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Pro-cathepsin D as a diagnostic marker in differentiating malignant from benign pleural effusion: A retrospective cohort study
Chang Youl Lee
Hallym University Medical Center
Corresponding Author
ORCiD: https://orcid.org/0000-0002-4088-4993
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published version at BMC Cancer.
Background: Malignant pleural effusion (MPE) causes substantial symptomatic burden in advanced malignancy. Although pleural fluid cytology is a commonly accepted gold standard of diagnosis, its low diagnostic yield is a challenge for clinicians. The aim of this study was to determine whether pro-cathepsin D can serve as a novel biomarker to discriminate between MPE and benign pleural effusion (BPE).
Methods: This study included 81 consecutive patients with exudative pleural effusions who had underwent thoracentesis or pleural biopsy. Pleural fluid and serum were collected as a standard procedure for all individuals at the same time. The level of pro-cathepsin D was measured by the sandwich enzyme-linked immunosorbent assay method.
Results: Though there were no significant differences in plasma pro-cathepsin D between the two groups, the level of pleural fluid pro-cathepsin D was significantly higher in the MPE group than the BPE group (0.651 versus 0.590 pg/mL, P = 0.034). The discriminative power of pleural fluid pro-cathepsin D for diagnosing MPE was moderate, with 81% sensitivity and 53% specificity at a pro-cathepsin D cut-off ≥0.596 pg/mL (area under the curve: 0.656). Positive and negative predictive values for MPE were 38% and 89%, respectively, with pro-cathepsin D cut-off value (>0.596 pg/mL).
Conclusions: The level of pleural fluid pro-cathepsin D was found to be significantly higher in MPE than in BPE. Although results of this study could not support the sole use of pleural fluid pro-cathepsin D to diagnose MPE, pleural fluid pro-cathepsin D can be added to pre-existing diagnostic methods for ruling-in or ruling-out MPE.
Keywords
biomarker, pro-cathepsin D, malignant pleural effusion, benign pleural effusion
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CURRENT STATUS: Published
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Posted 17 Aug, 2020
Published
On 31 Aug, 2020
No community comments so far
Editorial decision: Accept
On 20 Aug, 2020
Editor assigned
On 12 Aug, 2020
Submission checks complete
On 11 Aug, 2020
Editor invited
On 11 Aug, 2020
No comments provided
Editorial decision: Minor revision
On 03 Aug, 2020
Review #1 received
Received 27 Jul, 2020
Reviewer #1 agreed
On 15 Jul, 2020
Reviewers invited
Invitations sent on 05 Jun, 2020
Editor assigned
On 03 Jun, 2020
Submission checks complete
On 02 Jun, 2020
Editor invited
On 02 Jun, 2020
No comments provided
Editorial decision: Major revision
On 11 May, 2020
Review #2 received
Received 10 May, 2020
Review #1 received
Received 10 May, 2020
Reviewer #2 agreed
On 02 May, 2020
Reviewer #1 agreed
On 28 Apr, 2020
Reviewers invited
Invitations sent on 27 Apr, 2020
Editor assigned
On 26 Apr, 2020
Submission checks complete
On 25 Apr, 2020
Editor invited
On 25 Apr, 2020
No comments provided
Editorial decision: Major revision
On 06 Apr, 2020
Review #2 received
Received 31 Mar, 2020
Reviewer #2 agreed
On 27 Mar, 2020
Review #1 received
Received 29 Feb, 2020
Reviewer #1 agreed
On 15 Feb, 2020
Reviewers invited
Invitations sent on 12 Feb, 2020
Editor assigned
On 30 Dec, 2019
Submission checks complete
On 29 Dec, 2019
Editor invited
On 29 Dec, 2019
First submitted
On 27 Dec, 2019
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This preprint is under consideration at BMC Cancer. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Pro-cathepsin D as a diagnostic marker in differentiating malignant from benign pleural effusion: A retrospective cohort study
Chang Youl Lee
Hallym University Medical Center
Corresponding Author
ORCiD: https://orcid.org/0000-0002-4088-4993
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
Version 4
Posted 17 Aug, 2020
Published
On 31 Aug, 2020
No community comments so far
Editorial decision: Accept
On 20 Aug, 2020
Editor assigned
On 12 Aug, 2020
Submission checks complete
On 11 Aug, 2020
Editor invited
On 11 Aug, 2020
No comments provided
Editorial decision: Minor revision
On 03 Aug, 2020
Review #1 received
Received 27 Jul, 2020
Reviewer #1 agreed
On 15 Jul, 2020
Reviewers invited
Invitations sent on 05 Jun, 2020
Editor assigned
On 03 Jun, 2020
Submission checks complete
On 02 Jun, 2020
Editor invited
On 02 Jun, 2020
No comments provided
Editorial decision: Major revision
On 11 May, 2020
Review #2 received
Received 10 May, 2020
Review #1 received
Received 10 May, 2020
Reviewer #2 agreed
On 02 May, 2020
Reviewer #1 agreed
On 28 Apr, 2020
Reviewers invited
Invitations sent on 27 Apr, 2020
Editor assigned
On 26 Apr, 2020
Submission checks complete
On 25 Apr, 2020
Editor invited
On 25 Apr, 2020
No comments provided
Editorial decision: Major revision
On 06 Apr, 2020
Review #2 received
Received 31 Mar, 2020
Reviewer #2 agreed
On 27 Mar, 2020
Review #1 received
Received 29 Feb, 2020
Reviewer #1 agreed
On 15 Feb, 2020
Reviewers invited
Invitations sent on 12 Feb, 2020
Editor assigned
On 30 Dec, 2019
Submission checks complete
On 29 Dec, 2019
Editor invited
On 29 Dec, 2019
First submitted
On 27 Dec, 2019
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published version at BMC Cancer.
Background: Malignant pleural effusion (MPE) causes substantial symptomatic burden in advanced malignancy. Although pleural fluid cytology is a commonly accepted gold standard of diagnosis, its low diagnostic yield is a challenge for clinicians. The aim of this study was to determine whether pro-cathepsin D can serve as a novel biomarker to discriminate between MPE and benign pleural effusion (BPE).
Methods: This study included 81 consecutive patients with exudative pleural effusions who had underwent thoracentesis or pleural biopsy. Pleural fluid and serum were collected as a standard procedure for all individuals at the same time. The level of pro-cathepsin D was measured by the sandwich enzyme-linked immunosorbent assay method.
Results: Though there were no significant differences in plasma pro-cathepsin D between the two groups, the level of pleural fluid pro-cathepsin D was significantly higher in the MPE group than the BPE group (0.651 versus 0.590 pg/mL, P = 0.034). The discriminative power of pleural fluid pro-cathepsin D for diagnosing MPE was moderate, with 81% sensitivity and 53% specificity at a pro-cathepsin D cut-off ≥0.596 pg/mL (area under the curve: 0.656). Positive and negative predictive values for MPE were 38% and 89%, respectively, with pro-cathepsin D cut-off value (>0.596 pg/mL).
Conclusions: The level of pleural fluid pro-cathepsin D was found to be significantly higher in MPE than in BPE. Although results of this study could not support the sole use of pleural fluid pro-cathepsin D to diagnose MPE, pleural fluid pro-cathepsin D can be added to pre-existing diagnostic methods for ruling-in or ruling-out MPE.
Figure 1
Figure 2
Figure 3