Abstract
OBJECTIVES:We compared the diagnostic potential of cancer ratio (CR, serum lactate dehydrogenase [LDH]/pleural fluid adenosine deaminase [pfADA]), cancer ratio plus (CR plus, cancer ratio/pleural lymphocyte percentage), and age/pfADA ratio with pfADA in malignant pleural effusion.METHODS:Data from 100 patients with malignant pleural effusion (MPE) and 119 patients with tuberculous pleural effusion (TPE) were retrospectively collected. PfADA, age/pfADA ratio, CR, and CR plus were compared between patients with MPE and those with TPE in two age groups (≤50 and >50 years). The best cut-off value was determined, and the diagnostic performance was evaluated according to the receiver operating characteristic curve.RESULTS:PfADA was statistically significantly lower while age/pfADA ratio, CR, and CR plus were significantly higher in the MPE group than in the TPE group in both age groups (p<0.05). For patients aged ≤50 years, the differential diagnostic value of pfADA for MPE was better than those of age/pfADA ratio, CR, and CR plus. At a cut-off value of 13.0 U/L, the sensitivity, specificity, and accuracy were 88.9%, 100.0%, and 98.9%, respectively. For patients aged >50 years, the diagnostic performance of CR plus was superior to those of pfADA, age/pfADA ratio, and CR. At a cut-off value of 22.6, the sensitivity, specificity, and accuracy of CR plus for the diagnosis of MPE were 86.8%, 84.6%, and 86.2%, respectively.CONCLUSIONS:The best parameter for diagnosing MPE was different for patients aged ≤50 years and >50 years. For patients aged >50 years, CR plus was a good parameter for the differential diagnosis of MPE. For patients aged ≤50 years, pfADA was better.
Highlights
Malignant pleural effusion (MPE) is caused by malignant tumors originating in the pleura or metastasis of malignant tumors from other locations to the pleura
MPE was diagnosed if pleural effusion was exudative and met one of the following criteria (6): (1) malignant cells were found in lung tissues and (2) malignant cells were found in pleural fluid or pleural tissues
We found that the level of pleural fluid adenosine deaminase (pfADA) in the MPE group was significantly lower than that in the tuberculous pleural effusion (TPE) group, while the age/pfADA ratio, cancer ratio (CR), and CR plus were significantly higher than those in the MPE group
Summary
Malignant pleural effusion (MPE) is caused by malignant tumors originating in the pleura or metastasis of malignant tumors from other locations to the pleura. Once diagnosed with MPE, the median survival is only 3–12 months (1). Thoracoscopic or closed pleural biopsy improves diagnostic sensitivity, it is traumatic with the risk of complications and requires high cost and technical requirements. New diagnostic techniques are limited by factors such as diagnostic efficiency, technical requirements, and cost.
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
