Open AccessDiagnostic value of soluble B7‐H4 and carcinoembryonic antigen in distinguishing malignant from benign pleural effusion
Author(s) -
Jing Xiaogang,
Wei Fei,
Li Jing,
Dai Lingling,
Wang Xi,
Jia Liuqun,
Wang Huan,
An Lin,
Yang Yuanjian,
Zhang Guojun,
Cheng Zhe
Publication year - 2018
Publication title -
the clinical respiratory journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.789
H-Index - 33
eISSN - 1752-699X
pISSN - 1752-6981
DOI - 10.1111/crj.12615
Subject(s) - medicine , carcinoembryonic antigen , pleural effusion , receiver operating characteristic , malignant pleural effusion , effusion , peritoneal effusion , gastroenterology , cancer , surgery
Objective To explore the diagnostic value of joint detection of soluble B7‐H4 (sB7‐H4) and carcinoembryonic antigen (CEA) in identifying malignant pleural effusion (MPE) from benign pleural effusion (BPE). Methods A total of 97 patients with pleural effusion specimens were enrolled from The First Affiliated Hospital of Zhengzhou University between June 2014 and December 2015. All cases were categorized into malignant pleural effusion group ( n = 55) and benign pleural effusion group ( n = 42) according to etiologies. Enzyme‐linked immunosorbent assay was applied to examine the levels of sB7‐H4 in pleural effusion and meanwhile CEA concentrations were detected by electro‐chemiluminescence immunoassays. Receiver operating characteristic (ROC) curve was established to assess the diagnostic value of sB7‐H4 and CEA in pleural effusion. The correlation between sB7‐H4 and CEA levels was analyzed by Pearson's product‐moment. Results The concentrations of sB7‐H4 and CEA in MPE exhibited obviously higher than those of BPE ([60.08 ± 35.04] vs. [27.26 ± 9.55] ng/ml, P = .000; [41.49 ± 37.16] vs. [2.41 ± 0.94] ng/ml, P = .000). The AUC area under ROC curve of sB7‐H4 and CEA was 0.884 and 0.954, respectively. Two cutoff values by ROC curve analysis of sB7‐H4 36.5 ng/ml and CEA 4.18 ng/ml were obtained, with a corresponding sensitivity (81.82%, 87.28%), specificity (90.48%, 95.24%), accuracy (85.57%, 90.72%), positive predictive value (PPV) (91.84%, 96.0%), negative predictive value (NPV) (79.17%, 85.11%), positive likelihood ratio (PLR) (8.614, 18.327), and negative likelihood ratio (NLR) (0.201, 0.134). When sB7‐H4 and CEA were combined to detect pleural effusion, it obtained a higher sensitivity 90.91% and specificity 97.62%. Furthermore, correlation analysis result showed that the level of sB7‐H4 was correlated with CEA level ( r = .770, P = .000). Conclusions sB7‐H4 was a potentially valuable tumor marker in the differentiation between BPE and MPE. The combined detection of sB7‐H4 and CEA could improve the diagnostic sensitivity and specificity for MPE.