LENT score (malignant pleural effusion)

LENT

Sum the Clive 2014 Table 3 LENT score (pleural fluid LDH, ECOG, serum NLR, tumour type) and return low (0-1), moderate (2-4), or high (5-7).

LIVE $0.005 USDC GET /api/calc/lent

Markdown: /docs/lent.md · Canonical: https://magentlab.com/docs/lent

Not a medical device. Not a diagnosis, dose, or listing recommendation.

What it computes

Sum the Clive 2014 Table 3 LENT score (pleural fluid LDH, ECOG, serum NLR, tumour type) and return low (0-1), moderate (2-4), or high (5-7).

When to use

When an agent already has pleural fluid LDH, a caller-assigned ECOG 0-4, a serum NLR number, and a Clive tumour token, and must not invent a diagnosis, treatment order, or survival assignment. magent does not observe the patient or compute NLR from percents.

When not to use

Not a medical device and not a diagnosis or treatment order. magent does not observe the patient.
Clive 2014 Table 3 writes <1500 vs >1500 and <9 vs >9 with no equals. LDH 1500 and NLR 9 are not scored.
Median survivals 319 / 130 / 44 days are Clive 2014 paper numbers only, not a prognosis assignment.
Oken 1982 ECOG 0-4 only. Grade 5 (dead) is not scored. The caller assigns ecog; magent does not convert Karnofsky.
nlr is a number. magent does not compute NLR from neutrophil or lymphocyte percents.

Formula

LENT = L (pleural LDH IU/L: <1500 → 0, >1500 → 1) + E (ECOG 0→0, 1→1, 2→2, 3-4→3) + N (serum NLR: <9 → 0, >9 → 1) + T (mesothelioma/haematological → 0; breast/gynaecological/renal_cell → 1; lung/other → 2); Clive 2014 Table 3; max 7; 0-1 low, 2-4 moderate, 5-7 high

Citation

Title: Predicting survival in malignant pleural effusion: development and validation of the LENT prognostic score
Authors: Clive AO, Kahan BC, Hooper CE, Bhatnagar R, Morley AJ, Zahan-Evans N, Bintcliffe OJ, Boshuizen RC, Fysh ETH, Tobin CL, Medford ARL, Harvey JE, van den Heuvel MM, Lee YCG, Maskell NA
Source: Thorax. 2014;69(12):1098-1104
DOI: 10.1136/thoraxjnl-2014-205285

Worked example

LDH 1000, ECOG 0, NLR 5, mesothelioma

Given: ecog=0nlr=5pleural_ldh_u_l=1000tumor_type=mesothelioma

L: pleural LDH 1000 < 1500 → 0
E: ECOG 0 → 0
N: NLR 5 < 9 → 0
T: mesothelioma → 0
score = 0 (max 7); risk = low

LDH 1000, ECOG 4, NLR 5, lung

Given: ecog=4nlr=5pleural_ldh_u_l=1000tumor_type=lung

L: 1000 < 1500 → 0; E: ECOG 4 → 3; N: 5 < 9 → 0; T: lung → 2
score = 5 (max 7); risk = high

Also searched as

LENT score
LENT prognostic score
malignant pleural effusion score
Clive LENT
pleural LDH ECOG NLR
MPE LENT
LENT survival score

Try

Opens the live endpoint. Unpaid browser requests show the paywall; agents should send Accept: application/json.

/api/calc/lent?pleural_ldh_u_l=1000&ecog=0&nlr=5&tumor_type=mesothelioma

Full URL: https://api.magentlab.com/api/calc/lent?pleural_ldh_u_l=1000&ecog=0&nlr=5&tumor_type=mesothelioma

Call

Expect HTTP 402 until you retry with PAYMENT-SIGNATURE. Incomplete query params return HTTP 400 before any quote or charge.

curl -i -H "Accept: application/json" "https://api.magentlab.com/api/calc/lent?pleural_ldh_u_l=1000&ecog=0&nlr=5&tumor_type=mesothelioma"

