دوره 27، شماره 1 - ( 1-1403 )                   جلد 27 شماره 1 صفحات 45-39 | برگشت به فهرست نسخه ها

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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-fa.html
حلوانی ابوالحسن، رفعت مقام ساره، سعیدی درسا. عوامل مؤثر در بدخیمی پلور بر اساس خصوصیات مایع پلور و نوع تومور اولیه در بیمارستان شهید صدوقی و شهید رهنمون یزد از سال ١٣٩٨ تا ١٤٠٠. مجله دانشگاه علوم پزشكي اراك. 1403; 27 (1) :39-45

URL: http://jams.arakmu.ac.ir/article-1-7650-fa.html


1- گروه بیماری‌های داخلی، دانشکده پزشکی، دانشگاه آزاد اسلامی واحد یزد، یزد، ایران
2- گروه بیماری‌های داخلی، دانشکده پزشکی، دانشگاه علوم پزشکی فسا، فسا، ایران ، r.sareh2012@gmail.com
3- دانشکده پزشکی، دانشگاه آزاد اسلامی واحد یزد، یزد، ایران
چکیده:   (204 مشاهده)
مقدمه: در این مطالعه، عوامل مؤثر در بدخیمی پلور بر اساس خصوصیات مایع پلور و نوع تومور اولیه در بیمارستان شهید صدوقی و شهید رهنمون یزد از سال ١٣٩٨ تا ١٤٠٠ ارزیابی شد.
روش کار: تعداد 98 بیمار مبتلا به پلورال افیوژن که برای توراکوسکوپی به بخش جراحی قفسه سینه از سال ١٣٩٨ تا ١٤٠٠ به بیمارستان‌های شهید صدوقی و شهید رهنمون یزد مراجعه کردند مورد مطالعه قرار گرفتند. روش جمع‌آوری داده‌ها پرونده‌خوانی بود. در بین بیمارانی که در این بازه زمانی توراکوسکوپی انجام داده بودند، فقط بیمارانی که حداقل یک مطالعه توراسنتز مایع جنب و آنالیز مایع پلور از نظر سیتولوژی
(White blood cells) WBC و (Red blood cells) RBC، پروتئین، آلبومین، (Lactate Dehydrogenase) LDH و pH داشتند و پس از بررسی پاتولوژی بیوپسی پلور بیماران توراکوسنتز شده، افرادی که در گزارش آن‌ها موارد بدخیمی پلور گزارش ‌شده بود به مطالعه وارد شدند. ابزار مورد استفاده در این پژوهش، چک‌لیست متغیرهای مورد مطالعه بود.

یافته‌ها: در بررسی مایع پلور بیماران مبتلا به بدخیمی پلور از نظر میزان WBC، اکثر موارد زیر 1000 واحد بر میلی‌لیتر مکعب و از نظر میزان LDH اکثر موارد بیشتر از 1000 واحد بر لیتر بود. در تفکیک گلبول‌های سفید در تمامی موارد، لنفوسیت غالب بود که اکثر موارد بالای 90 درصد لنفوسیت داشتند. تمامی موارد مایع پلور اگزوداتیو داشتند که بیشتر به علت سطح LDH و هر دو سطح پروتئین و LDH به‌صورت هم‌زمان، اگزوداتیو شده بودند.
نتیجه گیری: با توجه به یافته‌ها به نظر می‌رسد در بیماران مبتلا به بدخیمی پلور افیوژن، پلور در تمام موارد اگزوداتیو بود که بیشتر به علت تأثیر میزان LDH در مایع پلور است. همچنین از نظر درصد گلبول‌های سفید در تمامی موارد، غالب بودن درصد لنفوسیت دیده شد.
متن کامل [PDF 1108 kb]   (36 دریافت)    
نوع مطالعه: پژوهشي اصیل | موضوع مقاله: داخلی
دریافت: 1402/12/8 | پذیرش: 1403/2/19

فهرست منابع
1. 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
2. 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
3. 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
4. Lepus CM, Vivero M. Updates in effusion cytology. Surg
5. Pathol Clin. 2018;11(3):523-44. pmid: 30190139 doi: 10.1016/j.path.2018.05.003
6. 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
7. 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
8. 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
9. doi: 10.1007/s00408-017-0032-3
10. 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
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.
20. pmid: 31528168 doi: 10.30699/IJP.14.2.122
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
57. 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
58. 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
59. 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
60. Lepus CM, Vivero M. Updates in effusion cytology. Surg
61. Pathol Clin. 2018;11(3):523-44. pmid: 30190139 doi: 10.1016/j.path.2018.05.003
62. 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
63. 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
64. 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
65. doi: 10.1007/s00408-017-0032-3
66. 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
67. 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
68. 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
69. 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
70. 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
71. 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
72. Kastelik JA. Management of malignant pleural effusion. Lung. 2013;191(2):165-75. pmid: 23315213 doi: 10.1007/s00408-012-9445-1
73. Feller-Kopman D, Light R. Pleural disease. N Engl J Med. 2018;378(8):740-51. pmid: 29466146 doi: 10.1056/NEJMra1403503
74. 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
75. 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.
76. pmid: 31528168 doi: 10.30699/IJP.14.2.122
77. 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
78. 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
79. 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
80. 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
81. 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
82. 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
83. 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
84. 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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