Diagnostic and prognostic significance of survivin levels in malignant pleural effusion

Abstract

Survivin level was 41.75 ± 76.20 in MPE, 15.83 ± 10.92 in TPE and 8.33 ± 8.67 in TE. When the patients divided two groups as malignant and non-malignant pleural effusion (non-MPE), survivin level was significantly higher in MPE (41.75 ± 76.20) than in non-MPE (13.33±2.05) (p = 0.012). The cutoff value for survivin levels detected by ROC curve analysis was 7.5 pg/ml, with sensitivity and specificity values of 72%, 44%, respectively. Survivin had no discriminative power in differentiating exudative effusions of MPE from TPE (p = 0.405). There was no correlation between survivin level and age, sex, location, fluid pH, glucose, protein, albumine and ADA level while there was significant moderate correlation with fluid LDH (r = 0.49; p < 0.001). Survivin levels can distinguish patients who had poor prognosis (median survival 75 days, n = 24) and those who had good prognosis (median survival 219 days, n = 27, p = 0.03) in MPE. In conclusion, survivin expression levels detected with ELISA had no discriminative power in differentiating exudative effusions included MPE and TPE. Elevated survivin levels are associated with poor survival in MPE. Our results suggest that survivin may be a potential prognostic marker in MPE.

Age and sex distribution in malignant and tuberculous serous effusions: A study of 127 patients and review of the literature

“…However, the difference in the male‐to‐female ratio between tuberculosis and non‐tuberculous benign lesions was not significant ( P = 0.42756). A similar trend was observed when the various studies from the review of the literature were taken into consideration (Table ); the malignancy patients (male : female = 730:649 with females accounting for 47.1%) were significantly different from tuberculosis patients (male : female = 656: 342 with females accounting for 35.7%, P = 0.00000) as well as non‐tuberculous benign cases (male : female = 232:129, P = 0.00014). However, the difference between tuberculosis and non‐tuberculous benign lesions was not significant ( P = 0.65151).…”

“…Whereas tuberculous serous effusion was mostly a disease of those aged <40 years, malignant effusion was a commonly found in the ≥50 years age group. A review of the literature (Table ) shed light on age and sex distribution in 13 studies that were based on pleural effusion and ascitic fluids involved by malignancy and tuberculous processes and six studies in which malignancy, tuberculosis and non‐tuberculous benign lesions presented with serous effusions . In all these 19 studies, the mean and/or median age of malignancy patients were ≥50 years, as opposed to tuberculous pleurisy cases in which the mean/median age was ≥50 years in just eight patients ( P = 0.00006).…”

Management of malignant pleural effusion: challenges and solutions

“…In a study by Görgün et al,79 survivin levels below a level of 20 pg/mL was predictive of poor survival (median survival 75 days) compared with levels above 20 pg/mL (median survival 219 days).…”

Useful Application of Immunostaining to Malignant Pleural Effusion among Lao People in Vientiane Capital, Lao PDR

“…The incidence rate of MPE was estimated to be greater than 150,000 cases every year in the United States (Morgensztern et al, 2012), and 50,000 cases in the United Kingdom (Psallidas et al, 2016). Lung carcinoma is the most common origin of MPE (37.5%), while 8% to 15% of patients with lung cancer had MPE (Morgensztern et al, 2012;Görgün et al, 2013). Breast cancer ranks as the second most common origin (11.5%), followed by malignant lymphoma, including both Hodgkin's and non-Hodgkin's lymphoma (11.5%) (Antunes et al, 2003).…”