The value of B7-H4 and carcinoembryonic antigen in diagnosing the benign and malignant pleural effusion
10.3760/cma.j.issn.0253-3766.2017.07.009
- VernacularTitle: B7－H4和癌胚抗原鉴别诊断良恶性胸腔积液的价值
- Author:
Fei WEI
1
;
Yan WEI
2
;
Lifeng LI
3
;
Gelin LI
1
;
Guiji WANG
1
Author Information
1. Department of Medical Oncology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
2. Rehabilitation Department, the Seventh People′s Hospital of Zhengzhou, Zhengzhou 450000, China
3. Biotherapy Center, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
- Publication Type:Clinical Trail
- Keywords:
Pleural effusion, malignant;
Carcinoembryonic antigen;
B7-H4;
Diagnosis;
Sensitivity;
Specifity
- From:
Chinese Journal of Oncology
2017;39(7):524-527
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the value of combined detection of negative costimulatory molecule B7-H4 and carcinoembryonic antigen (CEA) in diagnosing malignant and benign pleural effusion.
Methods:Ninety-seven pleural effusion specimen were collected, 55 of which were diagnosed as malignant pleural effusion and 42 were benign pleural effusion. Enzyme-linked immunosorbent assay(ELISA) was used to examine the concentration of B7-H4 and CEA in pleural effusion. Electro-chemiluminescence immunoassay was used to detect the CEA level in pleural effusion. Receiver operating characteristic (ROC) curve was established to analyze and evaluate the single or combined detection of B7-H4 and CEA in diagnosing malignant and benign pleural effusion.
Results:The concentrations of B7-H4 and CEA in malignant pleural effusion (MPE) group were (60.08±35.04) ng/ml and (41.49±37.16) ng/ml, respectively, obviously higher than (27.26±9.55) ng/ml and (2.41±0.94) ng/ml of benign pleural effusion (BPE) group (both P<0.01). Area under curve (AUC) of B7-H4 was 0.884 in MPE groupand the diagnostic sensitivity and specificity were 81.8% and 90.5%, respectively, at the optimized cut off value of 37.25 ng/ml. Likewise, area under curve (AUC) of CEA was 0.954 and the sensitivity and specificity were 87.3% and 95.2%, respectively, at the cut off value of 4.18 ng/ml. When B7-H4 >37.25 ng/ml or CEA>4.18 ng/ml, the sensitivity of diagnosis as MPE was down-regulated to 90.9% and the specificity was elevated to 88.1%. When B7-H4 >37.25 ng/ml and CEA>4.18 ng/ml, the sensitivity of diagnosis as MPE was down-regulated to 78.2% and the specificity was elevated to 97.6%. The sensitivity and specificity of combined detection of B7-H4 and CEA to diagnose MPE were elevated to 90.9% and 97.6%, respectively. The level of B7-H4 in MPE and BPE were both positively correlated with CEA (r=0.670, P=0.001 in MPE and r=0.002, P=0.001 in BEP).
Conclusions:B7-H4 is a potential tumor marker in diagnosing the benign and malignant pleural effusion. Although the diagnostic value of B7-H4 may not precede to CEA, the combined detection of B7-H4 and CEA can improve the diagnostic sensitivity and specificity of MPE.
