Predicting Malignant and Paramalignant Pleural Effusions by Combining Clinical, Radiological and Pleural Fluid Analytical Parameters

Lara, Susana Herrera; Fernández-Fabrellas, Estrella; Samper, Gustavo Juan; Buades, J.; Andreu, Rafael; Moreno, Amparo Pinilla; Suárez-Varela, María Morales

doi:10.1007/s00408-017-0032-3

Cited by 29 publications

(22 citation statements)

References 19 publications

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“…Tumor markers and LDH are the important parameters to differentiate benign and malignant lesions, particularly when detected in pleural effusion, ascetic fluid, and pancreatic cystic fluid. 14,15,26 However, we did not consider mediastinal cyst fluid biochemical examinations in this study. Previous studies have shown that serum carbohydrate antigen 19-9 and CEA levels are only elevated in patients with benign mediastinal cysts; often an elevated CEA level indicates that the occupying lesions are cystic.…”

Section: Discussionsupporting

confidence: 92%

“…Humoral fluid biochemical analysis is routinely applied in a clinical setting. Tumor markers and LDH are the important parameters to differentiate benign and malignant lesions, particularly when detected in pleural effusion, ascetic fluid, and pancreatic cystic fluid . However, we did not consider mediastinal cyst fluid biochemical examinations in this study.…”

Section: Discussionmentioning

confidence: 96%

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Application of endoscopic ultrasound‐guided‐fine needle aspiration combined with cyst fluid analysis for the diagnosis of mediastinal cystic lesions

Zhao

Wang

et al. 2018

Thoracic Cancer

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BackgroundMediastinal cystic lesions account for approximately 15–20% of all mediastinal masses and are difficult to differentiate because of similar imaging manifestation. The aim of this study was to differentiate mediastinum cystic lesions through endoscopic ultrasound‐guided‐fine needle aspiration (EUS‐FNA) and parameters from cyst‐fluid analysis.MethodsOver a period of eight years, 37 patients suspected with mediastinal cystic lesions were assessed. Cyst fluid was collected via EUS‐FNA and further examined using cytological and biochemical techniques. Definitive diagnosis was established based on cytology, surgical pathology, and/or clinical follow‐up.ResultsBased on the final pathological reports or long‐term follow‐up, 19 patients were diagnosed with benign cysts, 14 with benign or malignant tumors, 2 with tuberculosis, 1 with an abscess, and 1 with a pancreatic pseudocyst. Computed tomography or magnetic resonance imaging mistakenly distinguished eight cases as solid masses (27.03%), but EUS revealed cystic characteristics. Carcinoembryonic antigen and lactate dehydrogenase (LDH) were evaluated from the cyst fluid obtained by EUS‐FNA. There was no statistically significant difference in carcinoembryonic antigen values between benign and malignant cysts; however the average LDH value in the malignancy group was significantly higher than in the benign group.ConclusionEUS‐FNA showed great potential for differentiating mediastinal lesions by combining imaging manifestation and cytological examination. The elevated LDH value from cyst fluid chemical analysis could be used as an auxiliary indicator for diagnosing malignancy.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 96%

Application of endoscopic ultrasound‐guided‐fine needle aspiration combined with cyst fluid analysis for the diagnosis of mediastinal cystic lesions

Zhao

Wang

et al. 2018

Thoracic Cancer

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“…In the literature, it has been reported that in cases with suspected cancer, if the malignant cell was not identified in the first cytological sample, repeated examination of the cytological mate-rial increases the likelihood of malignant neoplasm (1). However, since the contribution of repeated cytological samples to diagnosis is low, pleural biopsy is recommended in addition to the second cytological sampling (4). In another study, 44% of the first cytological samples of 414 patients were diagnosed with malignant cells, while 3 and more cytological samples obtained from all patients were found to contribute 6% to the diagnosis (15).…”

Section: Discussionmentioning

confidence: 99%

“…In some cases, it may even be the first sign of a primary malignant tumor. Although the classification of PEs as transudates and exudates by clinical data makes a significant contribution to narrowing the differential diagnosis and organizing of subsequent examinations and treatments, the presence of malignant cells on cytology material is also important because of its association with cancer staging, prognosis, and survival (2)(3)(4). The main purpose of this method is to detect the presence of malignant cells.…”

