Volume 27, Issue 1 (3-2024)
J Arak Uni Med Sci 2024, 27(1): 39-45 |
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Halvani A, Rafatmagham S, Saeedi D. Efficacious Factors in Pleural Malignancy Based on Characteristics of Pleural Fluid and Type of Primary Tumor in Shahid Sadouqhi and Shahid Rahmonun Hospitals of Yazd from 2019 to 2021. J Arak Uni Med Sci 2024; 27 (1) :39-45
URL: http://jams.arakmu.ac.ir/article-1-7650-en.html
URL: http://jams.arakmu.ac.ir/article-1-7650-en.html
1- Department of Internal Medicine, Yazd Medical Science Branch, Islamic Azad University, Yazd, Iran
2- Department of Internal Medicine, Fasa University of Medical Sciences, Fasa, Iran ,r.sareh2012@gmail.com
3- Yazd Medical Science Branch, Islamic Azad University, Yazd, Iran
2- Department of Internal Medicine, Fasa University of Medical Sciences, Fasa, Iran ,
3- Yazd Medical Science Branch, Islamic Azad University, Yazd, Iran
Abstract: (422 Views)
Introduction: In this study, the effective factors in pleural malignancy based on pleural fluid characteristics and the type of primary tumor in Shahid Sadouqhi and Shahid Rahmonun hospitals of Yazd from 2019 to 2021 were evaluated.
Methods: In this descriptive study, 98 patients with pleural effusion referred for thoracoscopy to the thoracic surgery department in Shahid Sadouqhi and Shahid Rahmonun hospitals in Yazd were studied from 2019 to 2021. The method of data collection in this research was file reading. Among the patients who underwent thoracoscopy during this period, only patients who had at least one study of pleural fluid thoracentesis and pleural fluid analysis in terms of cytology (White blood cells (WBC) and Red blood cells (RBC)), protein, albumin, Lactate Dehydrogenase (LDH), and pH and after reviewing the biopsy pathology report the pleura of these patients were thoracocentesis. Those who had reported cases of pleural malignancy were included in the study. The database used in this research was a simple questionnaire containing the studied variables.
Results: In the examination of the pleural fluid of patients with pleural malignancy, in terms of the WBC level, most of the cases were below 1000 units per cubic milliliter. In terms of the LDH level, most of the cases were more than 1000 units/liter. More than 90% of cases had lymphocytes, and the lowest amount was 62 % of lymphocytes. All cases had exudative pleural fluid, which was exudative mainly due to LDH level and then due to both protein and LDH levels at the same time.
Conclusions: According to the findings, in patients with pleural malignancy, pleural effusion is exudative in all cases, mainly due to the effect of LDH in the pleural fluid. On the other hand, the percentage of white blood cells in all Cases of predominant lymphocyte percentage were seen.
Methods: In this descriptive study, 98 patients with pleural effusion referred for thoracoscopy to the thoracic surgery department in Shahid Sadouqhi and Shahid Rahmonun hospitals in Yazd were studied from 2019 to 2021. The method of data collection in this research was file reading. Among the patients who underwent thoracoscopy during this period, only patients who had at least one study of pleural fluid thoracentesis and pleural fluid analysis in terms of cytology (White blood cells (WBC) and Red blood cells (RBC)), protein, albumin, Lactate Dehydrogenase (LDH), and pH and after reviewing the biopsy pathology report the pleura of these patients were thoracocentesis. Those who had reported cases of pleural malignancy were included in the study. The database used in this research was a simple questionnaire containing the studied variables.
Results: In the examination of the pleural fluid of patients with pleural malignancy, in terms of the WBC level, most of the cases were below 1000 units per cubic milliliter. In terms of the LDH level, most of the cases were more than 1000 units/liter. More than 90% of cases had lymphocytes, and the lowest amount was 62 % of lymphocytes. All cases had exudative pleural fluid, which was exudative mainly due to LDH level and then due to both protein and LDH levels at the same time.
Conclusions: According to the findings, in patients with pleural malignancy, pleural effusion is exudative in all cases, mainly due to the effect of LDH in the pleural fluid. On the other hand, the percentage of white blood cells in all Cases of predominant lymphocyte percentage were seen.