Parameters

Name	Type	Required	Description
`pleural_ldh_u_l`	number	required	Pleural fluid LDH in IU/L (1-20000, not 1500). Clive 2014 Table 3: <1500 scores 0, >1500 scores 1. Equality at 1500 is not scored.
`ecog`	integer	required	Oken 1982 ECOG performance status 0-4 as assigned by the caller. Clive 2014: 0→0, 1→1, 2→2, 3-4→3. Grade 5 (dead) is not scored. magent does not observe the patient.
`nlr`	number	required	Serum neutrophil-to-lymphocyte ratio as a number (0.05-200, not 9). Clive 2014 Table 3: <9 scores 0, >9 scores 1. Equality at 9 is not scored. Pass nlr; magent does not compute it from percents.
`tumor_type`	string	required · mesothelioma, haematological, breast, gynaecological, renal_cell, lung, other	Clive 2014 tumour type. mesothelioma or haematological (also hematological) scores 0; breast, gynaecological (also gynecological), or renal_cell scores 1; lung or other scores 2. magent does not assign tumour type from histology text.

Bulk (POST)

POST the same path with a JSON items array. The first item is the GET unit; each additional item is $0.002. Invalid items return HTTP 400 before settlement.

POST /api/calc/lent Max 25 unit_amount + extra_item_amount * (n - 1) extra $0.002 PREVIEW

1 to 25 items. Each item uses the same keys as the GET query parameters.
POST of 1 item costs the same as GET. Lists longer than 25: chunk into multiple POSTs. Extra items still execute; do not pad dummy rows.
The first invalid item fails the whole request (index in the 400 JSON). You are not charged.
HTTP 200 is {count, path, items}. Each items[i] is the GET 200 body for that row.
Catalog misses (empty matches, found=false) stay paid 200s inside that slot.
x402 resource URL is this path plus n and body_sha256. Browsers that prefer text/html get the same paywall as GET; Pay retries POST with the same items.

Example request (fixture)

{
  "items": [
    {
      "ecog": "0",
      "nlr": "5",
      "pleural_ldh_u_l": "1000",
      "tumor_type": "mesothelioma"
    },
    {
      "ecog": "0",
      "nlr": "5",
      "pleural_ldh_u_l": "1000",
      "tumor_type": "mesothelioma"
    }
  ]
}

Open bulk paywall →

Opens a two-item fixture on the API host. Unpaid browsers get the same MetaMask paywall as GET; Pay retries POST with those items.

Example 200 (fixture)

