Evaluation of an automated commercial ELISA method for calprotectin determination in pleural fluid

Vázquez-Iglesias, Lorena; Casado-Rey, Pedro; Botana-Rial, Maribel; Andrade-Olivié, María Amalia; Rodrı́guez-Berrocal, Francisco Javier; Cadena, Marı́a Páez de la; Fernández-Villar, Alberto

doi:10.1515/cclm-2016-0884

Cited by 6 publications

(15 citation statements)

References 5 publications

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“…Generally, studies examining CLP levels in effusions are very scarce. Emerging data support that pleural CLP levels were significantly higher in malignant PEs than non-malignant ones (transudates, parapneumonic, or tuberculous PEs) [ 89 , 90 , 91 ]. In a cohort of 425 patients, pleural CLP levels ranged from 772.48 to 3163.8 ng/mL (median: 1939 ng/mL) in malignant PEs, and 3216–24,000 ng/mL in non-malignant PEs (median: 9209 ng/mL) [ 90 ].…”

Section: Clp In Serous Effusionsmentioning

confidence: 98%

“…In a cohort of 425 patients, pleural CLP levels ranged from 772.48 to 3163.8 ng/mL (median: 1939 ng/mL) in malignant PEs, and 3216–24,000 ng/mL in non-malignant PEs (median: 9209 ng/mL) [ 90 ]. For a cut-off value of ≤6233.2 ng/mL, a 96% sensitivity and 60% specificity were reported in discriminating malignant from non-malignant PEs [ 90 ], suggesting pleural CLP as a novel and useful diagnostic biomarker in patients with PE of uncertain etiology [ 90 , 92 ].…”

Section: Clp In Serous Effusionsmentioning

confidence: 99%

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Calprotectin in Lung Diseases

Kotsiou

Papagiannis

Papadopoulou

et al. 2021

IJMS

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Calprotectin (CLP) is a heterodimer formed by two S-100 calcium-binding cytosolic proteins, S100A8 and S100A9. It is a multifunctional protein expressed mainly by neutrophils and released extracellularly by activated or damaged cells mediating a broad range of physiological and pathological responses. It has been more than 20 years since the implication of S100A8/A9 in the inflammatory process was shown; however, the evaluation of its role in the pathogenesis of respiratory diseases or its usefulness as a biomarker for the appropriate diagnosis and prognosis of lung diseases have only gained attention in recent years. This review aimed to provide current knowledge regarding the potential role of CLP in the pathophysiology of lung diseases and describe how this knowledge is, up until now, translated into daily clinical practice. CLP is involved in numerous cellular processes in lung health and disease. In addition to its anti-microbial functions, CLP also serves as a molecule with pro- and anti-tumor properties related to cell survival and growth, angiogenesis, DNA damage response, and the remodeling of the extracellular matrix. The findings of this review potentially introduce CLP in daily clinical practice within the spectrum of respiratory diseases.

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Section: Clp In Serous Effusionsmentioning

confidence: 98%

Section: Clp In Serous Effusionsmentioning

confidence: 99%

Calprotectin in Lung Diseases

Kotsiou

Papagiannis

Papadopoulou

et al. 2021

IJMS

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“…In this present study, the determination of calprotectin was adjusted to the workflow of the clinical laboratories at the three participating centres. Calprotectin levels were measured in conventional robotised equipment using a sandwich ELISA kit from Bühlmann Laboratories, which was extensively tested in our laboratory before initiating this present study 18 . We found that the calprotectin levels in BPE samples were higher than those in the MPE samples, and showed a good accuracy for predicting MPE.…”

Section: Discussionmentioning

confidence: 99%

“…Samples were diluted 1/100. This methodology was previously described and evaluated to confirm its validity and robustness 18 . The assay was performed with the DSXTM Automated System (DYNEX Technologies, Worthing, West Sussex-UK) according to the manufacturer's instructions.…”

Section: Pleural Effusion Diagnosismentioning

confidence: 99%

Validation of Calprotectin As a Novel Biomarker For The Diagnosis of Pleural Effusion: a Multicentre Trial

