ArticleBMC pulmonary medicine2023
Age affects the diagnostic accuracy of the cancer ratio for malignant pleural effusion.
Article in BMC pulmonary medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Influences of age and sex on the diagnostic accuracy of human epididymis secretory protein 4 for malignant pleural effusion.Scientific reports · 2025Article
- Diagnostic Utility of Pleural C-Reactive Protein and Procalcitonin for Parapneumonic Pleural Effusion: A Head-to-Head Comparison Study.Infection and drug resistance · 2025Article
- Influence of age and sex on the diagnostic accuracy of pleural fluid carcinoembryonic antigen for malignant pleural effusion: aFrontiers in oncology · 2025Article
- Innovative Biomarkers for Diagnosing Malignant Ascites in Liver Cancer.OncoTargets and therapy · 2025Article
- The Use of "Cancer Ratio" in Differentiating Malignant and Tuberculous Pleural Effusions: Protocol for a Prospective Observational Study.JMIR research protocols · 2024Observational
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Authors and funding
9 authors.
Funding
Abstract
BACKGROUND AND
objectiveCancer ratio (CR), which is defined as serum lactate dehydrogenase (LDH) to pleural fluid adenosine deaminase (ADA) ratio, has been reported to be a useful diagnostic marker for malignant pleural effusion (MPE). Whether its diagnostic accuracy is affected by age remains unknown. This study aimed to investigate the effects of age on the diagnostic accuracy of CR.
methodsThe participants in this study were from a prospective cohort (SIMPLE cohort, n = 199) and a retrospective cohort (BUFF cohort, n = 158). All participants were patients with undiagnosed pleural effusion (PE). We used receiver operating characteristic (ROC) curves to evaluate the diagnostic accuracy of CR. The effect of age on the diagnostic accuracy of CR was investigated by adjusting the upper limit of age for participant enrolment.
resultsEighty-eight MPE patients were verified in the SIMPLE cohort, and thirty-five MPE patients were verified in the BUFF cohort. The AUCs of CR in the SIMPLE and BUFF cohorts were 0.60 (95% CI: 0.52-0.68) and 0.63 (95% CI: 0.54-0.71), respectively. In both cohorts, the AUCs of CR decreased with the advancement of age.
conclusionAge can affect the diagnostic accuracy of CR for MPE. CR has limited diagnostic value in older patients. KEY MESSAGE: Cancer ratio is a promising diagnostic marker for malignant pleural effusion. This study revealed that its diagnostic accuracy decreased in older patients. Its diagnostic accuracy is overestimated by previous studies using tuberculosis and pneumonia patients as controls.
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