Impact of pericardial fluid glucose level and computed tomography attenuation values on diagnosis of malignancy-related pericardial effusion
| Autor: | Gaku Nakazawa, Mana Okune, Takashi Kurita, Kenji Yamaji, Kazuki Mizutani, Heitaro Watanabe, Masafumi Ueno, Masakazu Yasuda, Takashi Nakamura |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment Pericardial effusion 030204 cardiovascular system & hematology Malignancy Risk Assessment Gastroenterology 03 medical and health sciences 0302 clinical medicine Japan Predictive Value of Tests Risk Factors Interquartile range Neoplasms Hounsfield scale Internal medicine Multidetector Computed Tomography Humans Medicine Diseases of the circulatory (Cardiovascular) system 030212 general & internal medicine Aged Retrospective Studies Angiology Aged 80 and over business.industry Research Pericardial fluid CT attenuation values Pericardiocentesis Middle Aged Brain natriuretic peptide medicine.disease Pericardial fluid glucose level Glucose RC666-701 Pericardial Fluid Female Cardiology and Cardiovascular Medicine business Biomarkers |
| Zdroj: | BMC Cardiovascular Disorders, Vol 21, Iss 1, Pp 1-10 (2021) BMC Cardiovascular Disorders |
| ISSN: | 1471-2261 |
| Popis: | Background We evaluated malignancy according to the characteristics of pericardial fluid in symptomatic Japanese patients undergoing pericardiocentesis and computed tomography (CT). Methods This was a retrospective, single-center, observational study of 125 symptomatic patients undergoing pericardiocentesis. The patients were classified into two groups: a malignancy group and a non-malignancy group, according to the primary disease and cytology of the pericardial effusion (PE). We compared the pericardial fluid sample and CT measurements between both groups. Results All patients were diagnosed as having exudative PE by Light’s criteria. PE with malignant cells was demonstrated in 76.8% of the malignancy group patients. Pericardial to serum lactate dehydrogenase (LDH) ratio > 0.6, as one of Light’s criteria, was associated with malignancy (p = 0.017). Lower serum brain natriuretic peptide (BNP) concentration was also associated with malignancy (BNP: 126.9 ± 89.8 pg/ml vs 409.2 ± 97.7 pg/ml, malignancy vs non-malignancy groups, respectively; p = 0.037). A significant difference was observed in pericardial fluid glucose level between the malignancy and non-malignancy groups (pericardial fluid glucose: 78.24 ± 48.29 mg/dl vs 98.41 ± 44.85, respectively; p = 0.048). Moreover, CT attenuation values (Hounsfield units (HU)) tended to be higher in the malignancy group vs the non-malignancy group (22.7 [interquartile range (IQR), 17.4–26.0] vs 17.4 [IQR, 13.7–26.4], respectively; p = 0.08). The sensitivity and specificity of pericardial fluid glucose level ≤ 70 mg/dl and CT attenuation values > 20 HU were 40.9% and 89.6%, respectively, in the malignancy group. The positive- and negative predictive values of pericardial fluid glucose level ≤ 70 mg/dl and CT attenuation values > 20 HU were 85.7% and 50.0%, respectively, in the malignancy group. Pericardial fluid glucose level ≤ 70 mg/dl and CT attenuation values > 20 HU were cutoff values associated with malignancy (p = 0.012). Conclusions Lower pericardial fluid glucose level with higher CT attenuation values may suggest malignancy-related PE. |
| Databáze: | OpenAIRE |
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