Botana-Rial

Vázquez-Iglesias

Casado-Rey

et al. 2020

Sci Rep

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Discriminating between malignant pleural effusion (MPE) and benign pleural effusion (BPE) remains difficult. Thus, novel and efficient biomarkers are required for the diagnosis of pleural effusion (PE). The aim of this study was to validate calprotectin as a diagnostic biomarker of PE in clinical settings. A total of 425 patients were recruited, and the pleural fluid samples collected had BPE in 223 cases (53.7%) or MPE in 137 patients (33%). The samples were all analysed following the same previously validated clinical laboratory protocols and methodology. Calprotectin levels ranged from 772.48 to 3,163.8 ng/mL (median: 1,939 ng/mL) in MPE, and 3,216-24,000 ng/mL in BPE (median: 9,209 ng/mL; p < 0.01), with an area under the curve of 0.848 [95% CI: 0.810-0.886]. For a cutoff value of ≤ 6,233.2 ng/mL, we found 96% sensitivity and 60% specificity, with a negative and positive predictive value, and negative and positive likelihood ratios of 96%, 57%, 0.06, and 2.4, respectively. Multivariate analysis showed that low calprotectin levels was a better discriminator of PE than any other variable [OR 28.76 (p < 0.0001)]. Our results confirm that calprotectin is a new and useful diagnostic biomarker in patients with PE of uncertain aetiology which has potential applications in clinical practice because it may be a good complement to cytological methods. The diagnosis of pleural effusion (PE) is a clinical challenge because it can be produced by over 60 diseases 1,2. Nevertheless, in clinical practice the priority is to establish whether the PE is malignant or not. A diagnosis of malignant PE (MPE) implies the presence of advanced-stage tumours and is therefore associated with a poor prognosis 1,3 which requires urgent diagnosis. Thoracocentesis is the first and most simple procedure for the diagnosis of PE 2-4. Unfortunately, while its specificity for establishing malignancy is 100%, the diagnostic sensitivity of pleural fluid (PF) cytological analysis is low. Although the odds of establishing an MPE diagnosis by immunohistochemistry are improved by applying a panel of different antibodies, its diagnostic sensitivity is still only approximately 60% for metastatic PE and less than 30% for mesothelioma 5,6. When the cytology results are negative, more invasive methods such as a pleural biopsy or thoracoscopy are necessary 2,4,7. In this context, more groups are searching for PF biomarkers for malignancy with the aim of avoiding these invasive procedures 8-10. Recent meta-analyses have evaluated the ability of new biomarkers such

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“…Thus, we carried out this multicentre study to validate calprotectin levels in PE as a diagnostic biomarker of malignancy in clinical settings [ 7 ]. In this study, calprotectin levels were measured using the conventional robotised equipment and employing the enzyme-linked immunosorbent assay (ELISA fCA ® , Bühlmann Laboratories) routinely used in our laboratory [ 7 , 8 ]. The results of this work were useful when making early clinical decisions about the treatment of these patients because the use of this marker can lead to better diagnoses and can help avoid possible adverse consequences.…”

Section: Introductionmentioning

confidence: 99%

A rapid calprotectin test for the diagnosis of pleural effusion

et al. 2021

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In previous studies, measuring the levels of calprotectin in patients with pleural effusion (PE) was an exceptionally accurate way to predict malignancy. Here, we evaluated a rapid method for the measurement of calprotectin levels as a useful parameter in the diagnosis of malignant pleural effusion (MPE) in order to minimise invasive diagnostic tests. Calprotectin levels were measured with Quantum Blue® sCAL (QB®sCAL) and compared with the gold standard reference ELISA method. Calprotectin levels in patients with benign pleural effusion (BPE) were significantly higher (p < 0.0001) than for MPE patients. We measured the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and positive and negative likelihood ratios (LRs) for a cut-off value of ≤ 14,150 ng/mL; the diagnostic accuracy was 64%. The odds ratio for PE calprotectin levels was 10.938 (95% CI [4.133 − 28.947]). The diagnostic performance of calprotectin concentration was better for predicting MPE compared to other individual parameters. Comparison of two assays showed a slope of 1.084, an intercept of 329.7, and a Pearson correlation coefficient of 0.798. The Bland–Altman test showed a positive bias for the QB®sCAL method compared to ELISA fCAL®. Clinical concordance between both these methods was 88.5% with a Cohen kappa index of 0.76 (95% CI [0.68 − 0.84]). We concluded that QB®sCAL is a fast, reliable, and non-invasive diagnostic tool for diagnosing MPE and represents an alternative to ELISA that could be implemented in medical emergencies.

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Evaluation of an automated commercial ELISA method for calprotectin determination in pleural fluid

Cited by 6 publications

References 5 publications

Calprotectin in Lung Diseases

Calprotectin in Lung Diseases

Validation of Calprotectin As a Novel Biomarker For The Diagnosis of Pleural Effusion: a Multicentre Trial

A rapid calprotectin test for the diagnosis of pleural effusion

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