Interpreting borderline BeLPT results.

Area of Science:

• Immunotoxicology
• Occupational Medicine
• Diagnostic Test Evaluation

Background:

• The beryllium lymphocyte proliferation test (BeLPT) is crucial for identifying beryllium sensitization (BeS) and chronic beryllium disease (CBD) risk.
• BeLPT results are categorized as abnormal (AB), borderline (BL), or normal (NL).
• Interpretation of borderline BeLPT results requires further clarification.

Purpose of the Study:

• To assess the predictive value of borderline (BL) beryllium lymphocyte proliferation test (BeLPT) results.
• To clarify the interpretation of various BeLPT result combinations involving BL values.

Main Methods:

• Probability modeling was used to assess combinations of BeLPT results meeting referral criteria (≥1 AB + ≥1 BL).
• The predictive value of different three-result combinations for beryllium sensitization (BeS) was compared.

Main Results:

• Specific combinations of abnormal (AB) and borderline (BL) BeLPT results demonstrated high probabilities of BeS.
• For instance, 3 BL results predicted BeS with 91% probability, while 2 AB + 1 BL predicted 100% probability at 2% prevalence.
• Even combinations including normal (NL) results showed significant predictive power.

Conclusions:

• Borderline (BL) BeLPT results are clinically significant and contribute to predicting beryllium sensitization (BeS).
• Three borderline BeLPT results reliably predict BeS across diverse population prevalences.
• Further validation through longitudinal studies analyzing BeLPT and clinical data is recommended.