Aksoy Emine, Ataç Güliz, Sevim Tülin, Güngör Gökay, Törün Tülay, Maden Emin, Tahaoğlu Kemal
Department of Chest Disease, Süreyyapaşa Chest and Cardiovascular Disease Education and Research Hospital, Istanbul, Turkey.
Tuberk Toraks. 2005;53(3):238-44.
The aim of this study was to assess the diagnostic yield of closed pleural brushing (CPBR) in the diagnosis of malignant pleural effusion. Twenty-one adult patients (20 men and 1 woman); aged 62.9 +/- 8.6 were participated to this prospective study. Thoracentesis, CPBR and closed pleural biopsy (CPB) following the brushing were applied to every patient. While CPBR provided diagnosis in 12 (57.1%) of 21 cases, in 3 of these 12 cases, pleural fluid cytology (PFC) and CPB were negative. The sensitivities of PFC, CPBR and CPB in the diagnosis of malignant effusions were 33%, 57% and 52%, respectively. When three procedures were used in combination, the sensitivity increased to 67%. When CPBR is performed in addition to PFC and CPB, the yield of the diagnosis increased 14% additionally. There was no mortality due to these interventions. Complications were chest pain in 3 (14.2%) cases, hypotension in 2 (9.5%) cases, cough in 1 (4.8%) case, pneumothorax in 1 (4.8%) case, and hemothorax in 1 (4.8%) case. In conclusion, CPBR as a safe, simple and well tolerated procedure provides high diagnostic yield in diagnosis of patients with malignant pleural effusion.
本研究的目的是评估闭式胸膜刷检(CPBR)在恶性胸腔积液诊断中的诊断阳性率。21例成年患者(20例男性和1例女性)参与了这项前瞻性研究,年龄为62.9±8.6岁。对每位患者均进行了胸腔穿刺术、CPBR以及刷检后的闭式胸膜活检(CPB)。CPBR在21例中的12例(57.1%)中提供了诊断,在这12例中的3例中,胸水细胞学检查(PFC)和CPB均为阴性。PFC、CPBR和CPB在恶性胸腔积液诊断中的敏感性分别为33%、57%和52%。当三种检查方法联合使用时,敏感性提高到67%。当在PFC和CPB的基础上再进行CPBR时,诊断阳性率额外提高了14%。这些干预措施没有导致死亡。并发症包括3例(14.2%)胸痛、2例(9.5%)低血压、1例(4.8%)咳嗽、1例(4.8%)气胸和1例(4.8%)血胸。总之,CPBR作为一种安全、简单且耐受性良好的检查方法,在恶性胸腔积液患者的诊断中具有较高的诊断阳性率。