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Article: Quantitative analysis of pleural fluid cell-free DNA as a tool for the classification of pleural effusions

TitleQuantitative analysis of pleural fluid cell-free DNA as a tool for the classification of pleural effusions
Authors
Issue Date2003
PublisherAmerican Association for Clinical Chemistry, Inc. The Journal's web site is located at http://www.clinchem.org
Citation
Clinical Chemistry, 2003, v. 49 n. 5, p. 740-745 How to Cite?
AbstractBackground: Recently, much interest has been focused on the quantification of DNA in miscellaneous body fluids. In this study, the application is extended to classifying pleural effusions by measuring cell-free DNA in pleural fluid. Methods: We recruited 50 consecutive patients with pleural effusions with informed consent. Pleural fluids were centrifuged at 13 000g, with supernatants aliquoted for extraction and analysis of β-globin DNA sequence by quantitative real-time PCR. Serum and pleural fluid biochemistries were performed to classify pleural effusions using the modified criteria of Light et al. (Ann Intern Med 1972;77:507-13). The ROC curve was plotted to determine the cutoff DNA concentration for ciassifying pleural fluids as transudates or exudates. Indicators of diagnostic accuracy were calculated for both pleural fluid DNA and modified criteria of Light et al., using the discharge, microbiologic, and histologic diagnoses as the reference standard. Results: The area under the ROC curve was 0.95 [95% confidence interval (CI), 0.84-0.99]. At 509 genome-equivalents/mL, pleural fluid DNA alone correctly classified 46 of 50 pleural effusions with 91% sensitivity (95% CI, 76-98%), 88% specificity (95% CI, 64-98%), and positive and negative likelihood ratios of 7.7 (95% CI, 3.1-19.5) and 0.10 (95% CI, 0.04-0.27), respectively. With the modified criteria of Light et al., 43 of 50 pleural effusions were correctly classified with 97% sensitivity (95% CI, 91-100%) and 67% specificity (95% CI, 45-89%). There were significant correlations between cell-free DNA and both lactate dehydrogenase and total protein in pleural fluid, suggesting their common origin. Conclusions: Pleural fluid DNA concentrations are markedly increased in exudative effusions, making it a potential new tool to evaluate the etiologic causes of pleural effusions. © 2003 American Association for Clinical Chemistry.
Persistent Identifierhttp://hdl.handle.net/10722/148361
ISSN
2015 Impact Factor: 7.457
2015 SCImago Journal Rankings: 2.472
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorChan, MHMen_US
dc.contributor.authorChow, KMen_US
dc.contributor.authorChan, ATCen_US
dc.contributor.authorLeung, CBen_US
dc.contributor.authorChan, LYSen_US
dc.contributor.authorChow, KCKen_US
dc.contributor.authorLam, CWen_US
dc.contributor.authorLo, YMDen_US
dc.date.accessioned2012-05-29T06:12:29Z-
dc.date.available2012-05-29T06:12:29Z-
dc.date.issued2003en_US
dc.identifier.citationClinical Chemistry, 2003, v. 49 n. 5, p. 740-745en_US
dc.identifier.issn0009-9147en_US
dc.identifier.urihttp://hdl.handle.net/10722/148361-
dc.description.abstractBackground: Recently, much interest has been focused on the quantification of DNA in miscellaneous body fluids. In this study, the application is extended to classifying pleural effusions by measuring cell-free DNA in pleural fluid. Methods: We recruited 50 consecutive patients with pleural effusions with informed consent. Pleural fluids were centrifuged at 13 000g, with supernatants aliquoted for extraction and analysis of β-globin DNA sequence by quantitative real-time PCR. Serum and pleural fluid biochemistries were performed to classify pleural effusions using the modified criteria of Light et al. (Ann Intern Med 1972;77:507-13). The ROC curve was plotted to determine the cutoff DNA concentration for ciassifying pleural fluids as transudates or exudates. Indicators of diagnostic accuracy were calculated for both pleural fluid DNA and modified criteria of Light et al., using the discharge, microbiologic, and histologic diagnoses as the reference standard. Results: The area under the ROC curve was 0.95 [95% confidence interval (CI), 0.84-0.99]. At 509 genome-equivalents/mL, pleural fluid DNA alone correctly classified 46 of 50 pleural effusions with 91% sensitivity (95% CI, 76-98%), 88% specificity (95% CI, 64-98%), and positive and negative likelihood ratios of 7.7 (95% CI, 3.1-19.5) and 0.10 (95% CI, 0.04-0.27), respectively. With the modified criteria of Light et al., 43 of 50 pleural effusions were correctly classified with 97% sensitivity (95% CI, 91-100%) and 67% specificity (95% CI, 45-89%). There were significant correlations between cell-free DNA and both lactate dehydrogenase and total protein in pleural fluid, suggesting their common origin. Conclusions: Pleural fluid DNA concentrations are markedly increased in exudative effusions, making it a potential new tool to evaluate the etiologic causes of pleural effusions. © 2003 American Association for Clinical Chemistry.en_US
dc.languageengen_US
dc.publisherAmerican Association for Clinical Chemistry, Inc. The Journal's web site is located at http://www.clinchem.orgen_US
dc.relation.ispartofClinical Chemistryen_US
dc.subject.meshAdolescenten_US
dc.subject.meshAdulten_US
dc.subject.meshAgeden_US
dc.subject.meshAged, 80 And Overen_US
dc.subject.meshChilden_US
dc.subject.meshDna - Analysisen_US
dc.subject.meshExudates And Transudates - Chemistry - Cytologyen_US
dc.subject.meshFemaleen_US
dc.subject.meshGlobins - Analysis - Geneticsen_US
dc.subject.meshHumansen_US
dc.subject.meshMaleen_US
dc.subject.meshMiddle Ageden_US
dc.subject.meshPleural Effusion - Classification - Diagnosis - Etiologyen_US
dc.subject.meshPolymerase Chain Reactionen_US
dc.subject.meshProspective Studiesen_US
dc.subject.meshRoc Curveen_US
dc.titleQuantitative analysis of pleural fluid cell-free DNA as a tool for the classification of pleural effusionsen_US
dc.typeArticleen_US
dc.identifier.emailLam, CW:ching-wanlam@pathology.hku.hken_US
dc.identifier.authorityLam, CW=rp00260en_US
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.doi10.1373/49.5.740en_US
dc.identifier.pmid12709364-
dc.identifier.scopuseid_2-s2.0-0242585396en_US
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-0242585396&selection=ref&src=s&origin=recordpageen_US
dc.identifier.volume49en_US
dc.identifier.issue5en_US
dc.identifier.spage740en_US
dc.identifier.epage745en_US
dc.identifier.isiWOS:000182541900005-
dc.publisher.placeUnited Statesen_US

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