143 Patients With Malignant Pleural Effusion Diagnosis Analysis

ObjectiveTo investigate the diagnosis and differential diagnosis of malignant pleural effusion..Methods143 cases of malignant pleural effusion that were diagnosed definitely and had complete information were selected from the hospitalized patients.According to the clinical examination, retrospective and statistical analysis was carried out by using spss10.0 software.Results72 cases of lung cancer were detected from the patients with malignant pleural effusion, accounting for 50.3%of the total number. It ranked first in the primary causes,followed by gastrointestinal tumors in 20 cases (14.0%), breast cancer in 15 cases (10.5%),vaginal tumor in 12 cases (8.4%) and lymphoma in 7 cases (4.9%).Lung cancer,gastrointestinal tumors and lymphoma were the main causes of malignant pleural effusion in male patients,while lung cancer,breast cancer and genital tumor were more common in female. Chest X-ray/CT showed that 48 cases had left pleural effusion,63 cases had right pleural effusion and 32 cases were bilateral. Hydrothorax laboratory test results showed 140 cases had exudative hydrothorax, the remaining 3 cases were between exudative and leakage. The positive ratio of tumor marker CEA in lung cancer group is 62.5%and in gastrointestinal tumors group 75.0%.The positive ratio of vats pleural biopsy is 90.9%,and 84.6%in percutaneous computed (CT) guided lung biopsy,64.2%in post mortem microscopically bronchial lung biopsy,4 tomography 9%in blinded pleural biopsy and 27.3%in hydrothorax shedding cytology.ConclusionsThe most common pathogenesis of Malignant pleural effusion(MPE) are lung cancer, gastrointestinal tumors and breast cancer(always seen in women).Imaging examination can locate, quantify and provide diagnosis clues for MPE; tumor markers detection has certain directive significance for judgement of benign and malignant pleural effusion,but sensitivity and specificity are not ideal; Although Hydrothorax shedding cytology can provide diagnosis evidence, the positive rate is not high; Malignant pleural effusion diagnosis should rely on cytology or histological examination,including blinded pleural biopsies and thoracoscope visible pleural biopsy.Differential diagnosis need exclude tuberculous pleurisy and pneumonia correlated pleural effusion.