Zhu J, et al. – The diagnostic accuracy of neuron-Specific enolase (NSE) for malignant pleural effusion (MPE) through a clinical study and together with a meta–analysis, was examined. This study observed the limited role of pleural NSE measurement in diagnosing MPE, and it had a low sensitivity. This study suggested combining the clinical utility of NSE assay with the results of other tumor markers examination and the detail clinical information of the patient.

Methods

• Pleural effusion samples from 136 patients with MPE and 102 patients with benign pleural effusion (BPE) were collected, and electrochemiluminescence immunoassay estimated NSE levels.
• In order to differentiate MPE from BPE, receiver operating characteristic (ROC) curve analysis was performed to assess the ability of NSE.
• Researchers performed literature search to identify suitable publications, data were extracted and diagnostic indexes including sensitivity, specificity, positive/negative likelihood ratio (PLR/NLR), and diagnostic odds ratio (DOR) were pooled.
• The overall diagnostic accuracy of NSE for MPE was explored by generating summary ROC curve.

Results

• According to results, levels of NSE were significantly increased in pleural effusion from patients with MPE than that from BPE (18.53 ± 27.30 vs. 6.41 ± 6.95 ng/ml, p < 0.001).
• Pleural NSE had a sensitivity of 59.56% and a specificity of 83.33% in diagnosing MPE, with a cut-off value of 8.92 ng/ml.
• The meta-analysis incorporated a total of 14 studies with 1896 subjects.
• Following were the diagnostic parameters of NSE: sensitivity, 0.53 (95% CI: 0.38–0.67); specificity, 0.85 (95% CI: 0.75–0.91); PLR, 3.54 (95% CI: 2.33–5.39); NLR, 0.56 (95% CI: 0.42–0.73); and DOR, 6.39 (95% CI: 3.72–10.96).
• 0.78 was the area under the summary ROC curve.