Jaehee Lee1, Yong Dae Lee1, Jae Kwang Lim2, Deok Heon Lee3, Seung Soo Yoo1, Shin Yup Lee1, Seung Ick Cha1, Jae Yong Park1, Chang Ho Kim4. 1. Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, South Korea. 2. Department of Radiology, Kyungpook National University School of Medicine, Daegu, South Korea. 3. Department of Thoracic and Cardiovascular Surgery, Kyungpook National University School of Medicine, Daegu, South Korea. 4. Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, South Korea.. Electronic address: kimch@knu.ac.kr.
Abstract
BACKGROUND: Patients with cancer are at an increased risk of tuberculosis. As pleural effusion has great clinical significance in patients with cancer, the differential diagnosis between tuberculous pleural effusion (TPE) and malignant pleural effusion (MPE) is important. However, the predictive factors and treatment outcomes of TPE in patients with cancer have rarely been studied. MATERIALS AND METHODS: Confirmed TPE cases identified at cancer diagnosis and during anticancer management from 2008-2015 were retrospectively investigated. Patients in the study included coexisting TPE and cancer (n = 20), MPE (n = 40) and TPE without cancer (n = 40). Control groups were patients with MPE, and patients with TPE without cancer. Clinical, laboratory and pleural fluid characteristics were compared among groups. Treatment outcomes were compared between patients with TPE with and without cancer. RESULTS: In the final analysis, serum C-reactive protein (S-CRP) ≥3.0mg/dL and pleural fluid adenosine deaminase (ADA) ≥40U/L were independent predictors for identifying TPE in patients with cancer having pleural effusion. The combination of S-CRP with pleural fluid ADA using an "or" rule achieved a sensitivity of 100%, whereas both parameters combined in an "and" rule had a specificity of 98%. Treatment outcomes were not different between the TPE groups with and without cancer. CONCLUSIONS: S-CRP and pleural fluid ADA levels may be helpful for predicting TPE in patients with cancer with pleural effusion. The combination of these biomarkers provides better information for distinguishing between TPE and MPE in these patients. Treatment outcomes of TPE in patients with cancer are comparable to those in patients without cancer.
BACKGROUND:Patients with cancer are at an increased risk of tuberculosis. As pleural effusion has great clinical significance in patients with cancer, the differential diagnosis between tuberculous pleural effusion (TPE) and malignant pleural effusion (MPE) is important. However, the predictive factors and treatment outcomes of TPE in patients with cancer have rarely been studied. MATERIALS AND METHODS: Confirmed TPE cases identified at cancer diagnosis and during anticancer management from 2008-2015 were retrospectively investigated. Patients in the study included coexisting TPE and cancer (n = 20), MPE (n = 40) and TPE without cancer (n = 40). Control groups were patients with MPE, and patients with TPE without cancer. Clinical, laboratory and pleural fluid characteristics were compared among groups. Treatment outcomes were compared between patients with TPE with and without cancer. RESULTS: In the final analysis, serum C-reactive protein (S-CRP) ≥3.0mg/dL and pleural fluid adenosine deaminase (ADA) ≥40U/L were independent predictors for identifying TPE in patients with cancer having pleural effusion. The combination of S-CRP with pleural fluid ADA using an "or" rule achieved a sensitivity of 100%, whereas both parameters combined in an "and" rule had a specificity of 98%. Treatment outcomes were not different between the TPE groups with and without cancer. CONCLUSIONS: S-CRP and pleural fluid ADA levels may be helpful for predicting TPE in patients with cancer with pleural effusion. The combination of these biomarkers provides better information for distinguishing between TPE and MPE in these patients. Treatment outcomes of TPE in patients with cancer are comparable to those in patients without cancer.
Authors: Fazlkhan Abdugapparov; Ruzanna Grigoryan; Nargiza Parpieva; Sherali Massavirov; Anvar Riskiyev; Jamshid Gadoev; Mariana Buziashvili; Nestani Tukvadze; Arax Hovhannesyan; Andrei Dadu Journal: Int J Environ Res Public Health Date: 2021-05-27 Impact factor: 4.614