Malignant pleural effusions in lymphoproliferative disorders: A clinico-pathologic study
Bibliographic record
Abstract
6080 Objective: To facilitate the diagnosis of malignant involvement of pleura by examining various clinical and cyto-chemical characteristics of pleural effusions in patients with lymphoproliferative disorders and to identify factors that predict mortality in these patients Methods:Clinical data of 86 eligible patients with lymphoproliferative disorders who were hospitalized from 1993 to 2002 on 91 occasions and underwent thoracentesis were reviewed. Cytological examination was performed in all specimens whereas flow cytometry and/or DNA study was performed in 40 (44%) specimens. A logistic regression analysis was carried out to determine prognostic variables that predict malignant involvement of pleura and hospital mortality. Results: Median age was 70 years (4–92) and M:F was 44:42. Of 86 patients, 60% had non-Hodgkin lymphoma, 23% had CLL, 9% had multiple myeloma, and 7% had Hodgkin's disease. 19% had a secondary malignancy. 74% patients had advanced disease, 50% had prior chemotherapy and 10% were in remission. Of 91 cases of pleural effusions, 48% were bilateral and 88% were exudates. 48 (53%) cases of pleural effusions were due to malignant involvement of pleura. Among various variables examined with respect to their correlation with malignant pleural effusion or hospital mortality, symptomatic pleural effusion (odds ratio 10.3, 95% CI; 1.7–98.3), pleural fluid mesothelial cells % <5 (odd ratio 8.0, 95%CI; 1.4–58.2), pleural fluid: serum LDH >1 (odd ratio 6.4, 95%CI; 1.2–45.6) and pleural fluid lymphocytes % >50 (odd ratio 6.4, 95% CI: 1.2–50) were significantly correlated with malignant pleural effusion whereas secondary cancer (odd ratio 11.9, 95% CI; 2.3–88.8), pleural fluid: serum LDH >1, (odd ratio 10.9, 95% CI; 2.6–64.9), and pneumonia (odd ratio 6.4, 95% CI; 1.7–28.6) were significantly correlated with hospital mortality in multivariate analysis Conclusions: Our results reveal that many clinical and cyto-chemical markers have discriminatory values in identifying malignant effusion in patients with lymphoproliferative disorders. A high pleural fluid to serum LDH level correlates with malignant pleural involvement and mortality. No significant financial relationships to disclose.
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How this classification was reachedexpand
Direct model labels (unvalidated)
Per-model category and study-design labels from the labeling rounds. They are machine output, unvalidated, and the disagreement between models ships as data. No study design here is MEDLINE-validated yet.
| Model arm | Categories | Study design | Confidence |
|---|---|---|---|
| gemma | no category Domain: not available · Genre: Empirical About the Canadian research system: no · About a Canadian topic: no | Observational | low |
| gpt | no category Domain: not available · Genre: Empirical About the Canadian research system: no · About a Canadian topic: no | Observational | medium |
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedLabeled directly by 2 models reading the full record.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".