Section: Introductionmentioning

confidence: 99%

“…Almost all cancers can spread to the pleura, and the local and systemic effects of tumors, as well as the effects of radiotherapy and chemotherapy used during the treatment, may cause the formation of PEs (6). The cytological examination of the pleural fluid is a very fast and effective method, particularly for diagnosing malignancy, although cytological samples of all cancer patients may not include malignant cells (4,6). The diagnosis of malignant PE is performed by cytopathological examination of pleural fluid and by pleural biopsy.…”

Section: Introductionmentioning

confidence: 99%

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The role of cytology in pleural effusion: a single-center experience

Sadullahoğlu¹

2019

Erciyes Med J

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Objective: As a fast and effective method, cytopathological examination of the pleural fluid is the diagnostic tool of choice in determining the etiology of a spectrum of inflammatory to neoplastic conditions. The aim of the present study was to investigate the role of pleural cytology samples examined within a certain time period in determining the presence of malignant cells. Materials and Methods: Cytological materials of 433 patients with pleural effusion (PE) were retrospectively analyzed. Clinical parameters and cytological diagnosis were recorded in consecutive patients with PE. Results: Of the 433 cases enrolled in the study, 264 (61%) were male, and 169 (39%) were female. 15.6% (67/433) of the cases were reported as malignant, and 85% were aged >50 years. It was found that the contribution of repeated cytological examination of a material to diagnosis was approximately 3%. The sensitivity and specificity of the cytological method were calculated as 34% and 99%, respectively. Immunocytochemistry was performed in 50 patients who received cell-block techniques, and 42.4% of those were diagnosed as malignant. Molecular tests were also performed in 5 patients. Conclusion: Although the sensitivity is low, cytological examination of the pleura can be considered a diagnostic tool of vital importance, especially in patients with an advanced-stage disease and poor performance, who can benefit from rapidly evolving and changing treatment options.

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Parental perspectives on pediatric inflammatory bowel disease: Unraveling concerns, and study participation willingness

Eindor‐Abarbanel,

Pinchevski,

Shalem

et al. 2024

J. pediatr. gastroenterol. nutr.

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ObjectivesThe impact of disease burden extends beyond pediatric inflammatory bowel disease (IBD) patients to include their parents. Previous studies, predating the biologic era, have highlighted parental concerns about potential side effects associated with IBD medications. However, there is a notable gap in the literature regarding parents' perceptions of clinical studies involving pediatric IBD patients. This study aims to explore the specific concerns troubling parents of children with IBD, identifying factors influencing these concerns, and assesses parental willingness to allow their child's participation in clinical studies.MethodsUtilizing social media, we disseminated an anonymous questionnaire to parents of pediatric IBD patients. The questionnaire encompassed queries about parental willingness for their child to partake in clinical studies, aspects of the disease deemed bothersome, and the sense of coherence scale (SOC).ResultsResponses were obtained from 101 parents, with a mean age of 46.4, of whom 82.2% were female. Concerns about potential future side effects of their child's medications surpassed worries about disease symptoms (80.04% vs. 73.47%). Linear regression analysis revealed that parents with lower SOC scores, limited medical care accessibility, and a higher age of the child at diagnosis, exhibited heightened concerns about the future impact of the disease on their child (p = 0.016, 0.003, and 0.045, respectively). While a majority rejected participation in studies involving new medications (54.5%), there was greater agreement for studies on nutritional therapies (84.2%) and complementary medicine (91.1%). Classification tree analysis indicated that women were more inclined to permit their child's participation in studies focusing on complementary medicine (adjusted p = 0.002).ConclusionParents of IBD patients express greater apprehension about potential side effects from IBD medications and display reluctance toward their child participating in clinical studies related to medications.

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Predicting Malignant and Paramalignant Pleural Effusions by Combining Clinical, Radiological and Pleural Fluid Analytical Parameters

Cited by 29 publications

References 19 publications

Application of endoscopic ultrasound‐guided‐fine needle aspiration combined with cyst fluid analysis for the diagnosis of mediastinal cystic lesions

Application of endoscopic ultrasound‐guided‐fine needle aspiration combined with cyst fluid analysis for the diagnosis of mediastinal cystic lesions

The role of cytology in pleural effusion: a single-center experience

Parental perspectives on pediatric inflammatory bowel disease: Unraveling concerns, and study participation willingness

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