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Blood cell proliferation response to beryllium: analysis by receiver-operating characteristics
1Department of Medicine, University of Pennsylvania School of Medicine, Philadelphia.
Journal of Occupational Medicine. : Official Publication of the Industrial Medical Association
|January 1, 1991
Summary
Testing blood cell proliferation to beryllium is not ideal for screening chronic beryllium disease. While differences were noted between patients and controls, the test showed limited sensitivity for diagnosing this condition.
Area of Science:
- Immunology
- Occupational Medicine
- Pulmonary Medicine
Background:
- Bronchoalveolar lavage cell testing for beryllium is unsuitable for screening.
- Chronic beryllium disease (CBD) diagnosis requires reliable screening methods.
Purpose of the Study:
- To evaluate the proliferative response of blood cells to beryllium as a potential screening tool for CBD.
- To determine optimal test parameters and cutoff values for blood cell proliferation assays.
Main Methods:
- Compared blood cell proliferation in 27 CBD patients (histology and lung lavage positive) versus 30 controls.
- Used receiver operating characteristic (ROC) curves to assess test performance.
- Analyzed responses to beryllium salts at 100 and 10 microM concentrations.
Main Results:
- Significant differences in blood cell proliferation observed between CBD patients and controls at tested beryllium concentrations (p < .05).
- ROC curve analysis yielded a maximum predictive value positive of 26% at a stimulation index cutoff of 2.5.
- This cutoff corresponded to 38% sensitivity and 97% specificity for detecting CBD.
Conclusions:
- Blood cell proliferation response to beryllium demonstrates limited sensitivity for screening chronic beryllium disease.
- The test's low predictive value suggests it is not a suitable primary screening method for CBD.