The diagnosis of pleural effusions

Porcel, José M.; Azzopardi, Maree; Koegelenberg, Coenraad F.N.; Maldonado, Fabien; Rahman, Najib M.; Lee, Gary

doi:10.1586/17476348.2015.1098535

Cited by 73 publications

(59 citation statements)

References 87 publications

(136 reference statements)

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“…An estimated 3,000 people per million population develop a pleural effusion. 1 Although scientific research in pleural diseases has increased in recent decades, it seems that it has attracted far less attention than other less common respiratory conditions. 2 Scientific knowledge is mainly transmitted through publications.…”

Section: Introductionmentioning

confidence: 99%

Trends in Pleural Effusion Research

Bielsa

Porcel

2016

PLEURA

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Background: Research in pleural diseases has traditionally been neglected but is now growing. Objectives: This study aimed to analyze scientific research trends on pleural effusions over the last decades. Method: We conducted a bibliometric analysis of the Scopus database from its inception to March 2016, searching for original articles and reviews on ''pleural effusion'' (key word). Journal, year of publication, number of citations, authors and their affiliations, and the Hirsch (H)-index for some of these variables were recorded and analyzed. Results: A total of 15 982 documents were retrieved, of which half have been published in the last 18 years and a quarter during the last 8 years. Chest ranked first regarding the number of documents on pleural effusions (both absolute number and yearly rate) and their scientific relevance (H-index of 76). The United States had contributed the most to pleural research productivity (23%). American pulmonologists Dr Richard Light and Dr Steven Sahn exhibited the highest number of papers (206 and 156, respectively) and author H-indexes (44 and 38, respectively). Conclusion: There is growing research activity in the field of pleural effusions, which has gained relevance and visibility in clinical respiratory journals. The United States is the leader in quantity and quality of research productivity in pleural medicine.

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Section: Introductionmentioning

confidence: 99%

Trends in Pleural Effusion Research

Bielsa

Porcel

2016

PLEURA

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“…MPE, an advanced malignancy disease, with a median survival following diagnosis ranges from 3 to 12 months and is dependent on the stage and type of the underlying malignancy [14]. Histocytological analysis, for example discovering tumor cells in PE, remains necessary to confirm a malignant diagnosis and to define the histological tumor type [15]. At the moment, it should be emphasized that a definite diagnosis of TPE is achieved by a histological and pathogen test.…”

Section: Discussionmentioning

confidence: 99%

“…To confirm the diagnosis of TPE sometimes requires further invasive procedures such as medical thoracoscopy and thoracotomy. However, pleural biopsy is invasive, operator-dependent, and requires expertise [15] and pleurae of needle biopsy are not conclusive in 20–40% of patients with TPE [17, 18]. These invasive procedures may cause various complications and may even increase morbidity and cannot be carried out in all hospitals.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic Accuracy of Interleukin-27 between Tuberculous Pleural Effusion and Malignant Pleural Effusion: A Meta-Analysis

Liu

Wang

et al. 2018

Respiration

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Background: The concentration assay of pleural effusion interleukin-27 (IL-27) has raised concern for diagnosing tuberculous pleurisy. Compared with malignant pleural effusion (MPE), the concentration of IL-27 in tuberculous pleural effusion (TPE) increased significantly. Accurate differentiating diagnosis is essential for choosing treatment for pleural effusion. Objective: The present meta-analysis is aimed at determining the accuracy of IL-27 in the differential diagnosis between TPE and MPE. Material and Method: After having retrieved the published studies, we combined the sensibility (SEN), specificity (SPE), positive likelihood ratio (PLR), negative likelihood ratio (NLR), and diagnostic odds ratio (DOR) of IL-27 in the diagnosis of TPE compared to MPE using a fixed-effect model. The summary receiver operating characteristic curve was applied to estimate the overall test performance. Results: In total, 550 patients (285 patients with TPE and 265 patients with MPE), included in 7 case-control studies, were enrolled. The summary assessments for IL-27 in the diagnosis between TPE and MPE were: SEN 0.93 (95% CI 0.90–0.96), SPE 0.97 (95% CI 0.94–0.98), PLR 25.88 (95% CI 13.84–48.39), NLR 0.07 (95% CI 0.05–0.11), and DOR 333.26 (95% CI 146.10–760.19), respectively. The maximal joint SEN and SPE was 0.95; the area under the curve was 0.99. Conclusion: IL-27 determination is a relatively accurate test for the diagnosis of TPE, which has very high SEN and SPE for discriminating TPE from MPE. The results of IL-27 assays should be interpreted in parallel with clinical findings and the results of conventional tests.

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“…This has stimulated the search for new pleural fluid biomarkers of malignancy, either soluble (and thus detected on supernatants) or cell attached (e.g. immunocytochemical panels) [7]. Unfortunately, few have been introduced into routine clinical practice.…”

Section: Pleural Fluid Biomarkersmentioning

confidence: 99%