{
  "count": 2,
  "path": "/api/calc/lent",
  "items": [
    {
      "components": [
        {
          "value": 1.0e3,
          "factor": "pleural_ldh",
          "points": 0,
          "present": false
        },
        {
          "value": 0,
          "factor": "ecog",
          "points": 0,
          "present": true
        },
        {
          "value": 5.0,
          "factor": "nlr",
          "points": 0,
          "present": false
        },
        {
          "value": "mesothelioma",
          "factor": "tumor_type",
          "points": 0,
          "present": false
        }
      ],
      "disclaimer": "Not a medical device. Deterministic published-formula or published-code output for autonomous agents. A licensed clinician remains responsible for patient care and billing submissions.",
      "citation": {
        "authors": "Clive AO, Kahan BC, Hooper CE, Bhatnagar R, Morley AJ, Zahan-Evans N, Bintcliffe OJ, Boshuizen RC, Fysh ETH, Tobin CL, Medford ARL, Harvey JE, van den Heuvel MM, Lee YCG, Maskell NA",
        "doi": "10.1136/thoraxjnl-2014-205285",
        "id": "clive-2014",
        "pmid": "25100651",
        "source": "Thorax. 2014;69(12):1098-1104",
        "title": "Predicting survival in malignant pleural effusion: development and validation of the LENT prognostic score"
      },
      "formula": "lent",
      "formula_expression": "LENT = L (pleural LDH IU/L: <1500 → 0, >1500 → 1) + E (ECOG 0→0, 1→1, 2→2, 3-4→3) + N (serum NLR: <9 → 0, >9 → 1) + T (mesothelioma/haematological → 0; breast/gynaecological/renal_cell → 1; lung/other → 2); Clive 2014 Table 3; max 7; 0-1 low, 2-4 moderate, 5-7 high",
      "max_score": 7,
      "score": 0,
      "ecog": 0,
      "pleural_ldh_u_l": 1.0e3,
      "nlr": 5.0,
      "risk": "low",
      "tumor_type": "mesothelioma"
    },
    {
      "components": [
        {
          "value": 1.0e3,
          "factor": "pleural_ldh",
          "points": 0,
          "present": false
        },
        {
          "value": 0,
          "factor": "ecog",
          "points": 0,
          "present": true
        },
        {
          "value": 5.0,
          "factor": "nlr",
          "points": 0,
          "present": false
        },
        {
          "value": "mesothelioma",
          "factor": "tumor_type",
          "points": 0,
          "present": false
        }
      ],
      "disclaimer": "Not a medical device. Deterministic published-formula or published-code output for autonomous agents. A licensed clinician remains responsible for patient care and billing submissions.",
      "citation": {
        "authors": "Clive AO, Kahan BC, Hooper CE, Bhatnagar R, Morley AJ, Zahan-Evans N, Bintcliffe OJ, Boshuizen RC, Fysh ETH, Tobin CL, Medford ARL, Harvey JE, van den Heuvel MM, Lee YCG, Maskell NA",
        "doi": "10.1136/thoraxjnl-2014-205285",
        "id": "clive-2014",
        "pmid": "25100651",
        "source": "Thorax. 2014;69(12):1098-1104",
        "title": "Predicting survival in malignant pleural effusion: development and validation of the LENT prognostic score"
      },
      "formula": "lent",
      "formula_expression": "LENT = L (pleural LDH IU/L: <1500 → 0, >1500 → 1) + E (ECOG 0→0, 1→1, 2→2, 3-4→3) + N (serum NLR: <9 → 0, >9 → 1) + T (mesothelioma/haematological → 0; breast/gynaecological/renal_cell → 1; lung/other → 2); Clive 2014 Table 3; max 7; 0-1 low, 2-4 moderate, 5-7 high",
      "max_score": 7,
      "score": 0,
      "ecog": 0,
      "pleural_ldh_u_l": 1.0e3,
      "nlr": 5.0,
      "risk": "low",
      "tumor_type": "mesothelioma"
    }
  ]
}

Response

Field	Type	Description
`formula`	string	lent
`formula_expression`	string	Clive 2014 Table 3 LENT rule
`score`	integer	LENT points 0-7
`max_score`	integer	7
`risk`	string	low when score is 0-1, moderate when 2-4, high when 5-7 (Clive 2014). Not a diagnosis or treatment order. Paper median survivals 319 / 130 / 44 days are table numbers only.
`pleural_ldh_u_l`	number	Pleural fluid LDH used, IU/L
`ecog`	integer	Caller-assigned Oken 1982 ECOG grade 0-4
`nlr`	number	Serum NLR used (caller-supplied number)
`tumor_type`	string	Canonical Clive 2014 tumour token used for T
`components`	array	L, E, N, and T points
`citation`	object	Clive 2014 Thorax citation
`disclaimer`	string	Not a medical device

Example JSON

Machine form of the same example. Frozen fixture. Not a live lookup.

