Pleural fluid mesothelin as an adjunct to the diagnosis of pleural malignant mesothelioma.
Pleural fluid mesothelin as an adjunct to the diagnosis of pleural malignant mesothelioma.
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DOI：
10.1155/2014/413946
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发表时间：
2014
期刊：
影响因子：
--
通讯作者：
Robinson BW
中科院分区：
文献类型：
--
作者：
Creaney J;Segal A;Olsen N;Dick IM;Musk AW;Skates SJ;Robinson BW
理由。胸腔积液细胞学诊断恶性间皮瘤（MM）可能是困难的，目前是有争议的。MM患者的有效间皮素水平升高，但该试验的临床作用尚不确定。目标.目的：探讨胸腔积液上清液间皮素水平对MM诊断的临床价值。从1331名连续患者中前瞻性收集胸腔积液样本。通过商业ELISA测定渗出液中的间皮素水平，并确定其与并发病理学报告和最终临床诊断的关系。结果分析了来自1331个个体的2156个胸腔积液样本。最终临床诊断为183例MM、436例非MM恶性肿瘤和712例非恶性积液。有效间皮素对MM的敏感性为67%，特异性为95%。超过47%的MM病例在MM确诊前获得的积液中间皮素升高。在积液细胞学检查结果不确定的情况下，积液间皮素对MM和恶性肿瘤的阳性预测值分别为79%和94%。结论.间皮素阳性的胸腔积液，无论是否鉴定出恶性细胞，都表明可能存在恶性肿瘤，并增加了进一步调查以确定恶性诊断的临床依据的权重。
Rationale. The diagnosis of pleural malignant mesothelioma (MM) by effusion cytology may be difficult and is currently controversial. Effusion mesothelin levels are increased in patients with MM but the clinical role of this test is uncertain. Objectives. To determine the clinical value of measuring mesothelin levels in pleural effusion supernatant to aid diagnosis of MM. Methods and Measurements. Pleural effusion samples were collected prospectively from 1331 consecutive patients. Mesothelin levels were determined by commercial ELISA in effusions and their relationship to concurrent pathology reporting and final clinical diagnosis was determined. Results. 2156 pleural effusion samples from 1331 individuals were analysed. The final clinical diagnosis was 183 MM, 436 non-MM malignancy, and 712 nonmalignant effusions. Effusion mesothelin had a sensitivity of 67% for MM at 95% specificity. Mesothelin was elevated in over 47% of MM cases in effusions obtained before definitive diagnosis of MM was established. In the setting of inconclusive effusion cytology, effusion mesothelin had a positive predictive value of 79% for MM and 94% for malignancy. Conclusions. A mesothelin-positive pleural effusion, irrespective of the identification of malignant cells, indicates the likely presence of malignancy and adds weight to the clinical rationale for further investigation to establish a malignant diagnosis.
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影响因子：
9.6
作者：
Renshaw, AA;Dean, BR;Cibas, ES
通讯作者：
Cibas, ES
影响因子：
5.3
作者：
Boudville, Neil;Paul, Rohan;Creaney, Jenette
通讯作者：
Creaney, Jenette
DOI：
10.1164/rccm.200811-1729oc
发表时间：
2009-09-01
影响因子：
24.7
作者：
Davies, Helen E.;Sadler, Ross S.;Lee, Y. C. Gary
通讯作者：
Lee, Y. C. Gary
影响因子：
5.3
作者：
Musk, AW;de Klerk, NH
通讯作者：
de Klerk, NH
影响因子：
10
作者：
Creaney, Jenette;Yeoman, Deborah;Robinson, Bruce W. S.
通讯作者：
Robinson, Bruce W. S.