Table 1.
Diagnostic accuracy of three inflammatory marker scores for a cancer diagnosis within 6 months of a first presentation to primary care with unexpected weight loss.
| TP | FP | FN | TN | AUC | Sens (%) | Spec (%) | PLR | NLR | PPV (%) | ||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ≥18 y | 40–59 y | 60–79 y | ≥80 y | ||||||||||
| Unexpected WL | 217 | 11,807 | 1.80 (1.57–2.06) | 0.78 (0.5–1.16) | 2.65 (2.20–3.16) | 2.99 (2.35–3.75) | |||||||
| Individual inflammatory markers in people with unexpected WL | |||||||||||||
| Low albumin | 60 | 790 | 157 | 11,017 | 0.60 (0.57–0.63) | 27.65 (21.81–34.11) | 93.31 (92.84–93.75) | 4.13 (3.30–5.18) | 0.78 (0.71–0.84) | 7.06 (5.43–8.99) | 3.81 (1.05–9.47) | 10.6 (7.65–14.20) | 4.94 (2.90–7.79) |
| Raised CRP | 154 | 2,306 | 63 | 9,501 | 0.76 (0.73–0.79) | 70.97 (64.44–76.91) | 80.47 (79.74–81.18) | 3.63 (3.31–3.99) | 0.36 (0.29–0.44) | 6.26 (5.34–7.29) | 3.27 (1.75–5.53) | 7.71 (6.21–9.43) | 7.01 (5.31–9.05) |
| Raised neutrophils | 85 | 1,299 | 132 | 10,508 | 0.64 (0.61–0.67) | 39.17 (32.63–46.01) | 89.00 (88.42–89.56) | 3.56 (2.99–4.24) | 0.68 (0.61–0.76) | 6.14 (4.93–7.54) | 3.02 (1.39–5.66) | 7.36 (5.38–9.79) | 9.07 (6.28–12.56) |
| Low lymphocytes | 101 | 3,377 | 116 | 8,430 | 0.59 (0.56–0.62) | 46.54 (39.76–53.42) | 71.40 (70.57–72.21) | 1.63 (1.41–1.88) | 0.75 (0.66–0.85) | 2.90 (2.37–3.52) | 1.91 (1.02–3.24) | 3.74 (2.80–4.89) | 3.26 (2.29–4.49) |
| Raised platelets | 50 | 534 | 167 | 11,273 | 0.59 (0.56–0.62) | 23.04 (17.61–29.22) | 95.48 (95.09–95.85) | 5.09 (3.94–6.59) | 0.81 (0.75–0.87) | 8.56 (6.42–11.13) | 6.87 (3.19–12.64) | 9.62 (6.49–13.61) | 10.08 (5.32–16.95) |
| Inflammatory marker scores in people with unexpected WL | |||||||||||||
| mGPS = 2 | 74 | 762 | 143 | 11,045 | 0.64 (0.61–0.67) | 34.10 (27.82–40.82) | 93.55 (93.09–93.98) | 5.28 (4.34–6.44) | 0.70 (0.64–0.78) | 8.85 (7.01–10.99) | 5.32 (1.75–11.98) | 12.27 (9.12–16.02) | 6.87 (4.40–10.12) |
| NLS = 2 | 41 | 386 | 176 | 11,421 | 0.58 (0.55–0.60) | 18.89 (13.91–24.75) | 96.73 (96.39–97.04) | 5.78 (4.31–7.74) | 0.84 (0.79–0.89) | 9.60 (6.98–12.80) | 8.00 (2.22–19.23) | 11.05 (6.88–16.55) | 10.24 (6.08–15.89) |
| PLS = 2 | 19 | 159 | 198 | 11,648 | 0.54 (0.52–0.56) | 8.76 (5.35–13.34) | 98.65 (98.43–98.85) | 6.50 (4.12–10.26) | 0.92 (0.89–0.96) | 10.67 (6.55–16.17) | 20.83 (7.13–42.15) | 12.36 (6.33–21.04) | 5.36 (1.12–14.87) |
Bold plus italic values represent a PPV of 5% or higher. Bold values represent a PPV of 3% or higher, the threshold above which the National Institute for Health and Care Excellence recommends investigation for cancer. Italic values represent a PPV of 2–3%.
WL weight loss, TP true positive, FP false positive, FN false nositive, TN true negative, AUC area under the curve, Sens sensitivity, Spec specificity, PLR positive likelihood ratio, NLR negative likelihood ratio, y years, mGPS modified Glasgow prognostic score, NLS neutrophil–lymphocyte score, PLS the platelet–lymphocyte score.