References
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11. Nguyen AH, Miller EJ, Wichman CS, Berim IG, Agrawal DK. Diagnostic value of tumor antigens in malignant pleural effusion: a meta-analysis. Transl Res. 2015;166(5):432-9. pmid: 25953662 doi: 10.1016/j.trsl.2015.04.006
12. Bonomo L, Feragalli B, Sacco R, Merlino B, Storto ML. Malignant pleural disease. Eur J Radiol. 2000;34(2):98-118. pmid: 10874176 doi: 10.1016/s0720-048x(00)00168-6
13. Bianchi C, Bianchi T. Malignant mesothelioma: global incidence and relationship with asbestos. Ind Health. 2007;45(3):379-87. pmid: 17634686 doi: 10.2486/indhealth.45.379
14. Carbone M, Adusumilli PS, Alexander Jr HR, Baas P, Bardelli F, Bononi A, et al. Mesothelioma: Scientific clues for prevention, diagnosis, and therapy. CA Cancer J Clin. 2019;69(5):402-29. pmid: 31283845 doi: 10.3322/caac.21572
15. Neumann V, Löseke S, Nowak D, Herth FJ, Tannapfel A. Malignant pleural mesothelioma: incidence, etiology, diagnosis, treatment, and occupational health. Dtsch Arztebl Int. 2013;110(18):319. pmid: 23720698 doi: 10.3238/arztebl.2013.0319
16. Kastelik JA. Management of malignant pleural effusion. Lung. 2013;191(2):165-75. pmid: 23315213 doi: 10.1007/s00408-012-9445-1
17. Feller-Kopman D, Light R. Pleural disease. N Engl J Med. 2018;378(8):740-51. pmid: 29466146 doi: 10.1056/NEJMra1403503
18. Roberts ME, Neville E, Berrisford RG, Antunes G, Ali NJ. Management of a malignant pleural effusion: British Thoracic Society pleural disease guideline 2010. Thorax. 2010;65(Suppl 2):ii32-ii40. pmid: 20696691 doi: 10.1136/thx.2010.136994
19. Halimi M, BeheshtiRouy S, Salehi D, Rasihashemi SZ. The role of immunohistochemistry studies in distinguishing malignant mesothelioma from metastatic lung carcinoma in malignant pleural effusion. Iran J Pathol. 2019;14(2):122-6.
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21. Zhang Y, Li X, Liu J, Hu X, Wan C, Zhang R, et al. Diagnostic accuracy of the cancer ratio for the prediction of malignant pleural effusion: evidence from a validation study and meta-analysis. Ann Med. 2021;53(1):558-66. pmid: 33818231 doi: 10.1080/07853890.2021.1906943
22. Hassan M, Gadallah M, Mercer RM, Harriss E, Rahman NM. Predictors of outcome of pleurodesis in patients with malignant pleural effusion: a systematic review and meta-analysis. Expert Rev Respir Med. 2020;14(6):645-54. pmid: 32213100 doi: 10.1080/17476348.2020.1746647
23. Tsim S, Paterson S, Cartwright D, Fong CJ, Alexander L, Kelly C, et al. Baseline predictors of negative and incomplete pleural cytology in patients with suspected pleural malignancy – Data supporting ‘Direct to LAT’ in selected groups. Lung Cancer. 2019;133:129-33. pmid: 31200818 doi: 10.1016/j.lungcan.2019.05.017
24. Bielsa S, Salud A, Martínez M, Esquerda A, Martín A, Rodríguez-Panadero F, et al. Prognostic significance of pleural fluid data in patients with malignant effusion. Eur J Intern Med. 2008;19(5):334-9. pmid: 18549935 doi: 10.1016/j.ejim.2007.09.014
25. Kassirian S, Hinton SN, Cuninghame S, Chaudhary R, Iansavitchene A, Amjadi K, et al. Diagnostic sensitivity of pleural fluid cytology in malignant pleural effusions: systematic review and meta-analysis. Thorax. 2023;78(1):32-40. pmid:35110369 doi: 10.1136/thoraxjnl-2021-217959
