Pathological diagnoses and adenosine deaminase levels in patients undergoing pericardial window operation for large pericardial effusions

Abstract

Background: It might be challenging to determine the etiology of pericardial effusions as studies have usually focused on pericardial effusions in patients suspected to have specific underlying clinical conditions. We aimed to evaluate adenosine deaminase (ADA) levels in pericardial fluid samples of patients with large pericardial effusions in whom pericardial window surgeries with biopsy and pathological examinations were carried out. Materials and Methods:Pericardial fluid ADA levels of 149 consecutive patients having large pericardial effusions were evaluated. Pericardial effusion was detected by transthoracic echocardiography, ADA levels were measured from the fluid taken during pericardial windowing procedure, and pathological examination of the tissue samples were performed. Results:The median age of selected patients participating in the study was 58.43 ± 14.47 years. All the pericardial fluid samples were found to be exudative and 116 (77.9 %) of the cases had also concomitant pleural effusions. The median ADA level of the cases was calculated to be 19.57 U/L (9.47-38.70), well below the cut-off value (40 U/L). The mean ADA levels value was 9.21 U/L (7.70-9.91) in the nonspecific inflammations group and 38.35 U/L (23.92-48.67) in the lung malignancy group (p < 0.001). In the subgroup analysis of lung cancers, ADA levels in pericardial effusions of patients with adenocarcinoma were found to be statistically significantly higher than patients with squamous cell cancer. (p = 0.007). Conclusion:ADA levels in pericardial effusion were found to be significantly higher in lung cancer, especially in cases of lung adenocarcinoma. High levels of ADA may be used as a significative biochemical marker in the diagnosis of lung cancer.