ArticleLung2016
Identifying Malignant Pleural Effusion by A Cancer Ratio (Serum LDH: Pleural Fluid ADA Ratio).
Article in Lung, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 45 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
45 citing papers in PubMed, 1 synthesis or guideline pooled it, 94 citations in OpenAlex.
- Diagnostic accuracy of the cancer ratio for the prediction of malignant pleural effusion: evidence from a validation study and meta-analysis.Annals of medicine · 2021Pooled it
- The Clinical Risk Factors of Adenovirus Pneumonia in Children Based on the Logistic Regression Model: Correlation with Lactate Dehydrogenase.International journal of clinical practice · 2022Trial
- Diagnostic value of biochemical ratios in the differential diagnosis of tuberculous and malignant pleural effusions.BMC pulmonary medicine · 2026Article
- The cancer ratio plus in the differential diagnosis of pleural effusions: a scoping review of current evidence.Biochemia medica · 2026Article
- Development of a scoring system based on a nomogram to identify malignant pleural effusion.Journal of thoracic disease · 2025Article
- Diagnostic Utility of Thoracoscopy in Recurrent Exudative Pleural Effusion: A Single-Arm Interventional Study.Cureus · 2025Article
- Machine learning-based Diagnostic model for determining the etiology of pleural effusion using Age, ADA and LDH.Respiratory research · 2025Article
- Innovative Biomarkers for Diagnosing Malignant Ascites in Liver Cancer.OncoTargets and therapy · 2025Article
- High diagnostic accuracy of flexible thoracoscopy for distinguishing tuberculous from malignant pleural effusions.American journal of translational research · 2025Article
- The Use of "Cancer Ratio" in Differentiating Malignant and Tuberculous Pleural Effusions: Protocol for a Prospective Observational Study.JMIR research protocols · 2024Observational
- Etiology of exudative pleural effusion among adults: differentiating between tuberculous and other causes, a multicenter prospective cohort study.IJID regions · 2024Review
- Clinical significance of pleural fluid lactate dehydrogenase/adenosine deaminase ratio in the diagnosis of tuberculous pleural effusion.BMC pulmonary medicine · 2024Article
- Malignant pleural disease.Breathe (Sheffield, England) · 2023Review
- LDH/ADA ratio in pleural fluid for the diagnosis of infectious pleurisy.Clinical and experimental medicine · 2023Article
- Development and validation of the CAIL prognostic score in non-small cell lung cancer patients with malignant pleural effusion.The clinical respiratory journal · 2023Article
- Risk factors for symptomatic malignant pleural effusion recurrence in patients with actionable mutations in advanced lung adenocarcinoma.Translational lung cancer research · 2023Article
- Novel clinical radiomic nomogram method for differentiating malignant from non-malignant pleural effusions.Heliyon · 2023Article
- Age affects the diagnostic accuracy of the cancer ratio for malignant pleural effusion.BMC pulmonary medicine · 2023Article
- Differentiating between tuberculous and non-tuberculous pleural effusions using the pleural fluid ratio of 10× adenosine deaminase/lactate dehydrogenase.Journal of thoracic disease · 2023Article
- A Novel Clinical Prognostic Model for Breast Cancer Patients with Malignant Pleural Effusion: Avoiding Chemotherapy in Low-Risk Groups?Cancer management and research · 2023Article
Corrections and comments
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Authors and funding
3 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimWe studied the diagnostic potential of serum lactate dehydrogenase (LDH) in malignant pleural effusion.
methodsRetrospective analysis of patients hospitalized with exudative pleural effusion in 2013.
resultsSerum LDH and serum LDH: pleural fluid ADA ratio was significantly higher in cancer patients presenting with exudative pleural effusion. In multivariate logistic regression analysis, pleural fluid ADA was negatively correlated 0.62 (0.45-0.85, p = 0.003) with malignancy, whereas serum LDH 1.02 (1.0-1.03, p = 0.004) and serum LDH: pleural fluid ADA ratio 0.94 (0.99-1.0, p = 0.04) was correlated positively with malignant pleural effusion. For serum LDH: pleural fluid ADA ratio, a cut-off level of >20 showed sensitivity, specificity of 0.98 (95 % CI 0.92-0.99) and 0.94 (95 % CI 0.83-0.98), respectively. The positive likelihood ratio was 32.6 (95 % CI 10.7-99.6), while the negative likelihood ratio at this cut-off was 0.03 (95 % CI 0.01-0.15).
conclusionHigher serum LDH and serum LDH: pleural fluid ADA ratio in patients presenting with exudative pleural effusion can distinguish between malignant and non-malignant effusion on the first day of hospitalization. The cut-off level for serum LDH: pleural fluid ADA ratio of >20 is highly predictive of malignancy in patients with exudative pleural effusion (whether lymphocytic or neutrophilic) with high sensitivity and specificity.
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Registered trials
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