Identifying Thoracic Malignancies Through Pleural Fluid Biomarkers: A Predictive Multivariate Model.

摘要: The diagnosis of malignant pleural effusions may be challenging when cytological examination aspirated fluid is equivocal or noncontributory. purpose this study was to identify protein candidate biomarkers differentially expressed in the patients with mesothelioma, lung adenocarcinoma, lymphoma, and tuberculosis (TB).A multiplex biochip comprising 120 used determine profile 29 mesotheliomas, adenocarcinomas, 12 lymphomas, 35 tuberculosis. relative abundance these predetermined among groups served establish differential of: versus benign (TB) effusions, adenocarcinoma lymphoma TB. selected putative markers were validated using widely available commercial techniques an independent sample 102 patients.Significant differences found expressions metalloproteinase-9 (MMP-9), cathepsin-B, C-reactive protein, chondroitin sulfate between TB effusions. When integrated into a scoring model, proteins yielded 85% sensitivity, 100% specificity, area under curve (AUC) 0.98 for labeling malignancy verification sample. For adenocarcinoma-mesothelioma discrimination, combining CA19-9, CA15-3, kallikrein-12 had maximal discriminatory capacity (65% AUC 0.94); figures which also refer validation set. Last, cathepsin-B isolation only moderately useful (sensitivity 89%, specificity 62%, 0.75) separating lymphomatous However, last differentiation improved significantly respect patient's age 72%, 100%, 0.94).In conclusion, panels 4 (i.e., MMP-9, sulfate), 3 kallikrein-12) different on samples are highly discriminative signaling tuberculous effusion, respectively. Cathepsin-B could helpful establishing presence effusion that TB, if simultaneously taken consideration.