Development of a scoring system based on a nomogram to identify malignant pleural effusion

Area of Science:

• Oncology
• Pulmonology
• Diagnostic Medicine

Background:

• Malignant pleural effusion (MPE) is a serious complication of advanced cancers, signaling poor prognosis.
• Accurate and timely diagnosis of MPE is crucial but challenging in clinical practice.

Purpose of the Study:

• To develop and validate a nomogram-based scoring system for differentiating MPE from benign pleural effusion (BPE).

Main Methods:

• A retrospective study of 382 patients with pleural effusion was conducted.
• Patients were divided into training (n=268) and validation (n=114) sets.
• A scoring system was developed using logistic regression and LASSO for variable selection.

Main Results:

• The scoring system, incorporating six clinical variables, demonstrated high diagnostic performance (AUC training: 0.961, AUC validation: 0.872).
• At an optimal cutoff of 28 points, sensitivity and specificity were favorable in both sets.
• The system outperformed individual tumor biomarkers in identifying MPE, especially in cytologically negative cases.

Conclusions:

• A simple, cost-effective scoring system using easily accessible variables was developed for MPE identification.
• This scoring system shows good diagnostic performance and clinical applicability for distinguishing MPE from BPE.