{
  "components": [
    {
      "value": 1.0e3,
      "factor": "pleural_ldh",
      "points": 0,
      "present": false
    },
    {
      "value": 0,
      "factor": "ecog",
      "points": 0,
      "present": true
    },
    {
      "value": 5.0,
      "factor": "nlr",
      "points": 0,
      "present": false
    },
    {
      "value": "mesothelioma",
      "factor": "tumor_type",
      "points": 0,
      "present": false
    }
  ],
  "disclaimer": "Not a medical device. Deterministic published-formula or published-code output for autonomous agents. A licensed clinician remains responsible for patient care and billing submissions.",
  "citation": {
    "authors": "Clive AO, Kahan BC, Hooper CE, Bhatnagar R, Morley AJ, Zahan-Evans N, Bintcliffe OJ, Boshuizen RC, Fysh ETH, Tobin CL, Medford ARL, Harvey JE, van den Heuvel MM, Lee YCG, Maskell NA",
    "doi": "10.1136/thoraxjnl-2014-205285",
    "id": "clive-2014",
    "pmid": "25100651",
    "source": "Thorax. 2014;69(12):1098-1104",
    "title": "Predicting survival in malignant pleural effusion: development and validation of the LENT prognostic score"
  },
  "formula": "lent",
  "formula_expression": "LENT = L (pleural LDH IU/L: <1500 → 0, >1500 → 1) + E (ECOG 0→0, 1→1, 2→2, 3-4→3) + N (serum NLR: <9 → 0, >9 → 1) + T (mesothelioma/haematological → 0; breast/gynaecological/renal_cell → 1; lung/other → 2); Clive 2014 Table 3; max 7; 0-1 low, 2-4 moderate, 5-7 high",
  "max_score": 7,
  "score": 0,
  "ecog": 0,
  "pleural_ldh_u_l": 1.0e3,
  "nlr": 5.0,
  "risk": "low",
  "tumor_type": "mesothelioma"
}

Client errors (HTTP 400)

Invalid params return 400 without charge. Shared HTTP 402 and 503 meanings: Payments.

HTTP	Code	When
400	`invalid_lent_ldh`	pleural_ldh_u_l must be a number from 1 to 20000 and not 1500 (Clive 2014 LENT uses <1500 vs >1500). Returned before settlement; you are not charged.
400	`invalid_ecog_ps`	ecog must be an integer from 0 to 4 (Oken 1982). Grade 5 (dead) is not scored. Returned before settlement; you are not charged.
400	`invalid_lent_nlr`	nlr must be a number from 0.05 to 200 and not 9 (Clive 2014 LENT uses <9 vs >9). Returned before settlement; you are not charged.
400	`invalid_lent_tumor`	tumor_type must be mesothelioma, haematological, breast, gynaecological, renal_cell, lung, or other (Clive 2014 LENT). Returned before settlement; you are not charged.
400	`invalid_items`	POST body must be a JSON object with only an items array Returned before settlement; you are not charged.
400	`invalid_item_count`	items must be an array of 1 to 25 objects Returned before settlement; you are not charged.
400	`invalid_item`	each items entry must be a JSON object Returned before settlement; you are not charged.

Related tools

Light's criteria — Apply Light 1972 pleural fluid criteria from protein ratio, LDH ratio, and pleural LDH versus two-thirds the laboratory LDH upper limit of normal.
NLR — Compute the Zahorec 2001 neutrophil-to-lymphocyte ratio from relative neutrophil and lymphocyte percents.
ECOG — Return the Oken 1982 ECOG performance status grade 0-4 from a caller-assigned integer, with a stable label.

Payment

Unpaid requests return HTTP 402 even if query parameters or POST items are missing or invalid, so CDP and agents can index the path. After a PAYMENT-SIGNATURE, invalid params return HTTP 400 JSON before settlement. magent does not charge. Fix the params, then request a new 402 quote for that complete URL. Catalog misses (empty matches, found=false) are valid paid 200s. Unpaid valid requests return HTTP 402 with a base64 PAYMENT-REQUIRED header. HTTP 503 is not a new quote: retry the same PAYMENT-SIGNATURE. Full handshake and shared payment errors: Payments. Stdio MCP: /docs/mcp.

Guarantees

HTTP 402 is unpaid, including a missing query. After PAYMENT-SIGNATURE, invalid parameters return HTTP 400 before settlement. You are not charged. HTTP 402 never includes the tool JSON.
exact: settlement finishes before the tool (paymentFlow upfront). batch-settlement: verify/deposit before the tool; chargedCumulativeAmount commits after HTTP 2xx. Uncertain or failed settlement fails closed (HTTP 503). Retry the same PAYMENT-SIGNATURE.
HTTP 402 is unpaid only. Do not sign a second authorization because of a 503.
Execution is timeout-bounded and concurrency-capped.
Calculator inputs are stored encrypted for allowlisted operators (Magent Console). They are not in public logs, SSH lookups, catalog, or rollups. Request logs store path without query.