26. Wu A, Liang Z, Yuan S, Wang S, Peng W, Mo Y, et al. Development and validation of a scoring system for early diagnosis of malignant pleural effusion based on a nomogram. Front Oncol. 2021;11:775079. pmid: 34950585 doi: 10.3389/fonc.2021.775079
27. Peng P, Yang Y, Du J, Zhai K, Shi H-Z. Prognostic biomarkers of malignant patients with pleural effusion: a systematic review and meta-analysis. Cancer Cell Int. 2022;22(1):99. pmid: 35209915 doi: 10.1186/s12935-022-02518-w
28. Fallahi MJ, Rezvani A, Al-Saif Z. Survival of patients with malignant pleural effusion: a single center study [in Persian]. Sadra Med J 2022;10(3):311-6. doi: 10.30476/smsj.2023.95854.1354
29. Feller-Kopman DJ, Reddy CB, DeCamp MM, Diekemper RL, Gould MK, Henry T, et al. Management of Malignant Pleural Effusions. An Official ATS/STS/STR Clinical Practice Guideline. Am J Respir Crit Care Med. 2018;198(7):839-49. pmid: 30272503 doi: 10.1164/rccm.201807-1415ST
30. Penz E, Watt KN, Hergott CA, Rahman NM, Psallidas I. Management of malignant pleural effusion: challenges and solutions. Cancer Manag Res. 2017;9:229-41. pmid: 28694705 doi: 10.2147/CMAR.S95663
31. Bibby AC, Dorn P, Psallidas I, Porcel JM, Janssen J, Froudarakis M, et al. ERS/EACTS statement on the management of malignant pleural effusions. European journal of cardio-thoracic surgery: official journal of the European Association for Cardio-thoracic Surgery. 2019;55(1):116-32. doi: 10.1093/ejcts/ezy258
32. Lepus CM, Vivero M. Updates in effusion cytology. Surg
33. Pathol Clin. 2018;11(3):523-44. pmid: 30190139 doi: 10.1016/j.path.2018.05.003
34. Swiderek J, Morcos S, Donthireddy V, Surapaneni R, Jackson-Thompson V, Schultz L, et al. Prospective study to determine the volume of pleural fluid required to diagnose malignancy. Chest. 2010;137(1):68-73. pmid: 19741064 doi: 10.1378/chest.09-0641
35. Psallidas I, Kalomenidis I, Porcel JM, Robinson BW, Stathopoulos GT. Malignant pleural effusion: from bench to bedside. Eur Respir Rev. 2016;25(140):189-98. pmid: 27246596 doi: 10.1183/16000617.0019-2016
36. Herrera Lara S, Fernández-Fabrellas E, Juan Samper G, Marco Buades J, Andreu Lapiedra R, Pinilla Moreno A, et al. Predicting Malignant and paramalignant pleural effusions by combining clinical, radiological and pleural fluid analytical parameters. Lung. 2017;195(5):653-60. pmid: 28656381
37. doi: 10.1007/s00408-017-0032-3
38. Porcel JM. Biomarkers in the diagnosis of pleural diseases: a 2018 update. Ther Adv Respir Dis. 2018;12:1753466618808660. pmid: 30354850 doi: 10.1177/1753466618808660
39. Nguyen AH, Miller EJ, Wichman CS, Berim IG, Agrawal DK. Diagnostic value of tumor antigens in malignant pleural effusion: a meta-analysis. Transl Res. 2015;166(5):432-9. pmid: 25953662 doi: 10.1016/j.trsl.2015.04.006
40. Bonomo L, Feragalli B, Sacco R, Merlino B, Storto ML. Malignant pleural disease. Eur J Radiol. 2000;34(2):98-118. pmid: 10874176 doi: 10.1016/s0720-048x(00)00168-6
41. Bianchi C, Bianchi T. Malignant mesothelioma: global incidence and relationship with asbestos. Ind Health. 2007;45(3):379-87. pmid: 17634686 doi: 10.2486/indhealth.45.379
