublicationMedicine (United States)
ISSN0025-7974
Volume101Issue:41
Abstract

Pleural effusion (PE) is a common manifestation of tuberculosis (TB) and malignant tumors but tuberculous PE (TPE) is difficult to distinguish from malignant PE (MPE), especially by noninvasive detection indicators. This study aimed to find effective detection indices in blood and PE for differentiating TB from a malignant tumor. A total of 815 patients who were diagnosed with TB or cancer in Hubei Shiyan Taihe Hospital from 2014 to 2017 were collected. Amongst them, 717 were found to have PE by thoracoscopy. Clinical characteristics, patients' blood parameters and PE indicator information were summarized for analysis. Patients with MPE had higher percentages to be bloody and negative of Rivalta test in PE than those with TPE. For clinical indicators, comparison of the specific parameters in blood showed that 18 indicators were higher in the TPE group than in the MPE group. By contrast, 12 indicators were higher in the MPE group than in the TPE group (P < .01). In addition, in PE tests, 3 parameters were higher in the TPE group, whereas other 4 parameters were higher in the MPE group (P < .01). Then, for clinical diagnosing practice, ROC analysis and principal component analysis were applied. The top 6 relevant indicators with area under curve over 0.70 were screened out as follows: hydrothorax adenosine dehydrogenase (pADA, 0.90), hydrothorax high-sensitivity C reactive protein (0.79), percentage of blood monocyte (sMONp, 0.75), blood high-sensitivity C reactive protein (sHsCRP, 0.73), erythrocyte sedimentation rate (0.71) and blood D-dimer (0.70). Moreover, logistic regression model revealed that a specific combination of 3 biomarkers, namely, pADA, sMONp and sHsCRP, could enhance the distinguishment of TB from malignant tumor with PE (area under curve = 0.944, 95% confidence interval = 0.925-0.964). The diagnostic function of the top single marker pADA in patients from different groups was analyzed and it was found to maintain high specificity and sensitivity. The 6 indicators, namely, pADA, hydrothorax high-sensitivity C reactive protein, sMONp, sHsCRP, sESR and blood D-dimer, showed significant diagnostic value for clinicians. Further, the combination of pADA, sMONp and sHsCRP has high accuracy for differential diagnosis for the first time. Most interestingly, the single marker pADA maintained high specificity and sensitivity in patients with different statuses and thus has great value for rapid and accurate diagnosis of suspected cases.

KeywordBiomarker Cancerous Diagnosis Pleural Effusion Tuberculous
DOI10.1097/MD.0000000000031027
URLView the original
Indexed BySCIE
Language英語English
WOS Research AreaGeneral & Internal Medicine
WOS SubjectMedicine, General & Internal
WOS IDWOS:000868085500042
Scopus ID2-s2.0-85140204241
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Document TypeJournal article
CollectionDEPARTMENT OF BIOMEDICAL SCIENCES
Affiliation1.Dr. Neher's Biophysics Laboratory for Innovative Drug Discovery, State Key Laboratory of Quality Research in Chinese Medicine, Macau Institute for Applied Research in Medicine and Health, Macau University of Science and Technology, Macao
2.Department of Respiratory and Critical Care Medicine, Taihe Hospital, Hubei University of Medicine, Hubei, China
3.State Key Laboratory of Dampness Syndrome of Chinese Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, Guangdong, China
4.Cancer Center, Faculty of Health Science, University of Macau, Macao
5.MOE Frontiers Science Center for Precision Oncology, University of Macau, Macao
First Author AffilicationUniversity of Macau
Recommended Citation
GB/T 7714
Wang, Jian,Feng, Zhe Xiang,Ren, Tao,et al. Novel clinical biomarkers in blood and pleural effusion for diagnosing patients with tuberculosis distinguishing from malignant tumor[J]. Medicine (United States),2022,101(41).
APA Wang, Jian,Feng, Zhe Xiang,Ren, Tao,Meng, Wei Yu,Khan, Imran,Fan, Xing Xing,Pan, Hu Dan,Liu, Liang,Tang, Yi Jun,Yao, Xiao Jun,Li, Run Ze,Wang, Mei Fang,&Leung, Elaine Lai Han.(2022).Novel clinical biomarkers in blood and pleural effusion for diagnosing patients with tuberculosis distinguishing from malignant tumor.Medicine (United States),101(41).
MLA Wang, Jian,et al."Novel clinical biomarkers in blood and pleural effusion for diagnosing patients with tuberculosis distinguishing from malignant tumor".Medicine (United States) 101.41(2022).
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