42. Carbone M, Adusumilli PS, Alexander Jr HR, Baas P, Bardelli F, Bononi A, et al. Mesothelioma: Scientific clues for prevention, diagnosis, and therapy. CA Cancer J Clin. 2019;69(5):402-29. pmid: 31283845 doi: 10.3322/caac.21572
43. Neumann V, Löseke S, Nowak D, Herth FJ, Tannapfel A. Malignant pleural mesothelioma: incidence, etiology, diagnosis, treatment, and occupational health. Dtsch Arztebl Int. 2013;110(18):319. pmid: 23720698 doi: 10.3238/arztebl.2013.0319
44. Kastelik JA. Management of malignant pleural effusion. Lung. 2013;191(2):165-75. pmid: 23315213 doi: 10.1007/s00408-012-9445-1
45. Feller-Kopman D, Light R. Pleural disease. N Engl J Med. 2018;378(8):740-51. pmid: 29466146 doi: 10.1056/NEJMra1403503
46. Roberts ME, Neville E, Berrisford RG, Antunes G, Ali NJ. Management of a malignant pleural effusion: British Thoracic Society pleural disease guideline 2010. Thorax. 2010;65(Suppl 2):ii32-ii40. pmid: 20696691 doi: 10.1136/thx.2010.136994
47. Halimi M, BeheshtiRouy S, Salehi D, Rasihashemi SZ. The role of immunohistochemistry studies in distinguishing malignant mesothelioma from metastatic lung carcinoma in malignant pleural effusion. Iran J Pathol. 2019;14(2):122-6.
48. pmid: 31528168 doi: 10.30699/IJP.14.2.122
49. Zhang Y, Li X, Liu J, Hu X, Wan C, Zhang R, et al. Diagnostic accuracy of the cancer ratio for the prediction of malignant pleural effusion: evidence from a validation study and meta-analysis. Ann Med. 2021;53(1):558-66. pmid: 33818231 doi: 10.1080/07853890.2021.1906943
50. Hassan M, Gadallah M, Mercer RM, Harriss E, Rahman NM. Predictors of outcome of pleurodesis in patients with malignant pleural effusion: a systematic review and meta-analysis. Expert Rev Respir Med. 2020;14(6):645-54. pmid: 32213100 doi: 10.1080/17476348.2020.1746647
51. Tsim S, Paterson S, Cartwright D, Fong CJ, Alexander L, Kelly C, et al. Baseline predictors of negative and incomplete pleural cytology in patients with suspected pleural malignancy – Data supporting ‘Direct to LAT’ in selected groups. Lung Cancer. 2019;133:129-33. pmid: 31200818 doi: 10.1016/j.lungcan.2019.05.017
52. Bielsa S, Salud A, Martínez M, Esquerda A, Martín A, Rodríguez-Panadero F, et al. Prognostic significance of pleural fluid data in patients with malignant effusion. Eur J Intern Med. 2008;19(5):334-9. pmid: 18549935 doi: 10.1016/j.ejim.2007.09.014
53. Kassirian S, Hinton SN, Cuninghame S, Chaudhary R, Iansavitchene A, Amjadi K, et al. Diagnostic sensitivity of pleural fluid cytology in malignant pleural effusions: systematic review and meta-analysis. Thorax. 2023;78(1):32-40. pmid:35110369 doi: 10.1136/thoraxjnl-2021-217959
54. Wu A, Liang Z, Yuan S, Wang S, Peng W, Mo Y, et al. Development and validation of a scoring system for early diagnosis of malignant pleural effusion based on a nomogram. Front Oncol. 2021;11:775079. pmid: 34950585 doi: 10.3389/fonc.2021.775079
55. Peng P, Yang Y, Du J, Zhai K, Shi H-Z. Prognostic biomarkers of malignant patients with pleural effusion: a systematic review and meta-analysis. Cancer Cell Int. 2022;22(1):99. pmid: 35209915 doi: 10.1186/s12935-022-02518-w
56. Fallahi MJ, Rezvani A, Al-Saif Z. Survival of patients with malignant pleural effusion: a single center study [in Persian]. Sadra Med J 2022;10(3):311-6. doi: 10.30476/smsj.2023.95854.1354
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